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Eugenia Ortiz M, Sinhorim L, Hoffmann de Oliveira B, Hardt da Silva R, Melo de Souza G, de Souza G, Paula Piovezan A, Balduino Bittencourt E, Bianco G, Shiguemi Inoue Salgado A, Klingler W, Schleip R, Fernandes Martins D. Analgesia by fascia manipulation is mediated by peripheral and spinal adenosine A 1 receptor in a mouse model of peripheral inflammation. Neuroscience 2024; 555:125-133. [PMID: 39038598 DOI: 10.1016/j.neuroscience.2024.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 07/08/2024] [Accepted: 07/18/2024] [Indexed: 07/24/2024]
Abstract
The role of adenosine receptors in fascial manipulation-induced analgesia has not yet been investigated. The purpose of this study was to evaluate the involvement of the adenosine A1 receptor (A1R) in the antihyperalgesic effect of plantar fascia manipulation (PFM), specifically in mice with peripheral inflammation. Mice injected with Complete Freund's Adjuvant (CFA) underwent behavioral, i.e. mechanical hyperalgesia and edema. The mice underwent PFM for either 3, 9 or 15 min. Response frequency to mechanical stimuli was then assessed at 24 and 96 h after plantar CFA injection. The adenosinergic receptors were assessed by systemic (intraperitoneal, i.p.), central (intrathecal, i.t.), and peripheral (intraplantar, i.pl.) administration of caffeine. The participation of the A1R was investigated using the 1,3-dipropyl-8-cyclopentylxanthine (DPCPX), a selective A1R subtype antagonist. PFM inhibited mechanical hyperalgesia induced by CFA injection and did not reduce paw edema. Furthermore, the antihyperalgesic effect of PFM was prevented by pretreatment of the animals with caffeine given by i.p., i.pl., and i.t. routes. In addition, i.pl. and i.t. administrations of DPCPX blocked the antihyperalgesia caused by PFM. These observations indicate that adenosine receptors mediate the antihyperalgesic effect of PFM. Caffeine's inhibition of PFM-induced antihyperalgesia suggests that a more precise understanding of how fascia-manipulation and caffeine interact is warranted.
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Affiliation(s)
- Maria Eugenia Ortiz
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
| | - Larissa Sinhorim
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
| | - Bruna Hoffmann de Oliveira
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
| | - Rafaela Hardt da Silva
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
| | - Gabriel Melo de Souza
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
| | - Gabriela de Souza
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
| | - Anna Paula Piovezan
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
| | - Edsel Balduino Bittencourt
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil; Coastal Health Institute, Jacksonville, USA
| | - Gianluca Bianco
- Research Laboratory of Posturology and Neuromodulation (RELPON), Department of Human Neuroscience, Sapienza University, Rome, Italy; Istituto di Formazione in Agopuntura e Neuromodulazione (IFAN), Roma, Italy
| | | | - Werner Klingler
- SRH Hospitals, Sigmaringen, Germany; Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany; Department for Medical Professions, Diploma University of Applied Sciences, Bad Sooden-Allendorf, Germany
| | - Robert Schleip
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany; Department for Medical Professions, Diploma University of Applied Sciences, Bad Sooden-Allendorf, Germany; Fascia Research Group, Experimental Anesthesiology, Ulm University, Ulm, Germany
| | - Daniel Fernandes Martins
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil.
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Bali F, Bayram GA. Effects of myofascial release technique in patients with unilateral cervical radiculopathy: A single blind-randomized clinical trial. Explore (NY) 2024; 20:102981. [PMID: 38296722 DOI: 10.1016/j.explore.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/25/2023] [Accepted: 01/16/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the effectiveness of the myofascial release technique in individuals diagnosed with unilateral cervical radiculopathy. MATERIALS AND METHODS Thirty-four cervical radiculopathy patients were randomly assigned to either the myofascial release group or the exercise group. Both groups received conventional treatment. Additionally, the exercise group performed stretching and strengthening exercises while the myofascial release group received the myofascial release technique. The pain pressure threshold, muscle strength, cervical range of motion, pain, and disability variables were assessed for all patients. RESULTS The myofascial release group demonstrated significantly larger improvements in flexion (p = 0.001), extension (p = 0.037), left rotation (p = 0.012), and left lateral flexion (p = 0.001) range of motions compared to the exercise group. Muscle strength in the wrist flexors (p < 0.001), wrist extensors (p < 0.010), biceps (p < 0.001) and triceps (p < 0.001) were significantly higher in the myofascial release group compared to the exercise group. And, again, the myofascial release group demonstrated significantly larger improvements in wrist flexors (p < 0.001), wrist extensors (p < 0.001), biceps (p < 0.001), triceps (p < 0.001), pectorals (p < 0.001), subscapularis (p < 0.001), upper trapezius (p = 0.002), and the pain pressure threshold. Finally, the myofascial release group demonstrated statistically significant improvements in pain (p < 0.001) and disability (p < 0.001) scales compared to the exercise group. CONCLUSION Evaluation of the arm muscle strength and pain pressure threshold variables in patients with cervical radiculopathy may benefit clinicians in the preparation of treatments. Cervical radiculopathy symptoms may improve after the application of myofascial release techniques. A customized cervical exercise program and conventional treatment could be added to the non-surgical treatment of cervical radiculopathy.
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Affiliation(s)
- Fatih Bali
- Department of Physical Therapy and Rehabilitation, Istanbul Kent University, Istanbul, Turkey.
