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Central Nervous System SensitizationNCT04255212

Effects of Soft Tissue Treatment vs Mechanisms Explanation to Treat Delayed Onset Muscles Soreness Among Sport Climbers

A study testing Soft tissue treatment, Mechaninsms explanation and Neurodynamic treatment in people with Central Nervous System Sensitization and Peripheral Nervous System Disorders, run by University of Turin, Italy at 2 sites in Italy.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of the present research is to define the effects of short manual treatment of soft tissues compared to mechanisms explaining in Delayed Onset Muscle Soreness (DOMS) among sport climbers and to address the mechanisms of peripheral and central sensitization involved in DOMS phenomena. Read more about this study

Who is it for?
Ages 18 to 70 yearsHealthy volunteers can take part
What is being tested?
Soft tissue treatment, Mechaninsms explanation and Neurodynamic treatment
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
120 participants
Where
2 sitesItaly
Study dates
13 Jan 2020to 30 Oct 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Being explained all the associated risks and benefits of the research
  • Sign the written informed consent

Who cannot join

  • Significant neck or upper limbs pain (with Numeric Pain Rating Scale [NPRS] greater than 3/10)
  • Pregnancy
  • Recent neck or arm surgery or significant trauma in the preceding 3 months
  • Cancer or inflammatory disorders,
  • Spinal cord or cauda equina signs
  • Widespread neurological disorders affecting the tone of upper limbs and neck muscles
  • Underlying diseases, such as diabetes mellitus.

Trial locations and contacts

2 sites in 1 country.

Italy2 sites
  • Department of Biological and Clinical Science - University of Turin

    Orbassano, TO, 10043

  • Centro Universitario Sportivo

    Torino, TO, 10043

Other trials in Italy

About this study

Official title: Peripheral vs Central Pain Modulation Mechanisms Involved in Delayed Onset Muscles Soreness in Sport Climbers a Randomized Trial

The aim of the present research is to define the effects of short manual treatment of soft tissues compared to mechanisms explaining in Delayed Onset Muscle Soreness (DOMS) among sport climbers and to address the mechanisms of peripheral and central sensitization involved in DOMS phenomena.

Read the detailed description

Sport climbing is a growing success sport that will be debuting as an official discipline in the Tokyo 2020 Olympics game. They are used during competitions.

To practice this discipline, both dexterity in movement and extreme physical strength are needed to climb the sloping and vertical walls that are used during competitions.

The appearance of muscle pain induced by an unusual and strenuous physical activity (DOMS) is an extremely common factor in all sports activities that involves a maximum and repeated muscular effort. In the sport climbing practice this physiological phenomenon is common and occurs both in those who practice at as professional and amateur level. Numerous studies have shown that muscle pain is induced by physical activity and independent of damage to muscle fibers and classic inflammation of tissues. The phenomenon of DOMS is accompanied by hyperalgesia and allodynia during muscle contraction, these are conditions of irritation of the peripheral nervous system (SNP) and central nervous system (CNS), but today no evidence of such sensitization phenomena of the SNP and SNC has been provided. The presence of muscle pain is one of the main causes of impossibility to practice sports not only for those who practice sport climbing at a professional level, but for most amateur sportsmen. Thanks to the tools validated in the last decade, it is possible to study the involvement and awareness responses of the SNP and SNC with reliable and non-invasive techniques in the phenomenon of DOMS. Understanding the mechanisms underlying the appearance of the DOMS is today a primary priority for sports practice and for physical training for muscular effort both as a professional and amateur level.

Presence of peripheral and central sensitization in DOMS will be assessed and a three arm randomized controlled double blind multicentric study will be performed to assess the effects of treatment on peripheral tissues compared to pain mechanisms explanation. Healthy participants of both sexes will be assessed before DOMS, at 48 hours (the peak phase of symptoms) before and after treatment and at 96 hours when symptoms usually are in remission.

Being tested
Soft tissue treatment, Mechaninsms explanation, Control Group, Neurodynamic treatment
Keywords
Sport climber, Delayed Onset Muscle Soreness, Central sensitization, Peripheral sensitization, Soft tissue treatment
Medical subject headings
Peripheral Nervous System Diseases, Myalgia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Soft tissue treatmentOther

    Also called compression combined to longitudinal repeated mobilization of the forearm soft tissues

    Participants will be asked to sit in front of a medical table with their forearms supinated and relaxed. 5 minutes of deep tissue manual flossing on the proximal and medial aspect of the forearm of each side will be administered by keeping the hands contact on the skin of the participants for all the treatment duration. Direction of the gentle repeated manual compressions and shifts will be proximal to distal or vicerversa depending on the symptom reduction reported by the participants. Stimuli frequencies will be about 0,2-03 Hz. Subjects will be instructed to report immediately if the manual treatment starts to induce an increase in symptoms

  • Mechaninsms explanationOther

    Participants will be instructed with a 10 minutes lesson on mechanisms hypothesized to generate Delayed Onset Muscle Soreness. To trigger the most the bottom down pain modulation given by the placebo effect lesson will be concluded stressing the fact that DOMS have a good prognosis and that in a short amount of time they will be pain free and also that no drugs are effective to reduce pain intensity in DOMS condition suggesting them to stay physically active.

