Ultrasound therapy for exercise-induced muscle soreness and fatigue relief in women with type 2 diabetes: a randomized controlled trial.

BACKGROUND: Exercise-induced muscle soreness and fatigue are significant barriers to physical activity in middle-aged women with type 2 diabetes (T2D), exacerbated by impaired tissue healing and chronic inflammation. OBJECTIVES: To evaluate whether post-exercise therapeutic ultrasound (TUS) effectively reduces exercise-induced muscle soreness and fatigue while improving metabolic and inflammatory biomarkers in women with T2D. DESIGN: Randomized controlled trial. METHODS: Thirty sedentary women with T2D (aged 41-49 years, glycated hemoglobin (HbA1c) 6.5%-9.0%) were randomized to a TUS group (n = 15) or control (n = 15). Both groups completed an 8-week aerobic cycling program (3 sessions/week, 45 min/session, 60%-70% VO(2)max). The TUS group received post-exercise ultrasound (3 MHz, 1 W/cm(2), 7 min/leg) using the Intellect Mobile 2 device. Primary outcomes were pain (Von Korff scale) and fatigue (Borg scale), while secondary outcomes included fasting blood sugar (FBS), HbA1c, inflammatory markers (tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6)), and creatine kinase (CK), assessed at baseline and post-intervention. Linear mixed-effects models adjusted for baseline pain differences. RESULTS: The TUS group showed marked decreases in pain (-2.2, 95% CI: -2.8 to -1.6, p < 0.001) and fatigue (-1.8, 95% CI: -2.4 to -1.2, p = 0.004) compared to controls. Secondary outcomes substantially improved: HbA1c (-0.5%, p = 0.03), FBS (-19.8 mg/dL, p = 0.01), TNF-α (-24.9 pg/mL, p < 0.001), IL-6 (-11.9 pg/mL, p < 0.001), and CK (-30 U/L, p = 0.01). No adverse events were reported. CONCLUSION: TUS is a safe, effective adjunct for reducing exercise-induced muscle soreness and fatigue in women with T2D, with benefits in glycemic control and inflammation. Larger trials with sham controls are needed. TRIAL REGISTRATION: This trial was registered at the Iranian Registry of Clinical Trials (IRCT20211201053244N1) on June 21, 2022.