| | - Gülay Aras Bayram
- Department of Physical Therapy and Rehabilitation, Istanbul Medipol University, Istanbul, Turkey
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Li Y, Li X, Song H, Shou Y, Fang Q. Health-related outcomes with supervised exercise and myofascial release versus only supervised exercise in subacromial pain syndrome: a randomized controlled single-blind study. BMC Sports Sci Med Rehabil 2024; 16:171. [PMID: 39138546 PMCID: PMC11323458 DOI: 10.1186/s13102-024-00960-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 08/05/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND Myofascial tissue plays a critical role in shoulder joint mobility disorders. Myofascial release therapy (MFR) is frequently utilized to restore the extensibility of fascial tissue and is considered beneficial for various clinical conditions such as low back pain and ankle injuries. However, no studies have yet evaluated the effects of MFR on periscapular muscles activation and shoulder mobility in patients with subacromial pain syndrome(SAPS). OBJECTIVE The purpose of this study was to compare the effectiveness of MFR combined with supervised exercise(SE) and SE alone in patients with SAPS. DESIGN Assessor-blinded randomized controlled trial. SETTING Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. SUBJECTS Subacromial pain syndrome patients. METHODS Fifty participants were divided into two groups: SE group and MFR + SE group, each group 25 cases. Both treatment methods were performed 5 times a week for 4 weeks. MAIN MEASURES Shoulder pain severity was assessed by visual analog scale (VAS); shoulder range of motion (ROM) by a goniometer; functionality by shoulder Pain and Disability Index (SPADI); and periscapular muscles activation by sEMG. All measurements were evaluated both pre- and post-treatment. RESULTS An ANOVA analysis indicated no significant group by time interactions for flexion ROM and resting VAS (p > 0.05). However, significant group by time interactions were found for SPADI, abduction and external rotation ROM, and activity VAS (p < 0.05). Post-hoc tests revealed significant improvements in SPADI, abduction and external rotation ROM, and activity VAS in both groups compared to pre-treatment (p < 0.05). Additionally, there were significant group by time interactions for the sEMG values of the upper trapezius and serratus anterior (p < 0.05). Post-hoc tests showed that compared to pre-treatment, the MFR + SE group had decreased upper trapezius sEMG values and increased serratus anterior sEMG values(p < 0.05), while the SE group showed increased serratus anterior sEMG values(p < 0.05). After the 4-week intervention, there were significant between-group differences in SPADI, abduction and external rotation ROM, activity VAS, and sEMG values of the upper trapezius and serratus anterior(p < 0.05). CONCLUSION Four weeks of MFR combined with SE can increase shoulder ROM, improve pain, and thus enhancing functional activities in patients with SAPS. Additionally, it can further improve the balance between the upper trapezius and serratus anterior to improve the dynamics of the periscapular muscles. TRIAL REGISTRY NUMBER ChiCTR2200061054. Date of registration 15/06/2022.
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Affiliation(s)
- Yongzhong Li
- Department of Rehabilitation medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, P.R. China.
| | - Xuan Li
- Department of Rehabilitation medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, P.R. China
| | - Haixin Song
- Department of Rehabilitation medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, P.R. China
| | - Yiqun Shou
- Department of Rehabilitation medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, P.R. China
| | - Qian Fang
- Department of Rehabilitation medicine, Zhejiang Province Youth Hospital, 54, Qingchun Road East, Hangzhou, 310016, P.R. China
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Indrayani NLD, Kao CY, Suyasa IGPD, Padmalatha KMS, Chang JH, Wang CJ. Effectiveness of exercise programs to reduce low back pain among nurses and nursing assistants: A systematic review and meta-analysis. JOURNAL OF SAFETY RESEARCH 2024; 89:312-321. [PMID: 38858055 DOI: 10.1016/j.jsr.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 10/02/2023] [Accepted: 01/16/2024] [Indexed: 06/12/2024]
Abstract
INTRODUCTION Nurses have a high prevalence of low back pain due to ergonomic hazards in healthcare workplaces. While exercise programs have been suggested as an intervention strategy, the effectiveness of low back pain programs has been inconsistent in the research literature. The purpose of study is to determine the effect of exercise programs to reduce low back pain among nursing staff. METHODS A systematic review and meta-analysis was conducted with five databases and systematically searched. Following the PRISMA guidelines, included studies evaluated low back pain relief among nurses or nursing assistants and described the exercise program. Two reviewers independently appraised, extracted, and synthesized all available studies. The study protocol was registered in PROSPERO (CRD42022359511). RESULTS A total of 296 articles with 1,355 nursing staff from nine countries were obtained. Nine randomized controlled trials with a moderate to low risk of bias quality were included. Exercise programs had a small but significant effect on low back pain of nursing staff (SMD = -0.48; 95% CI = -0.76 to -0.19; p = 0.03, I2 = 62%, p = 0.001). A subgroup analysis of nurses and nursing assistants showed moderate and small effects, respectively (I2 = 0% p < 0.0001, SMD -0.73 CI 95% [-0.97 to -0.48], p = 0.76, and I2 = 0% p = 0.002, SMD -0.23 CI 95% [-0.38 to -0.08], p < 0.88). Exercise for back and trunk exhibited a moderate effect on low back pain (SMD -0.56 CI 95% [-0.86 to -0.25], p = 0.01, I2 = 66%, p < 0.0004). A subgroup analysis comparing age, under 40 years old revealed a moderate effect size (SMD = -0.59; 95% CI = -0.83to -0.35; p = 0.06; I2 = 64%, p < 0.0001). CONCLUSIONS Exercise programs are an effective treatment to reduce low back pain in nurses and nursing assistants, especially among younger staff. PRACTICAL APPLICATION Back and trunk exercise programs should be recommended for nursing staff with low back pain.
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Affiliation(s)
- Ni Luh Dwi Indrayani
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Technology and Health, Bali, Indonesia
| | - Chi-Yin Kao
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | | | | | - Jer-Hao Chang
- Institute of Allied Health Sciences, College of Medicine, National Cheng-Kung University, Tainan, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng-Kung University, Tainan, Taiwan
| | - Chi-Jane Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Ferguson J, Fritsch A, Rhon DI, Young JL. Adverse Events Reported in Trials Assessing Manual Therapy to the Extremities: A Systematic Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:507-517. [PMID: 38452161 DOI: 10.1089/jicm.2023.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Objective: This review aimed to describe the quality and comprehensiveness of adverse event (AE) reporting in clinical trials incorporating manual therapy (MT) as an intervention for extremity conditions using the Consolidated Standards of Reporting Trials (CONSORT)-Harms extension as the benchmark. The secondary aim was to determine whether the quality of AE reporting improved after the availability of the CONSORT reporting checklist. Design: Systematic review. Methods: A literature search was conducted using multiple databases to identify trials where MT was used to treat extremity conditions. Studies that reported AEs were identified and evaluated using the CONSORT-Harms extension. The frequency of trials reporting study AEs before and after the publication of the updated 2010 CONSORT statement was calculated, along with the categorization of how study AEs were reported. Results: Of the 55,539 studies initially identified, 220 trials met all inclusion criteria. Eighty trials (36.4%) reported AE occurrence. None of the studies that reported AEs adhered to all 10 criteria proposed by the 2010 CONSORT-Harms extension. The most commonly reported criterion was number four, which clarified how AE-related information was collected (30% of trials). The least reported criterion was number six, which describes the participant withdrawals for each arm due to AEs and the experience with the allocated treatment (1.3% of trials). The nomenclature used to describe AEs varied substantially. Fifty-nine of 76 trials (33.3%) were published after the updated CONSORT Harms-checklist was available, compared to 21 of 44 trials (46.7%) published before it was available. Conclusion: Reporting of AEs in trials investigating MT for extremity conditions is poor. Every included trial lacked adherence to all 10 criteria proposed by the CONSORT-Harms Extension. The quality and comprehensiveness of AE reporting did not improve after the most recent CONSORT update recommending AE reporting. Clinicians must obtain informed consent before performing any intervention, including MT, which requires disclosing potential risks, which could be better known with improved tracking, analyzing, and reporting of AEs. The authors recommend improved adherence to best practices for adequately tracking and reporting AEs in future MT trials.
