PNF Versus Cryotherapy in Delayed Onset Muscle Soreness

NCT07624032 | Completed

• 1 other identifier: UPSA-DOMS-2025
• Study Type: interventional
• Target: 29
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized, double-blind, single-center pilot clinical trial evaluated three interventions for delayed onset muscle soreness in the hamstring muscles. Twenty-nine untrained adults were included. Delayed onset muscle soreness was induced using two eccentric hamstring exercises. Participants were then assigned to one of three groups: proprioceptive neuromuscular facilitation, local cryotherapy, or placebo consisting of water with sugar. The main outcome was pressure pain threshold in the hamstring muscles. Other outcomes included knee range of motion, hamstring strength, pain intensity, perceived exertion, and blood lactate levels. Measurements were taken before the eccentric exercise, 24 hours after exercise before treatment, immediately after treatment, and 48 hours after exercise.

Conditions

Delayed Onset Muscle Soreness (DOMS)

Keywords

Delayed onset muscle soreness; DOMS; Proprioceptive neuromuscular facilitation; PNF; Cryotherapy; Eccentric exercise; Hamstrings; Blood lactate; Physical therapy; Pressure pain threshold; Muscle strength; Range of motion; Pain intensity

Outcome Measures

Primary Outcomes (1)

• Change in Pressure Pain Threshold in the Hamstring Muscles

  Pressure pain threshold was assessed using a pressure algometer over three points of maximum pain in the hamstring muscles. Three measurements were taken and the mean value was calculated.

  Baseline, 24 hours after eccentric exercise before treatment, immediately after treatment, and 48 hours after eccentric exercise

Secondary Outcomes (5)

• Change in Active Knee Range of Motion

  Baseline, 24 hours after eccentric exercise before treatment, immediately after treatment, and 48 hours after eccentric exercise

• Change in Hamstring Muscle Strength

  Baseline, 24 hours after eccentric exercise before treatment, immediately after treatment, and 48 hours after eccentric exercise

• Change in Pain Intensity

  Baseline, 24 hours after eccentric exercise before treatment, immediately after treatment, and 48 hours after eccentric exercise

• Change in Blood Lactate Concentration

  Before exercise, immediately after exercise, and 48 hours after exercise

• Perceived Exertion After Eccentric Exercise

  Immediately after eccentric exercise

Study Arms (3)

Proprioceptive Neuromuscular Facilitation

EXPERIMENTAL

Participants received a proprioceptive neuromuscular facilitation intervention targeting the hamstring muscles 24 hours after eccentric exercise-induced delayed onset muscle soreness.

Other: Proprioceptive Neuromuscular Facilitation

Cryotherapy

EXPERIMENTAL

Participants received local cryotherapy over the hamstring muscles 24 hours after eccentric exercise-induced delayed onset muscle soreness.

Other: Local Cryotherapy

water with sugar

PLACEBO COMPARATOR

Participants received a placebo intervention consisting of water with sugar 24 hours after eccentric exercise-induced delayed onset muscle soreness.

Other: Placebo: Water With Sugar

Interventions

Proprioceptive Neuromuscular Facilitation OTHER

A contract-relax-antagonist-contract proprioceptive neuromuscular facilitation technique was applied to the hamstring muscles. The protocol included isometric hamstring contraction, rest, quadriceps contraction, and passive movement into a deeper hamstring stretch. The protocol was repeated twice on each leg.

Proprioceptive Neuromuscular Facilitation

Local Cryotherapy OTHER

Participants were placed in prone position and an ice pack was applied over the hamstring muscles for 20 minutes. A thin cloth was placed between the ice pack and the skin to avoid direct contact.

Cryotherapy

Placebo: Water With Sugar OTHER

Participants consumed 200 mL of water with 5 g of dissolved sugar after the eccentric exercise protocol.

water with sugar

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Adults aged between 18 and 45 years.
• Participants who did not usually perform physical exercise or whose exercise was not focused on the lower limbs.
• Participants who had previously experienced delayed onset muscle soreness and were familiar with its effects.

You may not qualify if:

• Musculoskeletal injury of the lower limb.
• Pregnancy.
• Diabetes.
• Cardiovascular problems.
• History of cancer.
• Autoimmune diseases, including Raynaud disease or rheumatoid arthritis.
• Sensory disorders.
• Skin disorders.
• Skin conditions.
• Peripheral venous or lymphatic vascular insufficiency.

Sponsors & Collaborators

• Universidad Pontificia de Salamanca: lead

Study Sites (1)

Clínica Universitaria Salus Infirmorum, Universidad Pontificia de Salamanca

Madrid, Madrid, 28015, Spain

Location

MeSH Terms

Conditions

Pain

Interventions

Muscle Stretching Exercises; Sugars

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Carbohydrates

Study Officials

• Sara Perpiña Martínez, PhD

  Universidad Pontificia de Salamanca

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Participants and outcome assessors were masked to group allocation. Group assignment was concealed using opaque envelopes, and only the investigator responsible for administering the active intervention knew the allocated treatment.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator and Professor of Physiotherapy

Model Details: Participants were assigned to one of three parallel groups: proprioceptive neuromuscular facilitation, cryotherapy, or placebo. Delayed onset muscle soreness was induced through eccentric hamstring exercises before the assigned intervention.

Study Record Dates

• First Submitted: May 28, 2026
• First Posted: June 3, 2026
• Study Start: January 1, 2025
• Primary Completion: April 26, 2025
• Study Completion: April 30, 2025
• Last Updated: June 4, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will share

Locations

ES (1)