Effects of dry cupping on the upper-extremity function of baseball players
After 4 weeks of cupping during PSC, the participants’ scores on the DASH questionnaire for upper-extremity disability and exercise disability were not significantly changed (time effect). Furthermore, no significant changes were noted in their scores on the FLEX-SF questionnaire (Table 1). In addition, no significant difference was discovered in the group×time interaction effect after 4-week cupping; this result was consistent with the participants’ scores on the DASH and FLEX-SF questionnaires.
After 4 weeks of cupping during ISC, no significant changes were noted in the participants’ upper-extremity disability or shoulder disability (time effect). Furthermore, no significant difference in shoulder disability (FLEX-SF) or exercise disability (DASHe) was discovered in the group×time interaction effect. Although the group×time interaction effect for upper-extremity disability (DASHs) exhibited significant difference (P = .045), no significant changes were noted in the cupping group; however, a decreasing trend in DASHs was observed in the sham group (Table 1). This finding may be attributable to factors unrelated to cupping during the ISC period
Table 1. Upper-extremity function after short-term regular cupping (n = 40).
Upper extremity function
|
Group
|
Pre-test
|
Post-test
|
P (F) value
|
Time
|
Group × time
|
Preseason conditioning (1-4 weeks)
|
|
|
DASHs
|
Sham (n=20)
|
4.19±1.03
|
4.07±0.88
|
0.774
(0.084)
|
0.925
(0.009)
|
Cupping (n=20)
|
3.03±1.03
|
2.81±0.88
|
DASHe
|
Sham (n=20)
|
4.38±1.99
|
6.56±2.28
|
0.594
|
0.340
|
Cupping (n=20)
|
5.31±1.99
|
4.69±2.28
|
(0.288)
|
(0.934)
|
FLEX-SF
|
Sham (n=20)
|
45.95±1.37
|
45.35±1.22
|
0.604
(0.274)
|
0.951
(0.004)
|
Cupping (n=20)
|
45.95±1.41
|
45.47±1.25
|
In-season conditioning (4-8 weeks)
DASHs
|
Sham (n=20)
|
4.07±0.88
|
2.10±0.72
|
0.066
(3.587)
|
0.045
(4.285)
|
|
Cupping (n=20)
|
2.81±0.88
|
2.89±0.72
|
DASHe
|
Sham (n=20)
|
6.56±2.28
|
5.31±2.13
|
0.692
|
0.692
|
|
Cupping (n=20)
|
4.69±2.28
|
4.69±2.13
|
(0.160)
|
(0.160)
|
FLEX-SF
|
Sham (n=20)
|
45.68±1.24
|
46.32±1.19
|
0.285
(1.177)
|
0.738
(0.113)
|
|
Cupping (n=20)
|
45.7±1.21
|
46.9±1.16
|
Note: DASH: Disabilities of the Arm, Shoulder, and Hand; DASHs: a disability/symptom unit; DASHe: highly skilled exercise; FLEX-SF: Flexilevel Scale of Shoulder Function.
Data are presented in terms of the mean ± standard error of the mean (s.e.m.).
Effects of dry cupping on exercise performance and aerobic capacity
Cupping during PSC led to no significant changes in most parameters of the maximal exercise test (time effect); only the peak heart rate decreased significantly (P = .041; Table 2). No significant difference was discovered in the group×time interaction effect for any exercise parameter. Compared with the sham group, the cupping group exhibited increasing trends for VO2max (P = .069) and peak ventilation (P = .078), but neither difference was significant. Furthermore, no significant difference was noted in the time or group×time interaction effect for Tvent (anaerobic threshold) during PSC (Table 2).
Cupping during ISC led to a significant increase in only peak ventilation (time effect; P = .025; Table 2). Upward trends were noted in exercise duration (P = .086), peak power (P = .074), and VO2peak (P = .068), but the changes were nonsignificant. No significant difference was found in the group×time interaction effect for any exercise parameter, the time effect for Tvent, or the group×time interaction effect for Tvent (Table 2).
Effects of dry cupping on the rate of recovery of HRV activity after the incremental exercise test
Four weeks of cupping during PSC led to no significant changes in the 10-min recovery rate (time×trial interaction effect) of any HRV parameter after high-intensity exercise (Table 3). However, when the between-group difference in HRV recovery was considered (time×trial×group), 4-week cupping was found to significantly improve the rate of LF recovery after intense exercise; the rate was significantly higher in the cupping group than in the sham group (P = .013; Fig. 3; Table 3). A similar, but nonsignificant, trend was noted in the rate of TP recovery (time×trial×group interaction effect; P = .061). However, the rate of HF recovery (time×group interaction effect) was significantly lower in the cupping group than in the sham group (P = .05; Table 3).
