The Effect of Pedal Pump Lymphatic Technique Versus Passive Recovery Following Maximal Exercise: A Randomized Cross-Over Trial

Abstract

Context Muscle damage and delayed onset muscle soreness (DOMS) can occur following intense exercise. Various modalities have been studied to improve blood lactate accumulation, which is a primary reason for DOMS. It has been well established that active recovery facilitates blood lactate removal more rapidly that passive recovery due to the pumping action of the muscle. The pedal pump is a manual lymphatic technique used in osteopathic manipulative medicine to increase lymphatic drainage throughout the body. Pedal pump has been shown to increase lymphatic flow and improve immunity. This may improve circulation and improve clearance of metabolites post-exercise. Objective This study compared the use of pedal pump lymphatic technique to passive supine recovery following maximal exercise. Methods 17 subjects (male n = 10, age 23 ± 3.01; female n = 7, age 24 ± 1.8), performed a maximal volume O2 test (VO2 max) using a Bruce protocol, followed by a recovery protocol using either pedal pump technique or supine passive rest for 10 min, followed by sitting for 10 min. Outcome measures included blood lactate concentration (BL), heart rate (HR), systolic blood pressure (SBP) and VO2. Subjects returned on another day to repeat the VO2 max test to perform the other recovery protocol. All outcomes were measured at rest, within 1- minute post-peak exercise, and at minutes 4, 7, 10 and 20 of the recovery protocols. A 2 × 6 repeated measures ANOVA was used to compare outcome measures (p ≤ 0.05). Results No significant differences were found in VO2, HR, or SBP between any of the recovery protocols. There was no significant difference in BL concentrations for recovery at minutes 4, 7, or 10 (p > 0.05). However, the pedal pump recovery displayed significantly lower BL concentrations at minute 20 of recovery (p = 0.04). Conclusion The pedal pump significantly decreased blood lactate concentrations following intense exercise at recovery minute 20. The use of manual lymphatic techniques in exercise recovery should be investigated further.

Differential effects of intermittent energy restriction vs. continuous energy restriction combined high-intensity interval training on overweight/obese adults: A randomized controlled trial

“…Research personnel provided verbal encouragement and support to assist participants in reaching a maximal effort. The termination criteria for the VO 2max test was any of the following: (1) angina pectoris or angina-like symptoms; (2) hyperelevation of blood pressure (BP), SBP>250 mmHg, and/or DBP>115 mmHg; (3) age-adjusted maximal heart rate attained; (4) a plateau of oxygen uptake was attained; (5) if the subject was unable to maintain the pace of the treadmill; (6) Respiratory Exchange Ratio (RER) of over 1.3 and/or a plateau in ventilation (41). Participants were instructed not to eat or drink beverages other than water for at least 90 min before their treadmill test.…”

Comment on: The Effect of Pedal Pump Lymphatic Technique Versus Passive Recovery Following Maximal Exercise: A Randomized Cross-Over Trial

“…I read with interest the article by DiFrancisco-Donoghue et al, a randomized cross-over trial carried out on healthy subjects and with the aim of reducing post-anaerobic metabolites (blood lactate accumulation), through an osteopathic manual approach for the stimulation of lymphatic circulation [ 1 ]. I would like to bring to your attention some clarifications.…”

“…In the text we can read that great importance is given to lactic acid; the latter is considered to be one of the most important causes for contractile fatigue of the skeletal muscle and for the onset of delayed muscle soreness (DOMS) [ 1 ]. During a muscular effort the demand by the contractile fibers (cross-bridge cycling and ionic pumping) of adenosine triphosphate (ATP) can increase by 100 times compared to a resting condition [ 2 ].…”