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Affiliation(s)
- Jeffrey Ferguson
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
| | - Adam Fritsch
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
| | - Daniel I Rhon
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
- Department of Rehabilitation Medicine, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Jodi L Young
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
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Irving R, Schmidt E, Stone M, Fleming RK, Xie JY. Meta-epidemiologic review: blinding and sham treatment in clinical trial design for osteopathic manipulative treatment research. INT J OSTEOPATH MED 2024; 51:100705. [PMID: 38312536 PMCID: PMC10836155 DOI: 10.1016/j.ijosm.2023.100705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Objective To analyze the consistency of study designs in osteopathic manipulative treatment (OMT) research, focusing on blinding protocols and the use of sham treatments. Data Source and Study Selection PubMed and CINAHL were searched in January 2022. A total of 83 research studies between 2009 and 2021 were selected based on the presence of a double- or single-blind study design and/or sham treatment. Data Extraction and Analysis Data regarding the primary outcome measures, blinding design, measures used to determine success of blinding, osteopathic technique used, and sham technique used for each eligible study were extracted and compared among different study designs. Results A total of 5968 subjects participated in the 83 trials. The study population mainly consisted of asymptomatic individuals (25%) and chronic back pain patients (19%). Light touch was employed most commonly (49%) as the sham treatment, followed by unrelated sham (20%) and incomplete maneuvers (20%). Most studies blinded the subjects (80%) or the outcome evaluator/data analyzer (71%), while only 20% studies blinded the osteopathic physicians. Conclusions Strict double-blinding is achievable for OMT clinical research by blinding the subjects and data collectors/analyzers rather than the osteopaths providing the actual treatment. The use of questionnaires to determine the success of blinding should be considered. Additionally, including OMT-naïve subjects is preferred to enhance blinding success. When designing a sham treatment, careful consideration should be given to blinding the data collector, accounting for the placebo effect, and incorporating an additional no-treatment control group to improve the rigor of the study design.
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Affiliation(s)
- Richard Irving
- Department of Basic Sciences, New York Institute of Technology College of Osteopathic Medicine at Arkansas State University, Jonesboro, AR, USA
| | - Emma Schmidt
- Department of Basic Sciences, New York Institute of Technology College of Osteopathic Medicine at Arkansas State University, Jonesboro, AR, USA
| | - Michaela Stone
- Biology Department, Arkansas Biosciences Institute, Arkansas State University, Jonesboro, AR, USA
| | - Regina K. Fleming
- Department of Osteopathic Manipulative Medicine, New York Institute of Technology College of Osteopathic Medicine at Arkansas State University, Jonesboro, AR, USA
| | - Jennifer Yanhua Xie
- Department of Basic Sciences, New York Institute of Technology College of Osteopathic Medicine at Arkansas State University, Jonesboro, AR, USA
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dos Santos Amorim M, Sinhorim L, Baptistella do Nascimento I, Wagner J, de Paula Lemos F, Duarte França ME, Schleip R, Sonza A, Moraes Santos G. Peripheral muscle oxygenation, pain, and disability indices in individuals with and without nonspecific neck pain, before and after myofascial reorganization®: A double-blind randomized controlled trial. PLoS One 2024; 19:e0292114. [PMID: 38335169 PMCID: PMC10857696 DOI: 10.1371/journal.pone.0292114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 09/12/2023] [Indexed: 02/12/2024] Open
Abstract
To investigate whether myofascial reorganization® in the trapezius muscle (MRT) improves peripheral muscle oxygenation and pain tolerance and decreases neck disability index (NDI) scores in individuals with and without nonspecific neck pain (NP) using a double-blind randomized controlled trial. Seventy-five subjects were equally and randomly assigned to three groups: the intervention groups (experimental [EG] and sham sSG]) and the control group (CG). Several inclusion criteria were applied to the intervention groups: male or female, aged 18-32 years, self-reported NP in the last 3 months without a defined cause; at least "soft" pain in session 1 of the NDI, and at least a score of 1 on the Visual Analogue Scale (VAS). The CG was required to have NDI and VAS scores of 0 at recruitment. Intervention: The EG underwent MRT for 10 min, once a week for 6 weeks. Patients with NP in the SG underwent classical massage for the same duration and frequency. Patients in the CG had no pain and underwent no intervention. Data collection was performed using the NDI Questionnaire, a pressure algometer for pain evaluation, and near-infrared spectroscopy for muscle oxygenation measurements. It was registered as NCT03882515 at ClinicalTrials.gov. The NDI score in both the EG (p<0.001) and SG (p<0.001) decreased after 6 weeks of intervention compared to the CG. The CG demonstrated a lower basal tissue saturation (TSI) index than the EG (p<0.001) and SG (p = 0.02). The EG demonstrated higher oxyhemoglobin values than the SG (p<0.001) and CG (p = 0.03). The CG had higher pain tolerance than the EG (p = 0.01) and SG (p<0.001) post-intervention. MRT increased trapezius muscle oxygenation after 6 weeks of intervention.