  • Control GroupOther

    Participants will be asked to wait 10 minutes and to relax until the tests will be performed again.

  • Neurodynamic treatmentOther

    Participants will be asked to lay supine on a medical table and keep their arms relaxed. 30 repetitions of gentle upper limb nerves mobilization, performed through a combination of neck and arm physiological movements, will be administered with cycles of tensions and relaxation of 1/5 seconds for 3 minutes in total for each arm. Subjects will be instructed to report immediately if the manual treatment starts to induce an increase in symptoms

Study groups in NCT04255212
Study groupRoleWhat they receive
Soft tissue treatmentExperimentalParticipants will be treated with 5 minutes of deep tissue manual flossing on the proximal and medial aspect of the forearm of each side. Direction of the gentle repeated manual compressions and shifts will be proximal to distal or vicerversa depending on the symptom reduction reported by the participants. Subjects will be instructed to report immediately if the manual treatment starts to induce an increase in symptoms.
Receives: Other: Soft tissue treatment
Mechaninsms explanationPlacebo comparatorParticipants will be instructed with a 10 minute lesson on mechanisms hypothesized to generate Delayed Onset Muscle Soreness. To trigger the most the bottom down pain modulation given by the placebo effect lesson will be concluded stressing the fact that DOMS have a good prognosis and that in a short amount of time they will be pain free and also that no drugs are effective to reduce pain intensity in DOMS condition suggesting them to stay physically active.
Receives: Other: Mechaninsms explanation
Control groupOtherParticipants will be asked to wait 10 minutes and to relax until the tests will be performed again.
Receives: Other: Control Group
Neurodynamic treatmentExperimentalParticipants will be asked to lay supine on a medical table and keep their arms relaxed. 30 repetitions of gentle upper limb nerves mobilization, performed through a combination of neck and arm physiological movements, will be administered with cycles of tensions and relaxation of 1/5 seconds for 3 minutes in total for each arm. Subjects will be instructed to report immediately if the manual treatment starts to induce an increase in symptoms
Receives: Other: Neurodynamic treatment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from Baseline Numeric Pain Rating Scale at one week

    pain intensity will be tested asking the standardized question " on a scale from 0 to 10 when 0 is no pain and 10 is the worst pain ever rate the pain intensity you feel in this moment in the body part assessed"

    Measured: The test will be administered at baseline, before the first climbing training session, at 48 hours before and after treatment administration, and at 96 hours from baseline

  2. Change from Baseline Mechanical allodynia at one week

    The assessor thumb will be placed over the testing area and pressure will be applied for 10 s (Scholz et al., 2009). The pressure will be sufficient to indent the soft tissues and lead to skin blanching

    Measured: The test will be administered at baseline, before the first climbing training session, at 48 hours before and after treatment administration, and at 96 hours from baseline

  3. Change from Baseline Wind-Up at one week

    10 nociceptive standardized stimuli will be administered on the skin of the painful area involved by muscle soreness on the medial aspect of the proximal forearm

    Measured: The test will be administered at baseline, before the first climbing training session, at 48 hours before and after treatment administration, and at 96 hours from baseline

  4. Change from Baseline Upper limb neurodynamic test at one week

    The validated test to detect upper limb peripheral nervous system neuropathies involving physiological combined passive movements of the upper limb will be administered with the participant laying supine on a medical table.

    Measured: The test will be administered at baseline, before the first climbing training session, at 48 hours before and after treatment administration, and at 96 hours from baseline

  5. Change from basaeline Muscle endurance (flexor digiturum profundis and superficialis) test at one week

    subjects will be required to keep their body weight lifted from the ground, hanging as much time as possible with their fingers on a standardized metal bar

    Measured: The test will be administered at baseline, before the first climbing training session, at 48 hours before and after treatment administration, and at 96 hours from baseline

Secondary outcomes (6)
  1. Change from Baseline Forearm circumference

    using a standardized measuring tape circumference of the forearm at a standardized distance from the medial epicondylus will be recorded

    Measured: The test will be administered at baseline, before the first climbing training session, at 48 hours before and after treatment administration, and at 96 hours from baseline

  2. Change from post treatment Perceived Reported Outcome Measure at 48 hours follow-up as Likert scale

    A validated self administered 11 point Likert scale whit "0 Much Better and 10 Much Worse" will be fulfilled by participants to assess the degree of change in participant painful condition induced from the treatment administered.

