Małgorzata Smoter

Objectives: Myofascial pain syndrome (MPS) is a common musculoskeletal condition, and while percutaneous needle electrolysis (PNE) and intramuscular electrical stimulation (IMES) are emerging therapies for myofascial pain syndrome and tendinopathies, their effects remain unclear. This systematic review aimed to characterize the methodological features and synthesize the evidence on the clinical improvement and adverse events rates of PNE and IMES in treating MPS and tendinopathies. Data Sources: PubMed, Scopus, Web of Science, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform, Google Scholar, and reference lists. Searches were carried out on 10 July 2025 and repeated on 16 March 2026, just before final analysis. New results found during final searches were screened for inclusion to ensure currency of the review. Methods: We selected studies based on the PICOS framework and predefined selection criteria: Population: adults with MPS or active myofascial trigger points (TrPs), or tendinopathies; Intervention: PNE or IMES; Comparator: sham procedures, other interventions, or no intervention; Outcomes: pain intensity (e.g., Visual Analogue Scale or Numeric Pain Rating Scale), pressure pain threshold (PPT), and functional measures; and Study Design: experimental studies. Studies focused exclusively on post-surgical or neuropathic pain, studies without a relevant comparator, and studies not reporting clinically meaningful outcomes were excluded. We assessed the risk of bias of included studies and performed a narrative synthesis. Results: From 737 identified records, 30 studies met the selection criteria. PNE was generally effective in reducing pain and improving function in tendinopathies and MPS, although results varied across outcomes and follow-ups. IMES showed moderate evidence for reducing pain and enhancing function, particularly cervical range of motion and PPT. However, both interventions had inconsistent clinical improvement and adverse events rates on disability indices and quality of life. Most studies had a high risk of bias due to challenges in blinding. Reported adverse events were minor and self-limiting, indicating that both therapies are generally safe when performed by trained clinicians. Conclusions: PNE and IMES may improve pain and some functional outcomes in MPS and tendinopathies; however, these findings should be interpreted cautiously because most included studies had a high risk of bias.

Study aim: This study evaluated the effects of active recovery (AR), cold-water immersion (CWI), contrast-water therapy (CWT), and a no-recovery control (CWR) on creatine kinase (CK), myoglobin (Mb), and pain pressure thresholds (PPT) in national-level basketball players across three time points: immediately post-match, 24 h, and 48 h post-match. Materials and methods: Twenty professional players participated in a randomized crossover trial in which each underwent all four conditions. A single intervention was applied post-match, with CK and Mb levels assessed at each time point, and PPT measured on the quadriceps and triceps surae. Results: All conditions showed peak CK and Mb levels at 24 h post-match, followed by a decline at 48 h. Significant time effects were observed ( p < 0.001), with condition × time interactions for all variables ( η ² = 0.26–0.94). Unexpectedly, the CWR condition had the lowest CK and Mb concentrations and highest PPT values at 48 h, indicating better biochemical and nociceptive recovery. CWI resulted in significantly lower PPT compared to AR, CWT, and CWR ( p < 0.001). After accounting for baseline differences using analysis of covariance (ANCOVA), condition effects remained significant at both 24 h and 48 h post-match (all p < 0.01, η ² _p = 0.15–0.91). Conclusion: While AR, CWI, and CWT affected muscle damage and pain sensitivity, CWR led to the most favorable outcomes, suggesting that a single recovery intervention may not outperform rest. Notably, CWI was less effective for pain sensitivity despite moderating biomarkers.