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Affiliation(s)
- Mayane dos Santos Amorim
- College of Health Sciences and Sports at Santa Catarina State University (UDESC), Posture and Balance Laboratory (LAPEQ), Florianópolis, State of Santa Catarina, Brazil
| | - Larissa Sinhorim
- College of Health Sciences and Sports at Santa Catarina State University (UDESC), Posture and Balance Laboratory (LAPEQ), Florianópolis, State of Santa Catarina, Brazil
| | - Iramar Baptistella do Nascimento
- College of Health Sciences and Sports at Santa Catarina State University (UDESC), Posture and Balance Laboratory (LAPEQ), Florianópolis, State of Santa Catarina, Brazil
| | - Janaína Wagner
- College of Health Sciences and Sports at Santa Catarina State University (UDESC), Posture and Balance Laboratory (LAPEQ), Florianópolis, State of Santa Catarina, Brazil
| | - Francisco de Paula Lemos
- College of Health Sciences and Sports at Santa Catarina State University (UDESC), Posture and Balance Laboratory (LAPEQ), Florianópolis, State of Santa Catarina, Brazil
| | - Maria Elisa Duarte França
- College of Health Sciences and Sports at Santa Catarina State University (UDESC), Posture and Balance Laboratory (LAPEQ), Florianópolis, State of Santa Catarina, Brazil
| | - Robert Schleip
- Associate Professorship of Conservative and Rehabilitative Orthopaedics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
- DIPLOMA Hochschule Bad Sooden-Allendorf, Bad Sooden-Allendorf, Germany
| | - Anelise Sonza
- College of Health Sciences and Sports at Santa Catarina State University (UDESC), Posture and Balance Laboratory (LAPEQ), Florianópolis, State of Santa Catarina, Brazil
| | - Gilmar Moraes Santos
- College of Health Sciences and Sports at Santa Catarina State University (UDESC), Posture and Balance Laboratory (LAPEQ), Florianópolis, State of Santa Catarina, Brazil
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Basra M, Patel H, Stern-Harbutte A, Lee D, Gregg RK, Waters HB, Potter AK. A Narrative Review on the Viability of Osteopathic Manipulative Medicine in Treating Irritable Bowel Syndrome With Constipation (IBS-C). Cureus 2024; 16:e54180. [PMID: 38496183 PMCID: PMC10941805 DOI: 10.7759/cureus.54180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/13/2024] [Indexed: 03/19/2024] Open
Abstract
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by chronic abdominal pain and alterations in bowel habits, with global prevalence. The etiology of the disease is likely multifactorial; however, autonomic nervous system (ANS) dysfunction and immune-mediated inflammation may contribute the most to the hallmark symptoms of abdominal pain and altered motility of the gut. Current pharmacological therapies operate to modulate intestinal transit, alter the composition of the gut flora and control pain. Non-pharmacological approaches include dietary changes, increased physical activity, or fecal microbiota transplants. None of these therapies can modulate ANS dysfunction or impact the underlying inflammation that is likely perpetuating the symptoms of IBS. Osteopathic Manipulative Medicine (OMM) is a clinical approach focused on physical manipulation of the body's soft tissues to correct somatic dysfunctions. OMM can directly target the pathophysiology of IBS through many approaches such as ANS modulation and lymphatic techniques to modify the inflammatory mechanisms within the body. Particular OMM techniques of use are lymphatic manipulation, myofascial release, sympathetic ganglia treatment, sacral rocking, counterstrain, and viscerosomatic treatment. The aim of this study is to identify OMM treatments that can be used to potentially reduce the inflammation and ANS dysfunction associated with IBS symptoms, thereby providing a new non-pharmacological targeted approach for treating the disease.
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Affiliation(s)
- Mahi Basra
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Hemangi Patel
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Alison Stern-Harbutte
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - David Lee
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Randal K Gregg
- Research, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Holly B Waters
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Anna K Potter
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
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Güneş M, Yana M. Acute effects of thoracolumbar fascia release techniques on range of motion, proprioception, and muscular endurance in healthy young adults. J Bodyw Mov Ther 2023; 35:145-150. [PMID: 37330761 DOI: 10.1016/j.jbmt.2023.04.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/06/2023] [Accepted: 04/12/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE This study investigates the acute effects of Graston and myofascial release on thoracolumbar fascia (TLF) on lumbar range of motion (ROM), lumbar and cervical proprioception, and trunk muscle endurance in healthy young adults. METHOD Twenty-four healthy young individuals were included in the study. Individuals were randomly divided into two groups as Graston technique (GT) (n = 12) and myofascial release (MFR) (n = 12). GT group received a fascial treatment with a graston instrument and the MFR group (n = 12) received manual myofascial treatment. Both techniques were applied for 10 min and as a single session. Lumbar ROM (goniometer), lumbar proprioception (digital inclinometer), cervical proprioception (CROM device), and trunk muscle endurance (with McGill Endurance Test) were evaluated before and after treatment. RESULTS Age, gender and body mass index of individuals in both groups were similar (p > 0.05). In both GT and MFR groups, an increase in ROM in the flexion direction (p < 0.05) and a decrease in the angle of deviation in proprioception in the flexion direction were determined (p < 0.05). Neither technique had a significant effect on cervical proprioception and trunk muscle endurance (p > 0.05). In addition, no difference was found between the effectiveness of Graston and myofascial release (p > 0.05). CONCLUSION This study showed that Graston and myofascial release applied to TLF in healthy young adults effectively improve lumbar ROM and proprioception in the acute period. Considering these results, both Graston and myofascial release can be used to provide elasticity of TLF and improve proprioceptive return.
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Affiliation(s)
- Musa Güneş
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karabuk University, Karabuk, Turkey.
| | - Metehan Yana
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karabuk University, Karabuk, Turkey.