    Measured: The test will be administered after treatment at 48 hours from baseline and at 96 hours from baseline

  3. Change from post treatment Perceived Reported Outcome Measure at 48 hours follow-up

    It will be administered a validated categorical self administered scale of perceived improvement that inquires the pain intensity perceived changes induced by the treatment received:

    "Since when did you start the treatment, can you describe your impression of how your painful condition has changed (limitation of physical activity, emotion and quality of life)?" No change, (or even worsened) Always the same, it is difficult to think of an improvement A little better, but not remarkable Sometimes better, but change isn't a real difference Moderately better, a slight and noticeable improvement Better, a decided improvement that constitutes a real difference A big and decisive improvement, and that makes the difference

    Measured: The test will be administered after treatment at 48 hours from baseline and at 96 hours from baseline

  4. Change from Baseline Body Chart at one week

    Symptoms will be reported topographically using a validated pain drawing tool to collect information on the symptom area and on their intensity and behaviour

    Measured: The test will be administered before first training, at 48 hours before and after treatment administration, and at 96 hours from baseline

  5. Change from Baseline Central Sensitization Inventory at 48 hours

    A validated self administered inventory on the central sensitizing phenomenon will be administered. It briefly consists in a 25 item questionnaire that inquires the presence of symptoms related to central sensitization

    Measured: The test will be administered at baseline and after 48 hours before treatment

  6. Perceived Health Status

    Perceived Health status will be tested using a 11 point Likert scale from 0 equal to the worts and 100 equal to the best perceived health status and subjects will be asked to report with an x their actual condition.

    Measured: The test will be administered at baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Feb 2020
  2. Study start13 Jan 2020
  3. Primary completion22 Oct 2022
  4. Study completion30 Oct 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized trial
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
120 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04255212
Sponsor's protocol ID
437038-15102019
Status last verified
Nov 2022
First submitted
30 Jan 2020
Last updated
3 Nov 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: We intend to share all data after publication of the research on a scientific journal

Publications

  • Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness : treatment strategies and performance factors. Sports Med. 2003;33(2):145-64. doi: 10.2165/00007256-200333020-00005.

    PubMed 12617692
  • Chiarotto A, Viti C, Sulli A, Cutolo M, Testa M, Piscitelli D. Cross-cultural adaptation and validity of the Italian version of the Central Sensitization Inventory. Musculoskelet Sci Pract. 2018 Oct;37:20-28. doi: 10.1016/j.msksp.2018.06.005. Epub 2018 Jun 15.

    PubMed 29966856
  • Egloff N, Klingler N, von Kanel R, Camara RJ, Curatolo M, Wegmann B, Marti E, Ferrari ML. Algometry with a clothes peg compared to an electronic pressure algometer: a randomized cross-sectional study in pain patients. BMC Musculoskelet Disord. 2011 Jul 25;12:174. doi: 10.1186/1471-2474-12-174.

    PubMed 21787399
  • Jensen TS, Finnerup NB. Allodynia and hyperalgesia in neuropathic pain: clinical manifestations and mechanisms. Lancet Neurol. 2014 Sep;13(9):924-35. doi: 10.1016/S1474-4422(14)70102-4.

    PubMed 25142459
  • Mizumura K, Taguchi T. Delayed onset muscle soreness: Involvement of neurotrophic factors. J Physiol Sci. 2016 Jan;66(1):43-52. doi: 10.1007/s12576-015-0397-0.

    PubMed 26467448
  • Paulsen G, Mikkelsen UR, Raastad T, Peake JM. Leucocytes, cytokines and satellite cells: what role do they play in muscle damage and regeneration following eccentric exercise? Exerc Immunol Rev. 2012;18:42-97.

    PubMed 22876722

Questions about this trial

What is this clinical trial studying?

A study testing Soft tissue treatment, Mechaninsms explanation and Neurodynamic treatment in people with Central Nervous System Sensitization and Peripheral Nervous System Disorders, run by University of Turin, Italy at 2 sites in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 3 Nov 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from Baseline Numeric Pain Rating Scale at one week (time frame: The test will be administered at baseline, before the first climbing training session, at 48 hours before and after treatment administration, and at 96 hours from baseline). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04255212, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Nov 2022.

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