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Role of tissue perfusion, muscle strength recovery, and pain in rehabilitation after acute muscle strain injury: A randomized controlled trial comparing early and delayed rehabilitation
Author(s) -
Bayer Monika L.,
HoegbergetKalisz Maren,
Jensen Mikkel H.,
Olesen Jens L.,
Svensson Rene B.,
Couppé Christian,
Boesen Mikael,
Nybing Janus D.,
Kurt Engin Y.,
Magnusson S. Peter,
Kjaer Michael
Publication year - 2018
Publication title -
scandinavian journal of medicine and science in sports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.575
H-Index - 115
eISSN - 1600-0838
pISSN - 0905-7188
DOI - 10.1111/sms.13269
Subject(s) - medicine , rehabilitation , magnetic resonance imaging , randomized controlled trial , muscle tissue , atrophy , strain (injury) , muscle atrophy , perfusion , anesthesia , surgery , physical therapy , radiology
Muscle strain injuries disrupt the muscle‐tendon unit, early rehabilitation is associated with a faster return to sports ( RTS ), but the time course of tissue healing remains sparsely described. The purpose was to examine tissue regeneration and the effectiveness of early versus delayed rehabilitation onset on functional and structural recovery after strain injuries. A total of 50 recreational athletes with a severe acute strain injury in their thigh or calf muscles were randomized to early or delayed rehabilitation onset. Magnetic resonance imaging ( MRI ) was obtained initially, 3 and 6 months postinjury, and dynamic contrast‐enhanced MRI ( DCE ‐ MRI ) estimated tissue inflammation initially and after 6 months. Muscle strength was determined 5 weeks, 3 months, and 6 months postinjury, and a questionnaire determined soreness, pain, and confidence. DCE ‐ MRI microvascular perfusion was higher in the injured compared to an uninjured muscle acutely ( P < 0.01) and after 6 months ( P < 0.01), for both groups ( P > 0.05) and unrelated to RTS ( P > 0.05). Total volume of the injured muscle decreased from the acute to the 3‐month scan, and to the 6‐month scan ( P < 0.01) in both groups. Muscle strength was similar in both groups at any time. There was a nonsignificant trend ( P ≤ 0.1) toward less pain and higher confidence with early rehabilitation. One reinjury was recorded. In conclusion, our data showed prolonged tissue repair with the initial response linked to muscle atrophy but did not explain why early rehabilitation onset accelerated recovery considering that structural and functional recovery was similar with early and delayed rehabilitation.