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Rajan AP, Gurudut P. Gross myofascial release of trunk with leg pull technique on low back pain with radiculopathy - A randomised controlled trial. Hong Kong Physiother J 2023; 43:61-71. [PMID: 37584046 PMCID: PMC10423682 DOI: 10.1142/s1013702523500087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/21/2023] [Indexed: 08/17/2023] Open
Abstract
Background Lower Back Pain (LBP) with radiculopathy is a potentially more serious form of mechanical low back pain. A paucity of literature exists about the effect of the gross myofascial release (MFR) technique on the management of LBP. Objective The study aimed to evaluate the effect of gross MFR when given as an adjunct to conventional physical therapy in subjects with low back pain with radiculopathy. Methods Forty subjects (n = 40 ) clinically diagnosed with LBP with radiculopathy were enrolled and randomly allocated to either the control group (n = 20 ) or the experimental group (n = 20 ). Both study groups received 5 sessions of intervention. The control group received conventional physical therapy while the experimental group received gross MFR of the trunk and lower limb along with conventional physical therapy. The outcome measures included were pressure pain threshold for the lower back and lower extremity, lumbar flexion and extension range of motion (ROM), percentage disability, and patient satisfaction towards the treatment which were measured pre-intervention (day 1) and post-treatment (day 5). The interaction between group and time was analysed using two-way mixed ANOVA. Results The results suggested that the experimental group was statistically significant over the control group in terms of pressure pain threshold in the lower back (p < 0 . 001 ) and lower limb (p = 0 . 003 ), disability (p < 0 . 001 ), and patient satisfaction (p = 0 . 034 ) and lumbar flexion (p = 0 . 002 ) except lumbar extension ROM (p = 0 . 973 ). Conclusion When given as an adjuvant to conventional physical therapy, gross myofascial release proved to provide a significant and faster short-term improvement over conventional treatment alone in subjects diagnosed with low back pain with radiculopathy.
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Affiliation(s)
- Abey P Rajan
- Department of Orthopaedic Physiotherapy KLE Institute of Physiotherapy Belagavi 590010, Karnataka State, India
| | - Peeyoosha Gurudut
- Department of Orthopaedic Physiotherapy KLE Institute of Physiotherapy Belagavi 590010, Karnataka State, India
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11
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Khokhar D, Powers B, Yamani M, Edwards MA. The Benefits of Osteopathic Manipulative Treatment on a Patient With Ehlers-Danlos Syndrome. Cureus 2023; 15:e38698. [PMID: 37292533 PMCID: PMC10246933 DOI: 10.7759/cureus.38698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/07/2023] [Indexed: 06/10/2023] Open
Abstract
Ehlers-Danlos syndrome (EDS) is a disorder affecting connective tissue throughout the body. Inherited through several different genetic mutations, the EDS symptoms of hyperextensibility, hypermobility, and fragility cause significant somatic and visceral issues in those affected. Chronic somatic dysfunction, pain, and systemic involvement create lifelong comorbidities and discomfort for these patients. One in every 5,000 individuals is burdened with EDS worldwide; in the US, the range has been reported to be 1/2,500-1/5,000 people. Very few patients with EDS in the literature have been documented and treated with osteopathic manipulative treatment (OMT). The objective of this case report is to describe the response of an EDS patient to outpatient OMT over a series of three office visits. The patient has verbally consented to OMT at each encounter. A combination of soft tissue manipulation, muscle energy, Still's technique, counterstrain, and high-velocity low-amplitude (HVLA) was performed in the head and neck, thoracic, lumbar, ribs, and lower extremity regions. During the three clinic visits of this patient, OMT was performed in the same regions by the student physician under the supervision of the attending physician. At each visit, the patient was asked to report their pain levels pre- and post-treatment and assess symptom improvement using a one to 10 pain scale, as well as any subjective symptoms they are experiencing. Following each treatment, as well as at each follow-up encounter, the patient reported marked pain and symptom improvement. The objective of this case report is to describe the benefits that one patient experienced from three clinic visits. These results showed that subjective improvement in respiratory, gastrointestinal, and musculoskeletal symptoms secondary to the longstanding history of EDS may be possible through the use of OMT.
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Affiliation(s)
- Daniel Khokhar
- Osteopathic Manipulative Medicine, Edward Via College of Osteopathic Medicine, Spartanburg, USA
| | - Bethany Powers
- Osteopathic Manipulative Medicine, Edward Via College of Osteopathic Medicine, Spartanburg, USA
| | - Musaab Yamani
- Osteopathic Manipulative Medicine, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Michael A Edwards
- Department of Family Medicine, Hospital Corporation of America (HCA) Orange Park Hospital, Orange Park, USA
- Department of Family Medicine, Coastal Family Medicine, Orange Park, USA
- Department of Family Medicine, Baptist Health, Orange Park, USA
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12
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Song J, Kim H, Jung J, Lee S. Soft-Tissue Mobilization and Pain Neuroscience Education for Chronic Nonspecific Low Back Pain with Central Sensitization: A Prospective Randomized Single-Blind Controlled Trial. Biomedicines 2023; 11:biomedicines11051249. [PMID: 37238919 DOI: 10.3390/biomedicines11051249] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/16/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
This study was conducted to demonstrate the therapeutic effect of soft-tissue mobilization (STM) combined with pain neuroscience education (PNE) for patients with chronic nonspecific low back pain with central sensitization. A total of 28 participants were recruited and randomly allocated to either the STM group (SMG) (n = 14) or the STM plus PNE group (BG; blended group) (n = 14). STM was applied twice a week for four weeks, with a total of eight sessions, and PNE was applied within four weeks, for a total of two sessions. The primary outcome was pain intensity, and the secondary outcomes were central sensitization, pressure pain, pain cognition, and disability. Measurements were made at baseline, after the test, and at 2-week and 4-week follow-ups. The BG showed significant improvement in pain intensity (p < 0.001), pressure pain (p < 0.001), disability (p < 0.001), and pain cognition (p < 0.001) compared to the SMG. This study demonstrated that STM plus PNE is more effective for all measured outcomes compared to STM alone. This finding suggests that the combination of PNE and manual therapy has a positive effect on pain, disability index, and psychological factors in the short term.
