Accelerated Recovery Through Ultrasound Therapy: Lactic Acid Clearance and Muscle Recovery

sam® Professional System (Portable, wearable, low intensity therapeutic ultrasound device - Patient self-administers treatment for up to 4h per day)

• Long duration – up to 4 hours

• Low intensity– 0.132 W/cm²

• Duty Cycle– 100%

It is possible to deliver these long duration low Intensity treatments because the device is:

• Portable

• Small (about the size of a TENS unit

• Battery-Operated

• Self-administered

• Comfortable

• Worn during the course of daily life

Indicated for:

• Relief of Pain

• Relief of Muscle Spasms

• Local Increase in Circulation

• Studies on knee osteoarthritis, shoulder tendinitis, and trapezius muscle spasm have all found the SAM to be effective in substantially decreasing pain

• A study at BYU found that the SAM produces moderate to vigorous heating in human muscle

For each Subject

• 4 Power Controllers

• 8 Applicators

• Power Controller per 2 Applicators

Placement of Applicators

• Applied to L and R legs

• 2 applicators each on quadriceps and hamstrings/glutes as shown in figure

Ultrasound Benefits:

• Reduced pain

• Reduced inflammation

• Increased healing rate

• Non-invasive

• Simple treatment

Traditional:

• Large size and cost

• Not portable

• Treatment time 5-15 mins

• Applied by clinician

• Messy gel

Wearable Solution:

• Wearable

• No Mess

• Use Daily

• Long Lasting

• Battery Powered

• Muscles become fatigued during intense exercise

• Athletic performance and training will be enhanced if muscle fatigue occurred slower and muscle recovery occurred faster

• Therapeutic ultrasound has been associated with increased local blood flow1, which may enable muscles to perform for longer periods of time or recover faster after exercise

Study 1: Objective & Design

Study Objective

• Determine if wearing a long-duration ultrasound therapy device on muscles can accelerate lactic acid kinetics to promote clearance from blood

Study Design

• Double-blind, randomized, cross-over design

• Healthy volunteers: male subjects currently participating in resistance training 3-5 days/week for ≥ 3 months

• Site: SUNY Brockport, Department of Exercise Science and Athletic Training

Post-exercise lactate concentrations were adjusted by the pre-exerciseconcentration to reflect clearance of exercise-induced lactate

Study 1: Objective & Hypothesis

Objective

• Lactic acid (and its conjugate ion, lactate) are produced during exercise through the reduction of pyruvate

• Lactic acid (and its conjugate ion, lactate) are produced during exercise through the reduction of pyruvate

• Output Measure: Blood Lactate levels

• Correlated with return to pre-exercise conditions

• Can be measured through a readily available blood test

Hypothesis

• Ultrasound therapy accelerates lactic acid clearance postexercise.

• Area under blood lactate curve corresponds with the total dose over time in the body

• Used for analysis, crossover design permits use of a paired t-test to compare values

Average 13% decrease in total AUC over 1 h (p=0.0287)

Significant Difference between Active & Sham

Study 1 Summary

Blood Lactate Clearance

• Treatment with Sustained Acoustic Medicine resulted in accelerated clearance of blood lactate within 1-h post-exercise

Muscle Force

• Significantly greater muscle force exerted with Active v Sham SAM as measured by Total Work and Average Power

Significant differences between Active and Sham indicated with blue shading

Study 2: Objective & Hypothesis

Study Objective

• Determine if wearing a long-duration ultrasound therapy device on muscles can aid post-exercise muscle recovery and thereby positively impact subsequent athletic performance among professional cyclists

Hypothesis

• If cyclists perform physical exertion and then wear the ZetrOZ device on the main muscles that are activated during cycling (i.e. quadriceps, hamstrings, and gluteus maximus), then the muscles will recover faster because ultrasound therapy speeds nutrient transport and increases circulation, both of which are involved in muscle recovery. Faster recovery will be reflected by less of a decrease in power output in a subsequent workout among subjects treated with the device.

1. Double-blind, randomized, cross-over design

2. Study Population

• Professional Cyclists with race-training experience, experience with power meters

• 8 males, 4 females

• 25-45 years

3. Same applicator placement as Study 1 (4 applicators per leg)

4. Outcomes

• Power (W) and total work (KJ) during each 5 minute maximum effort

• Pain (NRS), Perceived Improvement (GROC) in Daily Diary

5. Site: Legaci Cycling Group, Rochester, NY (T Scheske)

Study Status

• All subjects enrolled and completed, analyses underway

2. Subjects exhibited greater energy output during 6 of 9 5-min Max Effort sessions with the active device than the sham device

3. On Day 3 of the Max Intensity workouts, riders averaged 1% more work per 5 minute sprint with active treatment than sham

• Approximately equivalent to riding 50 additional feet over 5 minutes

4. Results of pilot study indicate larger and more extensive study could be conducted to meaningfully examine impact of SAM on muscle recovery

Conclusions

• SAM Therapy significantly accelerated post-exercise lactate recovery

• SAM Therapy facilitated increased muscle force after a taxing exercise regimen

• SAM Therapy has been piloted to prevent fatigue and maintain muscle performance over a multi-day training regimen in professional cyclists

Future Research

• Investigate when device use provides greatest benefit on lactate clearance (before, during, or after exercise)

• Study impact of SAM on muscle performance in different types of exercise, different kinds of athletes

• Investigate how long muscle performance is extended following treatment

• Conduct fully powered study to assess impact of SAM on muscle recovery in professional athletes

1. Study Funded by: ZetrOZ, Inc.

2. ZetrOZ, Inc. is the manufacturer of sam®.

No Conflict of Interest.