Consensus on the Use of Therapeutic Interventions in Pain Management, Recovery, and Athletic Performance: A Delphi Study.

Abstract

Background: Therapeutic interventions are widely used in clinical practice to prepare individuals for movement, recover from exercise, and mediate pain and inflammation associated with injury. However, there has yet to be cited consensus regarding when to use such interventions.

Purpose: Using the Delphi method, this study aimed to develop consensus among physical therapists (PTs) and athletic trainers (ATs) regarding the use of percussive, vibration, infrared, heat, and cryotherapy in a variety of treatment circumstances. These included preparation and recovery from physical activity, treatment of acute and chronic joint pain, and treatment of acute and chronic soft tissue/muscle pain.

Methods: Four rounds of surveys were delivered to individuals who were licensed or certified PTs/ATs, with more than 1,000 hours of experience working with athletic populations and experience using at least one of the interventions of interest in the prior five years. Consensus was defined as a greater than 70% agreement, and consideration for use was defined as selecting "In Some Instances'' and"In Most Instances."

Results: Ninety-four individuals responded to the screening survey (n₁ = 74, n₂ = 68, n₃ = 44, n₄ = 32). The individuals who participated agreed that they would consider using the following therapeutic interventions in treatment: 1) percussive therapy, local vibration, and local heat therapy in the preparation for physical activity; 2) local cryotherapy in recovery from physical activity; 3) local cryotherapy for the treatment of acute joint pain and acute soft tissue/muscle pain; 4) local heat and local cryotherapy for the treatment of chronic joint pain; and 5) percussive, local vibration, local heat, and local cryotherapy in the treatment of chronic soft tissue/muscle pain.

Conclusion: Clinical intervention often relies on patient presentation and preference. This study provides a consensus on the use of common therapeutic interventions for the management of athletic recovery, pain, and inflammation among ATs and PTs.

Level of evidence: 3.