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Affiliation(s)
- Jeongkeun Song
- Yes Home Rehabilitation Center, 370-32 Seoljuk-ro, Gwangju 61052, Republic of Korea
| | - Hyunjoong Kim
- Neuromusculoskeletal Science Laboratory, 306 Jangsin-ro, Gwangju 62287, Republic of Korea
| | - Jihye Jung
- Institute of SMART Rehabilitation, Sahmyook University, 815 Hwarang-ro, Seoul 01795, Republic of Korea
| | - Seungwon Lee
- Department of Physical Therapy, College of Health and Welfare, Sahmyook University, 815 Hwarang-ro, Seoul 01795, Republic of Korea
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13
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Kim Y, Park EY, Lee H. The effect of myofascial release in patients with breast cancer-related lymphedema: a cross-over randomized controlled trial. Eur J Phys Rehabil Med 2023; 59:85-93. [PMID: 36637800 PMCID: PMC10035446 DOI: 10.23736/s1973-9087.22.07698-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AIM This study aimed to compare the effects of myofascial release (MFR) on upper extremity volume in patients with breast cancer-related lymphedema (BCRL). DESIGN A randomized, single-blinded, cross-over, controlled trial. SETTING An outpatient rehabilitation clinical setting. POPULATION Thirty patients with BCRL. METHODS Within a crossover design with randomized treatment sequences, fifteen subjects received MFR for 4 weeks, followed by 4 weeks of washout period, and then received placebo MFR and the other fifteen subjects received interventions in the reverse order. Each session had a 60 min process including either MFR or placebo MFR for 30 min, followed by complete decongestive therapy for 30 min twice a week. Upper limb volume as the primary outcome and subjective pain, shoulder range of motion (ROM), chest mobility, shoulder function, and quality of life as secondary outcomes were assessed before and at the end of each intervention period. RESULTS There were significant differences in upper limb volume after both MFR and placebo MFR (P<0.05) while no significant difference between MFR and placebo MFR treatments was found (P>0.05). MFR-based treatment also achieved a greater improvement than placebo MFR-based treatment in subjective pain and shoulder ROM (P<0.05), except for internal rotation, and shoulder function. CONCLUSIONS MFR-based treatment showed clinical improvement in shoulder function, induced by decreased edema volume and pain, and improved ROM and chest mobility. However, a further study with parallel randomized controlled trials to confirm what was achieved in the present study. CLINICAL REHABILITATION IMPACT MFR-based treatment is considered an important part of BCRL rehabilitation. Moreover, MFR-based treatment may be safe for patients with BCRL.
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Affiliation(s)
- Yena Kim
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, South Korea
| | - Eun Y Park
- College of Nursing, Gachon University, Incheon, South Korea
| | - Haneul Lee
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, South Korea -
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Ożóg P, Weber-Rajek M, Radzimińska A, Goch A. Analysis of Postural Stability Following the Application of Myofascial Release Techniques for Low Back Pain-A Randomized-Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2198. [PMID: 36767565 PMCID: PMC9915703 DOI: 10.3390/ijerph20032198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Low back pain (LBP) is one of the most frequently observed disorders of the musculoskeletal system in the modern population. It is suggested that myofascial disorders in the highly innervated thoracolumbar fascia (TLF), reported in patients with LBP, may be an underlying cause of the ailment. Research also confirms that patients with LBP demonstrate poorer postural stability compared with individuals without the condition. Myofascial release techniques (MFR) are additional therapeutic options that complement existing therapies and help provide a more holistic treatment for chronic LBP (CLBP). OBJECTIVE Evaluation of changes in postural stability following one MFR intervention applied to CLBP subjects immediately after manual therapy and after a month. It was hypothesized that postural stability is going to aggravate immediately after the MFR intervention and improve one month after treatment compared with the baseline results before the treatment. METHODS 113 patients with CLBP participated in a randomized-controlled trial. The experimental group (n = 59) received one MFR intervention, whereas the control group (n = 54) did not receive any therapeutic intervention. Posturography was performed to determine experimental group's immediate response to the therapy and to evaluate the experimental and control groups' responses to the therapy one month after the intervention. RESULTS Only 2 out of 12 comparisons of stabilometric parameters demonstrated reliable effects that are in line with our research hypotheses. Even though both comparisons were observed for therapy outcomes within the experimental group, no reliable differences between the groups were found. CONCLUSIONS A single MFR treatment in the TLF did not affect postural stability in CLBP patients in the experimental group. Further studies are needed to extend the findings by performing a series of holistic MFR treatments applied to a larger area of the body surface that would induce more general tissue changes and thus having a greater impact on postural stability.
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Prather H, Fogarty AE, Cheng AL, Wahl G, Hong B, Hunt D. Feasibility of an intensive interprofessional lifestyle medicine program for patients with musculoskeletal conditions in the setting of lifestyle-related chronic disease. PM R 2023; 15:41-50. [PMID: 34713577 PMCID: PMC9046467 DOI: 10.1002/pmrj.12728] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Lifestyle factors are associated with musculoskeletal pain and metabolic chronic diseases. To date, intensive lifestyle medicine programs have predominantly targeted metabolic rather than musculoskeletal conditions. OBJECTIVE To assess the feasibility of an intensive interprofessional lifestyle medicine program for patients with musculoskeletal conditions. DESIGN Prospective observational feasibility study. SETTING Tertiary academic medical center. PATIENTS Adults diagnosed with musculoskeletal condition(s) and lifestyle-related chronic disease(s) who previously completed standard-of-care musculoskeletal treatments, enrolled from 2018 to 2020. INTERVENTIONS Patients enrolled in an intensive interprofessional lifestyle medicine program led by a physiatrist, with options to interface with an acupuncturist, dietician, massage therapist, psychologist, physical therapist, and smoking cessation specialist. The physiatrist engaged in shared decision making with patients to establish program goals related to function, overall health, and required lifestyle changes. Bimonthly interprofessional team conferences facilitated communication between treatment team and patients. MAIN OUTCOME MEASURES Feasibility was measured by patient participation and goal attainment. Secondary outcomes included changes from program enrollment to discharge in patient anthropometric, metabolic lab, sleep apnea risk, and Patient-Reported Outcomes Measurement Information System (PROMIS) function, pain, and behavioral health measures. RESULTS Twenty-six patients enrolled in the program (18 [69%] female, mean age 59 [SD 14.5] years, baseline hemoglobin A1c 6.0% [0.8%], high-sensitivity C-reactive protein 7.7 [12.1] mg/dL, 25-hydroxy vitamin D 32.0 [14.2] ng/mL). Of 21 (81%) patients who completed the program, 13/21 (62%) met their goal. On average, program completers presented for 26.2 (10.6) total visits over 191 (88) days. By discharge, program completers achieved clinically meaningful improvement in PROMIS Anxiety (mean difference -3.5 points, 95% confidence interval [-6.5 to 0.5], p = .035), whereas noncompleters did not (p > .05). CONCLUSIONS An intensive interprofessional lifestyle medicine program for patients with musculoskeletal conditions is feasible. With training in lifestyle intervention, physiatrists are well suited to lead interprofessional teams aimed at assisting patients in making lifestyle changes to achieve personalized function- and health-related goals.