Table 3. HRV activity recovery after the maximal exercise test during PSC and ISC.
|
HRV
|
week (trial)
|
Sham (n=20)
|
Dry cupping (n=20)
|
P value
|
|
End of exercise
|
10 min recovery
|
End of exercise
|
10 min recovery
|
Time × trial
|
Time × group
|
Time × trial × group
|
Preseason Conditioning
(1-4 weeks)
|
TP
|
1st
|
4.75±0.18
|
6.66±0.21
|
4.95±0.19
|
6.33±0.22
|
0.141
|
0.091
|
0.061
|
[ln(ms2)]
|
4th
|
4.90±0.17
|
6.76±0.21
|
4.80±0.18
|
6.58±0.22
|
|
|
|
LF
|
1st
|
3.17±0.24
|
5.94±0.23
|
3.37±0.25
|
5.60±0.24
|
0.292
|
0.285
|
0.013
|
[ln(ms2)]
|
4th
|
3.37±0.24
|
5.97±0.22
|
3.22±0.25
|
5.86±0.23
|
|
|
|
HF
|
1st
|
1.31±0.24
|
4.88±0.25
|
1.80±0.26
|
4.55±0.26
|
0.506
|
0.050
|
0.149
|
[ln(ms2)]
|
4th
|
1.56±0.22
|
4.99±0.25
|
1.49±0.23
|
4.61±0.26
|
|
|
|
LF/HF
|
1st
|
1.86±0.13
|
1.07±0.17
|
1.57±0.13
|
1.05±0.18
|
0.994
|
0.108
|
0.841
|
(ln ratio)
|
4th
|
1.81±0.12
|
0.99±0.16
|
1.74±0.13
|
1.25±0.17
|
|
|
|
LF%
|
1st
|
67.4±3.0
|
69.3±3.0
|
64.5±3.2
|
69.0±3.2
|
0.960
|
0.360
|
0.731
|
|
4th
|
66.5±3.2
|
67.2±2.9
|
66.1±3.4
|
71.6±3.0
|
|
|
|
In-season Conditioning
(4-8 weeks)
|
TP
|
4th
|
4.90±0.17
|
6.76±0.21
|
4.82±0.17
|
6.57±0.21
|
0.647
|
0.221
|
0.194
|
[ln(ms2)]
|
8th
|
5.00±0.24
|
7.13±0.20
|
4.74±0.24
|
6.36±0.20
|
|
|
|
LF
|
4th
|
3.37±0.24
|
5.97±0.22
|
3.24±0.24
|
5.87±0.22
|
0.246
|
0.793
|
0.555
|
[ln(ms2)]
|
8th
|
3.40±0.33
|
6.34±0.20
|
3.02±0.33
|
5.76±0.20
|
|
|
|
HF
|
4th
|
1.56±0.21
|
4.99±0.24
|
1.50±0.21
|
4.56±0.24
|
0.890
|
0.071
|
0.247
|
[ln(ms2)]
|
8th
|
1.52±0.33
|
5.22±0.25
|
1.30±0.33
|
4.15±0.25
|
|
|
|
LF/HF
|
4th
|
1.81±0.12
|
0.99±0.16
|
1.75±0.12
|
1.31±0.16
|
0.121
|
0.004
|
0.317
|
(ln ratio)
|
8th
|
1.88±0.13
|
1.13±0.14
|
1.72±0.13
|
1.61±0.14
|
|
|
|
LF%
|
4th
|
66.5±3.3
|
67.2±2.9
|
66.0±3.3
|
72.8±2.9
|
0.050
|
0.037
|
0.481
|
|
8th
|
65.4±3.3
|
70.0±2.5
|
63.1±3.3
|
78.1±2.5
|
|
|
|
Noe: HRV: heart rate variability; TP: total power; LF: low-frequency power; HF: high-frequency power; LF/HF: ratio of LF to HF; LF%: LF in normalized unit. Data are presented in terms of the mean ± s.e.m.
Cupping during ISC significantly improved the rate of LF% recovery after intense exercise (time×trial interaction effect; P = .05; Fig. 4A; Table 3). The rate of LF% recovery was significantly higher in the cupping group than in the sham group (time×group interaction effect; P = .037; Fig. 4B). Furthermore, LF/HF activity 10 min after intense exercise was significantly higher in the cupping group than in the sham group (time×group interaction effect; P = .004; Table 3).
Effects of dry cupping on sleep quality during PSC and ISC
After 4 weeks of cupping during PSC, no significant difference was observed in the time effect or group×time interaction effect for the total PSQI score (Table 4). However, significant improvement was noted in the participants’ daytime dysfunction (C7 index) score (time effect; P = .012). Notably, the degree of improvement was significantly higher in the cupping group than in the sham (group×time interaction effect; P = .026). Furthermore, the cupping group exhibited greater improvement trend in sleep latency (C2 index) compared with the sham group (P = .060); however, the group×time interaction effect was nonsignificant.
Cupping during ISC led to significant improvements in sleep quality (total PSQI score), sleep latency, and sleep disturbance (time effect; Table 4). However, no significant between-group difference was noted in the group×time interaction effect for any PSQI component.