Exploring the acute recovery effects of dry cupping therapy and electrical stimulation on anaerobic performance metrics in active individuals: A quasi-experimental crossover study

Background: This quasi-experimental crossover study aimed to examine the acute effects of dry cupping therapy (DCT) and neuromuscular electrical stimulation (NMES) on fatigue and perceived exertion in anaerobic performance among physically active individuals. Methods: Twelve male participants (mean age: 24.1±2.37 years), all students from the Faculty of Sports Sciences, were recruited to participate voluntarily. Anaerobic performance parameters, including peak power, mean power (MP), and fatigue index (FI), were assessed using a Monark 839E cycling ergometer under 3 distinct conditions: NMES, DCT, and a control condition (no intervention), with each session separated by a 48-hour rest period. Perceived exertion was evaluated immediately following each test session using Borg's rate of perceived exertion (RPE) scale. Both NMES and DCT were administered bilaterally to the hamstring (m. hamstring) and quadriceps femoris (m. quadriceps femoris) muscles for 20 minutes before testing. Results: The results revealed no statistically significant differences in peak power and MP across the conditions. However, significant effects were identified for FI (F(2, 22)=4.08, P=.031, ηp2=0.27) and RPE (F(2, 22]=8.88, P=.0015, ηp2=0.45). Post hoc pairwise comparisons indicated that NMES significantly reduced FI compared to the control condition (P=.0311), with a small to medium effect size (Cohen's d=0.44). In terms of RPE, DCT significantly lowered values compared to both the control (P=.0018) and NMES conditions (P=.0005), demonstrating medium (Cohen's d=0.74) and small to medium (Cohen's d=0.37) effect sizes, respectively. Conclusions: While NMES and DCT did not elicit acute improvements in peak or mean anaerobic power, both interventions effectively mitigated fatigue and reduced perceived exertion during maximal anaerobic exercise. These findings suggest that NMES and DCT may serve as valuable recovery modalities for mitigating fatigue in sports characterized by high anaerobic demands. Future research should investigate the chronic effects of these interventions and explore their utility among trained athletes to determine their broader applicability in enhancing athletic performance.