Ultrasound-Guided Percutaneous Neuromodulation in the Strength of CrossFit Athletes

NCT06529770 | Completed DMC

• 1 other identifier: NMP-e.CF
• Study Type: interventional
• Target: 39
• Locations: 1 country
• Sites: 2

Brief Summary

The origin of CrossFit (CF) dates back to 1995 when Greg Glassman opened the first facility dedicated to the sport he named CF in Santa Cruz, California. However, the dissemination and promotion of this sport began in 2000 with the creation of the CF brand alongside his wife Lauren Jenai. Today, the brand generates around 100 million euros annually and has a market valuation of approximately 4 billion euros. CF boasts 14,000 boxes in 155 countries, with over five million users. Spain ranks as the fifth country with the most CF centers. CF training focuses on constantly varied functional movements, including gymnastics, weightlifting exercises, and cardiovascular activities (e.g., running or rowing). Variety is one of the main attractions for participants, as the workouts are short, intense, and diverse. Within invasive physiotherapy, there is the technique of ultrasound-guided percutaneous neuromodulation (US-PNM), which enhances muscle function, muscle recruitment patterns, and motor control. This minimally invasive intervention involves the application of percutaneous electrical stimulation through an electrode similar to an acupuncture needle, placed in close proximity to the nerve or motor point of the target muscle under ultrasound guidance. Performing this technique under ultrasound guidance is recommended as it makes the procedure safer and more effective, allowing real-time visualization of needle positioning and technique application. Most studies on US-PNM have focused on pain treatment in patients, but some studies have explored its benefits in healthy individuals. For instance, De-la-Cruz-Torre et al. demonstrated that applying this procedure to the sciatic nerve can increase hamstring flexibility; De-la-Cruz-Torres et al. also reported an increase in the performance of the flexor hallucis longus muscle in dancers; Álvarez-Prats et al. showed an improvement in quadriceps muscle strength after performing electrical stimulation on the femoral nerve; and Gallego-Sendarrubias et al. suggested an enhancement in performance skills in soccer players by applying the neuromodulation procedure to the femoral nerve before specific strength training. Overall, the literature suggests that US-PNM intervention improves strength levels, but the results should be confirmed with future research due to sample size limitations and short-term evaluations. Additionally, there are currently no studies on the application of US-PNM in a sample of CF athletes. Therefore, the objective of this study is to analyze the effectiveness and duration of the effects of two US-PNM protocols applied to the axillary and suprascapular nerves on shoulder rotation strength in healthy CF athletes.

Conditions

Healthy; CrossFit

Keywords

PNM-E; Neuromodulation

Outcome Measures

Primary Outcomes (1)

• Maximal Strength (1RM)

  This will be measured using the "shoulder press" exercise.

  Measurements will be taken only on the first and last days of the sessions (day 1 and day 21).

Secondary Outcomes (4)

• Internal Shoulder Rotator Muscle Strength. 0º abduction

  Measurements will be conducted in all 4 sessions of the study (day 1, day 7, day 13, and day 21).

• Internal Shoulder Rotator Muscle Strength. 90º abduction

  Measurements will be conducted in all 4 sessions of the study (day 1, day 7, day 13, and day 21).

• External Shoulder Rotator Muscle Strength. 0º abduction

  Measurements will be conducted in all 4 sessions of the study (day 1, day 7, day 13, and day 21).

• External Shoulder Rotator Muscle Strength. 90º abduction

  Measurements will be conducted in all 4 sessions of the study (day 1, day 7, day 13, and day 21).

Study Arms (3)

Control Group

NO INTERVENTION

The group receives no intervention

NMP-e 3 sessions

EXPERIMENTAL

The group receives 1 session of ultrasound-guided percutaneous neuromodulation. The session wil be received at day 1 of the study.

Other: NMP-e

NMP-e 1 session

EXPERIMENTAL

The group receives 3 sessions of ultrasound-guided percutaneous neuromodulation. The sessions wil be received at day 1, 7 and 14 of the study.

Other: NMP-e

Interventions

NMP-e OTHER

The US-PNM intervention uses a square-wave biphasic current (10 Hz, 250 ms pulse width) at maximum tolerable intensity for 1.5 minutes (10 seconds 10 times), per Fermín Valera and Fran Minaya's protocol. Participants will lie on their side, with the area cleaned and an ultrasound probe cover used. Needles (Agu Punt, Spain) will be inserted perpendicularly to target the nerve perineurium. For the axillary nerve (C5-C6), a 0.40/0.50×25 mm needle will be used in a short axis at 80°. For the suprascapular nerve (C5-C6), a 0.30/0.40×25 mm needle will be used. Each session involves two needle insertions, with the needle stationary and monitored by a physiotherapist with two years of experience.

NMP-e 1 session; NMP-e 3 sessions

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Be between 18 and 65 years old
• Have at least 1 year of experience in CrossFit training

You may not qualify if:

• Have not undergone any previous surgeries
• Have no pathology that causes any type of pain
• Have no physical impairment that would hinder dynamometry measurements (muscle injuries, joint instability, joint inflammation, etc.)
• Have no contraindications for the application of Ultrasound-Guided Percutaneous Neuromodulation (US-PNM) such as trypanophobia, pregnancy, epilepsy, or pacemakers.

Sponsors & Collaborators

• Universidad de Zaragoza: lead

Study Sites (2)

Canvi Crossfit

Tavernes de la Valldigna, Valencia, 46760, Spain

Location

Universidad de Zaragoza

Zaragoza, Zaragoza, 50009, Spain

Location

Related Publications (1)

• Sangiacomo R, Valera-Garrido F, Minaya-Munoz F, Carcasona-Otal A, Herrero P, Lapuente-Hernandez D. Effects of Ultrasound-Guided Percutaneous Neuromodulation on Shoulder Muscle Strength in CrossFit Athletes: A Pilot Randomized Controlled Trial. Neuromodulation. 2025 Jun;28(4):600-610. doi: 10.1016/j.neurom.2025.03.072. Epub 2025 Apr 3.

  PMID: 40183726 DERIVED

Study Officials

• Pablo Herrero, Physiotherapist

  Universidad de Zaragoza

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Physiotherapist

Study Record Dates

• First Submitted: July 26, 2024
• First Posted: July 31, 2024
• Study Start: September 15, 2024
• Primary Completion: December 12, 2024
• Study Completion: December 13, 2024
• Last Updated: December 18, 2024

Record last verified: 2024-12

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: Once research has been published
• Access Criteria: Study protocol will be publish in a scientific journal

Locations

ES (2)