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Affiliation(s)
- Heidi Prather
- Department of Physiatry, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
| | - Alexandra E Fogarty
- Department of Neurology, Division of Physical Medicine & Rehabilitation, St. Louis, Missouri, USA
| | - Abby L Cheng
- Departments of Orthopaedic Surgery and Neurology, Division of Physical Medicine and Rehabilitation; Department of Surgery, Division of Public Health Sciences, Chesterfield, Missouri, USA
| | - Garett Wahl
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Barry Hong
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Devyani Hunt
- Departments of Orthopaedic Surgery and Neurology, Division of Physical Medicine and Rehabilitation, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
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16
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Chitale N, Patil DS, Phansopkar P. Integrated Neuromuscular Inhibition Technique Versus Mulligan Mobilization on Functional Disability in Subjects With Nonspecific Low Back Pain: A Comparative Study. Cureus 2022; 14:e30253. [DOI: 10.7759/cureus.30253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
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Chen PC, Wei L, Huang CY, Chang FH, Lin YN. The Effect of Massage Force on Relieving Nonspecific Low Back Pain: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013191. [PMID: 36293771 PMCID: PMC9602448 DOI: 10.3390/ijerph192013191] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To investigate the effect of force applied during massage on relieving nonspecific low back pain (LBP). METHODS This single-blinded, randomized controlled trial enrolled 56 female patients with nonspecific LBP at a single medical center. For each participant, the therapist performed a 30 min massage session (20 min general massage and 10 min focal massage) using a special instrument with a force sensor inserted, for a total of six sessions in 3 weeks. During the 10 min focal massage, HF and LF groups received high force (HF, ≥2 kg) and low force (LF, ≤1 kg) massage, respectively. The primary outcome was pain intensity (i.e., visual analog scale (VAS), 0-10), and secondary outcomes comprised pain pressure threshold, trunk mobility, LBP-associated disability, and quality of life. RESULTS No significant between-group differences were observed in baseline characteristics. The HF group exhibited significantly lower VAS than did the LF group, with a mean difference of -1.33 points (95% CI: -2.17 to -0.5) at the end of the intervention, but no significant difference was noted at the end of the follow-up. A significant time effect (p < 0.05) was detected in all secondary outcomes except the pain pressure threshold and trunk mobility. A significant time × group interaction (p < 0.05) was found only for the VAS and pain pressure threshold. CONCLUSIONS Compared with LF massage, HF massage exerted superior effects on pain relief in female patients with nonspecific LBP at the end of intervention. Applying different levels of force showed no effects on LBP-associated disabilities and quality of life.
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Affiliation(s)
- Pei-Chun Chen
- Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei 110, Taiwan
| | - Li Wei
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei 110, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei 235, Taiwan
- Division of Neurosurgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
| | - Chung-Yu Huang
- Department of Traditional Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
| | - Feng-Hang Chang
- Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei 110, Taiwan
| | - Yen-Nung Lin
- Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei 110, Taiwan
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18
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Khan ZK, Ahmed SI, Baig AAM, Farooqui WA. Effect of post-isometric relaxation versus myofascial release therapy on pain, functional disability, rom and qol in the management of non-specific neck pain: a randomized controlled trial. BMC Musculoskelet Disord 2022; 23:567. [PMID: 35698187 PMCID: PMC9190112 DOI: 10.1186/s12891-022-05516-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 06/03/2022] [Indexed: 12/24/2022] Open
Abstract
Background Non-specific neck pain is the most prevailing musculoskeletal disorder which has a large socioeconomic burden worldwide. It is associated with poor posture and neck strain which may lead to pain and restricted mobility. Physical therapists treat such patients through several means. Post isometric relaxation and Myofascial release therapy are used in clinical practice with little evidence to be firmed appropriately. So, this study was conducted to explore the effect of Post-isometric relaxation in comparison to Myofascial release therapy for patients having non-specific neck pain. Methodology Sixty patients were randomly allocated to Post isometric group and the Myofascial group. The treatment period was of 2 weeks. All the patients were evaluated using the Visual analogue scale (VAS), Neck disability index (NDI), Universal Goniometer, and WHO BREF Quality of life-100 in the 1st and 6th sessions. Recorded data was entered on SPSS 21. Data were examined using two-way repeated ANOVA to measure the variance of analysis (group x time). Results Analysis of the baseline characteristics revealed that both groups were homogenous in terms of age and gender i.e. a total of 60 participants were included in this research study 30 in each group. Out of 60 patients, there were 20(33.3%) males and 40(66.7%) females with a mean age of 32.4(5.0) years. Participants in the Post Isometric group demonstrated significant improvements (p < 0.025) in VAS, NDI, Cervical Extension, left side rotation ranges, and QoL (Social Domain) at the 2-week follow-up compared with those in the Myofascial group. In addition, the Myofascial group indicated significantly better improvement in the mean score of CROM (flexion and right and left side bending). Conclusion The study demonstrated patients with nonspecific neck pain can benefit from the post isometric relaxation with significant improvement in pain, disability, cervical ROM, and Quality of life compared with myofascial release therapy. Trial registration Clinical Trial registered on clinicaltrial.gov (NCT number) NCT04638062, 20/11/2020 (prospectively registered).
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Affiliation(s)
- Zainab Khalid Khan
- Institute of Physical Medicine and Rehabilitation, Dow University of Health Sciences, Karachi, Pakistan.
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19
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Gans repositioning maneuver for the posterior canal BPPV patients: systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2022; 279:4241-4246. [PMID: 35460377 DOI: 10.1007/s00405-022-07396-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/06/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND OBJECTIVES BPPV (benign paroxysmal positional vertigo) is a syndrome marked by brief bouts of vertigo accompanied by rapid changes in head position. Recent ongoing therapeutic approaches used are vestibular rehabilitation exercises and physical maneuvers like the Epley maneuver, Semont maneuver. Gans repositioning maneuver (GRM) is a new hybrid maneuver, consisting of safe and comfortable series of postures that can be conveniently applied on patients with any spinal pathology or even in elderly. METHODS Randomized controlled/clinical trials of the Gans maneuver were identified. The proportion of patients who improved as a result of each intervention was assessed, as well as the conversion of a 'positive' Dix-Hallpike test to a 'negative' Dix-Hallpike test. RESULTS Improvement was seen in almost all patients with the Gans maneuver and the Epley Maneuver in three trials with the pooled estimate for random effect model is 1.12 [0.87; 1.43: 100%]. There were no significant side effects from the treatment. DISCUSSION This study shows that the Gans maneuver is a safe and effective treatment for patients suffering from posterior canal BPPV. TRIAL REGISTRATION The review is registered in Prospero with no. CRD42021234100.
