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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
A common question I am getting now  from colleagues  is:
 How  do you use MOXY in your daily  clinic  work.
 Easy to answer  : Daily  with many clients.
 1.  Motivational tool to  really push the muscle contraction  to the   level I like to see  and   as well to stop  , if there is a clear sign of " fatigue " not reaching anymore the goal settings.
 As a control  tool   after a few weeks  to see, whether  deoxygenation ability changed  due to the training and how close  it is now to the  non involved  healthy leg.
 As  bio feedback  for  intensity choice  for   chronic pain control.
  How hard  is too hard  in endurance workouts.  looking ate tHb  and optimal oxygenation  level. Here a  study   who  may back this  option   up.

Changed activation, oxygenation, and pain response of chronically painful muscles to repetitive work after training interventions: a randomized controlled trial

Karen Søgaard,1 Anne Katrine Blangsted,2 Pernille Kofoed Nielsen,3 Lone Hansen,4 Lars L. Andersen,5 Pernille Vedsted,6 and Gisela Sjøgaard1

1Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark

2Outcome Europe, St-Prex, Switzerland

3School of Health and Nursing Bornholm, Rønne, Denmark

4Team Danmark, Brondby, Denmark

5National Research Centre for the Working Environment, Copenhagen, Denmark

6ALECTIA A/S, Viby J, Denmark

Karen Søgaard, Phone: +45-65504409, Fax: +45-65503480, Email: .

Corresponding author.

Communicated by Fausto Baldissera.

Author information ►Article notes ►Copyright and License information ►

Received October 22, 2010; Accepted April 5, 2011.

Copyright © The Author(s) 2011

This article has been cited by other articles in PMC.

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The aim of this randomized controlled trial was to assess changes in myalgic trapezius activation, muscle oxygenation, and pain intensity during repetitive and stressful work tasks in response to 10 weeks of training. In total, 39 women with a clinical diagnosis of trapezius myalgia were randomly assigned to: (1) general fitness training performed as leg-bicycling (GFT); (2) specific strength training of the neck/shoulder muscles (SST) or (3) reference intervention without physical exercise. Electromyographic activity (EMG), tissue oxygenation (near infrared spectroscopy), and pain intensity were measured in trapezius during pegboard and stress tasks before and after the intervention period. During the pegboard task, GFT improved trapezius oxygenation from a relative decrease of −0.83 ± 1.48 μM to an increase of 0.05 ± 1.32 μM, and decreased pain development by 43%, but did not affect resting levels of pain. SST lowered the relative EMG amplitude by 36%, and decreased pain during resting and working conditions by 52 and 38%, respectively, without affecting trapezius oxygenation. In conclusion, GFT performed as leg-bicycling decreased pain development during repetitive work tasks, possibly due to improved oxygenation of the painful muscles. SST lowered the overall level of pain both during rest and work, possibly due to a lowered relative exposure as evidenced by a lowered relative EMG. The results demonstrate differential adaptive mechanisms of contrasting physical exercise interventions on chronic muscle pain at rest and during repetitive work tasks.

Keywords: Electromyography, Exercise, Stress task, RCT, Trapezius, NIRS, Aerobic training,
Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Thanks. Feedback question was.  Can I use MOXY  to assess   changes   for   physical modalities like US, dry needling,  trigger point therapy  , stretching techniques

Here  first another  study  and I  will try to explain  what i would change.
Eur J Appl Physiol. 2010 Sep;110(2):389-94. doi: 10.1007/s00421-010-1517-4. Epub 2010 May 29.

Effect of cycling on oxygenation of relaxed neck/shoulder muscles in women with and without chronic pain.


National Research Centre for the Working Environment, Copenhagen, Denmark.


Work-related neck/shoulder muscle pain has been associated with increased anaerobic muscle metabolism. Thus, interventions to enhance oxygenation of painful muscles seem relevant. While cycling with relaxed shoulders has been shown to result in acute neck/shoulder muscle pain reduction, the effect on tissue oxygenation remains unknown. The aim of the present study was to investigate tissue oxygenation of the passive trapezius muscle during and after cycling in female workers with (MYA) and without (CON) trapezius myalgia. Eligible participants (n = 17 MYA, n = 8 CON) performed 20 min sub-maximal cycling in an upright position with relaxed shoulders. Near-infrared spectroscopy was used to measure trapezius muscle oxygenation during and 2 min after the cycling period. For both MYA and CON, oxygenation of the passive trapezius increased in a linear fashion over time, to values approximately 5 microM above baseline at the end of the cycling period, with no significant group difference (CON 5.2, MYA 4.9 microM). Two min after termination of exercise, oxygenation was increased further in both groups, but significantly more in CON (8.8 microM) than in MYA (7.0 microM) (P = 0.05). In conclusion, cycling increases oxygenation of resting neck/shoulder muscles in women with and without trapezius myalgia, indicating acute positive effects of either neural or humoral factors on vascular beds of distant relaxed muscles. Although this beneficial response was observed in both groups, the post-exercise response was lower in women with trapezius myalgia.

   What I prefer is  to combine   the  info  SmO2   as  an indication of  Oxygenation of the area   with  tHb  as an inidcation of the blood flow in the tested  area.
 Remember, an increase in SmO2    means  more O2  in the tested area but not   always a   better use of O2  in that area.
  So  if  people with chronic  pain   are on a bike and we  assess the EtCO2 , we often can see, that chronic  pain  creates a hypocapnic   situation.  So  we  will see an increase in the SmO2  as in the study , but it may be  not  Bio available O2  due to the hypocapnia.  So  if we have a " positive  "  result we shoud see an increase in SmO2   and  at the same time an increase in tHb. As the muscels  are passive  we    do not increase  O2  needs  or use  but   if we increase  blood circulation we  have the same use  of O2  but  a higher intake of  O2.
  Now  it may be a positive reaction. If we see an increase in SmO2  but a d rop in  tHb  we have a  secondary vasoconstriction due to   hypocapnia  and  a  shift of the O2  diss curve to the left  and SmO2  is going up.

The indication in the study that SmO2  increase  further  after the load   could in fact indicate    a  chnage in respiration to slower and deeper  and now  an increase in tHb  and  SmO2  ??
  Paion reduction.  Pain reduction often is going together with   adrenalin and epinephrine  and norepinephrine  reactions . Will show some  great hormonal studies  in that  direction.
 Summary.  Please  try to get the picture  that  an increase in SmO2  is not simply  aleways a better     and positive reuslt , it is only an indication   that it changed  and we have to take  some additional ideas and information into account. Watch that the majority  of the   todays studies  miss this    connection betwen   tHb  and Smo2  and than the  additional info we need  from respiration  and CO2.
 So always take conclusions  with a  small  part of  critical observation.

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