Study aim: This study analyzed the influence of small-sided games (SSGs), tactical (T), conditioning (C), and combined sessions on the subsequent match demands in elite female soccer players. Material and methods: Twenty-four female players (age: 24.5 ± 2.3 years; height: 171 ± 3.0 cm; body mass: 63.5 ± 4.0 kg) from the Turkish National Team participated. Players were monitored during training and matches using 15 Hz global positioning system units, measuring external load parameters such as total distance (TD), player load (PL), high-speed running (HSR), accelerations (ACCs), decelerations (DECs), maximum speed (MaxSpeed), running deviations (RDs), and footstrikes (FS), relativized per minute. Results: Conditioning sessions significantly influenced match ACCs and DECs, while SSGs effectively replicated match-specific demands, particularly PL and HSR. Combined sessions (C + SSGs + T) contributed to improvements in MaxSpeed and HSR. FS during conditioning and SSGs were strong predictors of match TD and FS, respectively. Conclusion: Different training formats produce distinct external load responses during subsequent matches. SSGs closely mirrored key match demands such as PL and HSR, making them effective for match-specific conditioning. In contrast, conditioning sessions were more effective for enhancing ACCs and DECs. These findings may assist coaches in designing training sessions that are more aligned with the physical demands of competition.

BACKGROUND Despite advances in conservative back pain treatments, optimal methods for restoring multifidus muscle function - especially via neuromodulation like intramuscular electrical stimulation (IMES) - remain under investigation. This study evaluated the effects of a 6-week IMES protocol on multifidus muscle properties in individuals with chronic low back pain. MATERIAL AND METHODS In a randomized controlled trial, 29 participants (mean age: 39.2±10.9 years) were assigned to either a control group (receiving transcutaneous electrical nerve stimulation [TENS], myofascial trigger point therapy, and exercise), or an experimental group (same therapy but with IMES replacing TENS, applied via acupuncture needles under ultrasound guidance). Outcomes included muscle stiffness (MS), tension (MT), tissue perfusion (TP), pressure pain threshold (PPT), pain rating (NRS), postural stability (PS), range of motion (ROM), and maximal voluntary contraction (MVC). Assessments were conducted at baseline, immediately after treatment, and at follow-up 4 weeks later using validated instruments. RESULTS Compared to controls, the IMES group showed significant improvements after treatment and at follow-up in MT right, TP (right and left), PPT left, NRS, ROM, and PS (P values ranging from <0.001 to 0.006). No significant changes were found in MS (right or left) or MVC at any time point, nor in TP (right and left) at 4 weeks. CONCLUSIONS IMES combined with standard therapy significantly improves muscle tension, perfusion, pain threshold, intensity, ROM, and postural stability in chronic low back pain patients, outperforming standard therapy with TENS. However, causality remains uncertain due to both protocols being embedded in multimodal treatment.

INPLASY202570048 Effectiveness of Percutaneous Needle Electrolysis (PNE) and Intramuscular Electrical Stimulation (IMES) in the Management of Myofascial Pain Syndrome: A Systematic Review Keywords:…

This study aimed to compare the agreement of ball speed in throwing and kicking between the Bushnell and the Stalker radar guns. Sixty-four healthy young adults (21.8 ± 3.5 years) performed a total of 320 throws and 320 kicks during the study. Ball speed was measured using both the Bushnell and the Stalker radar guns for each trial. The mean difference in throwing speeds was found to be 1.39 km/h (95% CI: 1.20; 1.59), while the mean difference in kicking speeds was 1.38 km/h (95% CI: 1.20; 1.56). The agreement, assessed through intraclass correlation tests, revealed an excellent level of consistency for both ball speeds in throwing (ICC: 0.989 [95% CI: 0.986; 0.991]) and kicking (ICC: 0.986 [95% CI: 0.983; 0.989]). An analysis of variance showed significant differences for both throwing (p < 0.001; d = 0.799) and kicking (p < 0.001; d = 0.851), accompanied by a percentage difference of 2.17% in throwing and 1.91% in kicking. In conclusion, this study suggests that the correlation between both radar guns is excellent. However, Bushnell consistently underestimates the ball speeds of throws and kicks, with differences that are statistically significant and practically relevant. Despite this, the high correlation between the devices indicates that practitioners can use either device, provided they adjust normative values accordingly.

