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Cupping therapy has been popular in elite athletes in recent years. However, the effect of cupping therapy on reducing muscle fatigue has not been investigated. The purpose of this study was to investigate the immediate and delayed effects of cupping therapy on reducing biceps brachii fatigue during biceps curls. Twelve healthy untrained participants were recruited for this repeated-measures study. Cupping therapy (–300 mmHg pressure for 5 min) and sham control (no negative pressure for 5 min) were applied after biceps fatigue induced by performing repeated biceps curls at 75% of the 10 repetitions of maximum of the non-dominant hand. Surface electromyography (EMG) with spectral analyses [mean frequency (MNF), median frequency (MDF), and spectral moments ratio (SMR)] were used to assess muscle fatigue during the fatigue task. EMG signals during the first 10 repetitions and the last 10 repetitions of biceps curls were used to assess neuromuscular fatigue. There were significant decreases in MNF and MDF and a significant increase in SMR immediately and 24 h after the sham control (no intervention). When comparing the MNF, MDF, and SMR after cupping therapy to the sham control, there was no significant immediate effect on reducing muscle fatigue. However, there was a significant delayed effect on improving recovery following fatigue for the cupping therapy compared to the sham control (MNF changes: sham 0.87 ± 0.02 vs. cupping 0.91 ± 0.02, p < 0.05; MDF changes sham: 0.85 ± 0.03 vs. cupping: 0.91 ± 0.02, p < 0.05; SMR changes: sham 1.89 ± 0.15 vs. cupping 1.58 ± 0.13, p < 0.05). The findings of this study demonstrate that there is a time effect of cupping therapy for reducing muscle fatigue. Cupping therapy is effective on reducing biceps brachii muscle fatigue after 24 h.

Abstract Introduction Anesthesia residents and other professionals are far removed from their experiences in gross anatomy dissection. To address this, efforts were made to create videos that would remind residents of the important gross anatomy underlying the procedures that they were performing. This resource includes a set of four videos for teaching upper extremity peripheral nerve block anatomy and technique to anesthesia residents. Methods One week before the nerve block lecture, residents were assigned the four videos to review in order to get a sense of the procedure. Each video begins with a cadaver dissection of the gross anatomy pertinent to the nerve block being taught, then the physical landmarks are demonstrated on a standardized patient, and finally, ultrasound images and techniques for guiding the injection are displayed. At the beginning of the lecture parts of the videos were reviewed and questions were addressed. More detailed instruction and technique was then given, including medication and instrument specifics. The residents were then given permanent access to the videos. Results When first implemented in 2012, an initial paper survey and quiz was administered to 20 residents. The most preferred feature was the ultrasound demonstration with the patient and cadaver. Before watching the videos a mean previous knowledge score among all residents was 5/10 with a SD of 1.8. After watching the videos the mean knowledge assessment score was 8.2/10 with a SD of 1.2. In early 2014 a survey was administered to 22 second-year medical students to assess the videos as a tool for clinical correlation. Qualitative feedback, while overall positive in nature, suggested greater power over varying speeds, more illustration, and cosmetic changes. The survey also showed an increase in the mean knowledge assessment score from 65% to 87.9% before and after viewing the videos. Discussion While there are videos on performing peripheral nerve blocks, these videos include gross anatomy. Having gross anatomy, surface landmarks, and ultrasound in the same instruction helps to make important connections and we have yet to find a set of videos available that meets this same objective. In addition, this format allows students to progress at their own pace and convenience, while minimizing needless repetition from instructors.