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Massage Alleviates Delayed Onset Muscle Soreness after Strenuous Exercise: A Systematic Review and Meta-Analysis

PainSci » bibliography » Guo et al 2017
Tags: treatment, massage, DOMS, manual therapy, exercise, self-treatment, inflammation, pain problems, muscle

Two articles on PainSci cite Guo 2017: 1. A Deep Dive into Delayed-Onset Muscle Soreness2. Vibration Therapies, from Massage Guns to Jacuzzis

PainSci notes on Guo 2017:

This is a flawed meta-analysis with a technically “positive” conclusion that is clearly actually a damned-with-faint-praise result, consistent with the body of evidence on this topic. This analysis of pooled data from a dozen mostly poor quality trials — “garbage in, garbage out” — establishes nothing except that there probably isn’t a strong benefit to detect.

Common issues and characteristics relevant to this paper: ?Scientific papers have many common characteristics, flaws, and limitations, and many of these are rarely or never acknowledged in the paper itself, or even by other reviewers. I have reviewed thousands of papers, and described many of these issues literally hundreds of times. Eventually I got sick of repeating myself, and so now I just refer to a list common characteristics, especially flaws. Not every single one of them applies perfectly to every paper, but if something is listed here, it is relevant in some way. Note that in the case of reviews, the issue may apply to the science being reviewed, and not the review itself.

  1. Garbage in, garbage out — not enough good quality data to meaningfully review/analyze.
  2. Damned with faint praise — technically positive results (at least partially) that don’t actually impress.
  3. A high (and possibly unacknowledged) risk of bias and its consequences (p-hacking, etc).
  4. Declares statistical significance without acknowledging low effect sizes. Major foul.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the effects of massage on alleviating delayed onset of muscle soreness (DOMS) and muscle performance after strenuous exercise.

METHOD: Seven databases consisting of PubMed, Embase, EBSCO, Cochrane Library, Web of Science, CNKI and Wanfang were searched up to December 2016. Randomized controlled trials (RCTs) were eligible and the outcomes of muscle soreness, performance (including muscle maximal isometric force (MIF) and peak torque) and creatine kinase (CK) were used to assess the effectiveness of massage intervention on DOMS.

RESULTS: Eleven articles with a total of 23 data points (involving 504 participants) satisfied the inclusion criteria and were pooled in the meta-analysis. The findings demonstrated that muscle soreness rating decreased significantly when the participants received massage intervention compared with no intervention at 24 h (SMD: -0.61, 95% CI: -1.17 to -0.05, P = 0.03), 48 h (SMD: -1.51, 95% CI: -2.24 to -0.77, P < 0.001), 72 h (SMD: -1.46, 95% CI: -2.59 to -0.33, P = 0.01) and in total (SMD: -1.16, 95% CI: -1.60 to -0.72, P < 0.001) after intense exercise. Additionally, massage therapy improved MIF (SMD: 0.56, 95% CI: 0.21-0.90, P = 0.002) and peak torque (SMD: 0.38, 95% CI: 0.04-0.71, P = 0.03) as total effects. Furthermore, the serum CK level was reduced when participants received massage intervention (SMD: -0.64, 95% CI: -1.04 to -0.25, P = 0.001).

CONCLUSION: The current evidence suggests that massage therapy after strenuous exercise could be effective «Suggests? Could be? Well I'm convinced!» for alleviating DOMS and improving muscle performance.

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