The Covid-19 pandemic brought consequences for many aspects of people’s lives all over the world, such as lockdown, social distancing and reduced accessibility to sports and recreational facilities. The aim of this study was to assess mental state, physical well-being, and motivation to exercise among Polish students of Physical Education and other fields of study, considering their gender, place of living and financial situation. The study involved 1424 students from different universities in Poland. Two questionnaires were used – the EMI-2 to measure motivation to exercise and an original questionnaire to assess daily physical activity, physical and mental well-being. While 31.7% of the students assessed their access to recreational facilities as very poor,71.8% of them rated their financial situation to be average or quite good. Over one-third of the students declared that both their physical and mental well-being (nearly 37% and 33% respectively) were very poor. Among all analyzed motivating factors to exercise, positive health, appearance and strength and endurance were classified as the most important. The importance of different motivating factors differed between the Physical Education students and those of other faculties. To conclude, physical and mental well-being of Polish students during the pandemic was poor. The main reasons were very poor access to recreational facilities, too much time spent in a sitting or lying position daily and insufficient physical activity.

(1) Cognitive function may benefit from physical exercise in older adults. However, controversy remains over which mode of exercise is more beneficial. (2) The aim of the proposed study is to investigate the effect of open-skill exercise training on cognitive function in community dwelling older adults compared with closed-skill exercise, cognitive training, and active control. (3) One hundred and sixty participants, aged between 60 and 80 years old, will be recruited from community senior centers in Yangzhou, China and randomly assigned to one of four groups: open-skill exercise group, closed-skill exercise group, mobile game playing group, and active control group. All participants will join a 24-week program involving 50 min sessions three times a week. The primary outcome measure is visuospatial working memory. Secondary measures include subjective memory complaint, attention network, nonverbal reasoning ability, and physical activities. All participants will be measured before, mid-way, and immediately after intervention, and three months later. (4) If successful, this study is expected to provide evidence-based recommendations for older adults to select the most efficient and effective mode of exercise to improve cognitive function. Importantly, the three intervention groups provide an opportunity to separate the cognitive activity component from the physical activity component. Comparison of these components is expected to help elucidate possible mechanisms contributing to the additional cognitive benefit of open-skill exercises.

The goal of our study was to examine the muscle activity of the shoulder girdle after isokinetic fatigue, which may simulate muscle activities commonly occurring during specific sport-related activities in recreational overhead asymptomatic athletes. We hypothesized that exercise-induced fatigue, reported after isokinetic protocols, may cause a decrease in the median frequency (MF) of the upper trapezius (UT), infraspinatus (IS), and deltoid muscles. Twenty-four male overhead volleyball (n = 8), handball (n = 8), and tennis (n = 8) athletes participated in this study. All subjects were without shoulder injury history. The surface electromyography (SEMG) was collected on the right (dominant) side of the shoulder girdle muscles in the following order: UT, IS and anterior (DA), and posterior deltoideus (DP). The fatigue protocol consisted of three sets of 32 maximum isokinetic concentric contractions while performing shoulder internal and external rotation at an isokinetic speed of 120 o/s. The resultant difference in median frequency (ΔMF) values consistently dropped after the fatiguing tasks across all recorded muscles, in terms of the initial MF (MF_INI = 65.1 ± 1.1 Hz) and final MF (MF_FIN = 57.9 ± 0.9 Hz), and the main effect of time was significant (F(1,22) = 43.15, p < 0.001). MF values decreased mostly for IS (ΔMF_IS = −9.9 ± 1.6 Hz) and DP (ΔMF_PD = −9.5 ± 1.9 Hz) muscles, while DA and UT showed smaller changes (ΔMF_DA = −6.9 ± 1.5 Hz) and (ΔMF_UT = −3.2 ± 1.3 Hz). The results of our study show a meaningful contribution in determining increased fatigue of the shoulder girdle muscles during repeated isokinetic internal-external rotation protocols. We have also demonstrated a significant decrease in MF in all examined muscles, especially IS and DA.