Comparison of the effectiveness of manual massage, long-wave diathermy, and sham long-wave diathermy for the management of delayed-onset muscle soreness: a randomized controlled trial

Lorenzo Visconti, Corrado Forni, Rudi Coser, Marco Trucco, Elisa Magnano, Gianpiero Capra

Delayed-onset muscle soreness (DOMS) is a specific symptom that typically arises after unaccustomed eccentric muscular effort. It increases typically 24-72 h post-exercise and can affect physical performance. The pathophysiology of DOMS remains unclear, although it seems to be related to the remodeling phase of myofibrils. Different types of treatments have been proposed to minimize DOMS after exercise; however, no clear gold standard treatment exists. Among the most popular and easy-to-apply treatments, manual massage is often performed by clinicians and has been documented to be effective in reducing symptoms. For several years, long-wave diathermy (LWD) has been performed to manage musculoskeletal complaints, such as DOMS; however, no studies have reported its efficacy thus far.This study aimed to compare the clinical effectiveness of LWD, sham LWD, and manual massage in participants with lower limb DOMS. Participants with lower limb DOMS were included in the study. They were randomly assigned to undergo real LWD, sham LWD, or manual massage. The Numeric Pain Rating Scale (NPRS) score was the primary outcome, and the Patient Global Impression of Change (PGIC) Scale score was the secondary outcome. Outcomes were collected before and immediately after the treatment. Analysis of variance was performed to compare the post-treatment NPRS value variability among the groups and to compare the pre- and post-treatment NPRS differences among the groups. No clinically relevant differences were observed regarding the NPRS value variability among real LWD, sham LWD and manual massage groups. Differences were observed in the PGIC Scale scores. Future studies are needed to have a better understanding about the treatment of DOMS in clinical practice. The trial was registered on 29th February 2016 in ClinicalTrials.gov (NCT02693678).