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Sumariva-Mateos J, León-Valenzuela A, Vinolo-Gil MJ, Bautista Troncoso J, Del Pino Algarrada R, Carmona-Barrientos I. Efficacy of myofascial therapy and kinesitherapy in improving function in shoulder pathology with prolonged immobilization: A randomized, single-blind, controlled trial. Complement Ther Clin Pract 2022; 48:101580. [PMID: 35397306 DOI: 10.1016/j.ctcp.2022.101580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/22/2022] [Accepted: 04/01/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The best physiotherapeutic approach in shoulder pathology that generates prolonged immobilization is still uncertain. Kinesitherapy remains the most widely used option. Myofascial therapy is a therapeutic approach in which the aim is to release fascial tension and regain mobility although its efficacy in shoulder pathology has not been sufficiently studied. This Prospective, single-blind randomized controlled trial in a university hospital setting aimed to compare the efficacy of myofascial therapy and kinesitherapy in improving function in shoulder pathology with prolonged immobilization. METHODS Patients were randomly assigned to a control group or to the intervention group.Both groups completed a therapeutic exercise program. MAIN OUTCOME MEASURES The QuickDash questionnaire was the primary outcome, Pain Visual Analog Scale and the Range Of Motion of the shoulder were the secondary outcomes. The outcomes were evaluated at baseline (T0), at 4 (T2), 8 (T2), and 12 weeks (T3) RESULTS: 44 participants were included. In the analysis of evolution over time, a significant improvement in functionality and range of motion measurements was observed in both groups (p < 0.05), although at 12 weeks only Myofasical Group achieved a clinically and statistically significant reduction in pain. Comparative analysis at 12 weeks revealed no statistically significant differences between the two therapies in the variables explored. CONCLUSIONS Both, myofascial therapy and kinesitherapy can improve function, mobility, and pain in patients with painful shoulder associated with prolonged immobilization, with no significant differences between therapies, although in the medium term only myofascial therapy achieves a clinically and statistically significant improvement in pain. TRIAL REGISTRATION Trial registration: ClinicalTrials.gov NCT04944446.
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Affiliation(s)
| | - Angel León-Valenzuela
- Departamento Materno-Infantil, Facultad de Medicina, Universidad de Cádiz, Spain; Servicio de Rehabilitación, Hospital Puerta del Mar, Cádiz, Spain; Grupo de Investigación iRehab. Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain.
| | - María Jesús Vinolo-Gil
- Servicio de Rehabilitación, Hospital Puerto Real, Cádiz, Spain; Departamento de Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Cádiz. Spain
| | - Julián Bautista Troncoso
- Departamento Materno-Infantil, Facultad de Medicina, Universidad de Cádiz, Spain; Grupo de Investigación iRehab. Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - Rogelio Del Pino Algarrada
- Servicio de Rehabilitación, Hospital Puerto Real, Cádiz, Spain; Grupo de Investigación iRehab. Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - Inés Carmona-Barrientos
- Departamento de Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Cádiz. Spain
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21
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Bi R, Zhang Y, Liu X, Zhang S, Wang R, Liang B, Cui F. Research on the application of myofascial induction therapy in the rehabilitation of patients with acute facial palsy: A nonrandomized controlled trial. NeuroRehabilitation 2021; 50:143-149. [PMID: 34957958 DOI: 10.3233/nre-210204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In the healthy body, the fascial system maintains elasticity and coordination of movements. If these functions are destroyed, facial paraly appears. Myofascial induction therapy (MIT), a manual physical therapy method that focuses on restoring altered fascial tissue, is prevalently and widely used in clinical treatment. OBJECTIVE The study aimed to observe the application of MIT in the rehabilitation of patients with acute facial palsy. METHODS Sixty-eight patients with acute facial palsy were divided into control group and manual treatment group. The control group received drug treatments, such as prednisone, methylcobalamin, and vitamin B1, and instrumental physical therapy, such as semiconductor laser, shortwave therapy, and facial muscle training. In addition to these treatments, the manual treatment group received MIT. Both groups were treated for 4 weeks. The patients were assessed using the following methods: the House-Brackmann facial nerve function evaluation, Sunnybrook facial grading system, facial nerve electrophysiological examination compound muscle action potential (CMAP) amplitude, and blink reflex (BR) R1 latency. RESULTS House-Brackmann and Sunnybrook scores and CMAP amplitude and BRR1 latencies were significantly different between the two groups (p < 0.05). Furthermore, the manual treatment group showed greater improvement than the control group (p < 0.05). CONCLUSIONS Treatment with MIT promoted better recovery of acute facial palsy and thus may be considered a valid rehabilitation intervention that is worthy of clinical application.
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Affiliation(s)
- Ranran Bi
- Department of Rehabilitation, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Yahui Zhang
- Department of Rehabilitation, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Xiaochen Liu
- Department of Rehabilitation, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Shun Zhang
- Department of Rehabilitation, Shanghai Yangpu Hospital, Tongji University, Shanghai, China
| | - Rui Wang
- Department of Rehabilitation, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Bingyin Liang
- Department of Rehabilitation, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Fang Cui
- Department of Rehabilitation, Shanghai East Hospital, Tongji University, Shanghai, China
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22
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Brück K, Jacobi K, Schmidt T. Fascial treatment versus manual therapy (HVLA) in patients with chronic neck pain: A randomized controlled trial. J Back Musculoskelet Rehabil 2021; 34:997-1006. [PMID: 34092587 DOI: 10.3233/bmr-191731] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Chronic neck pain (CNP) is a common health problem in western industrialized nations. In recent years, the fascial tissue has attracted the attention of therapists, and a treatment of the fasciae promises to be a meaningful approach in the therapy of patients with CNP. OBJECTIVE The aim of this study was to investigate the effectiveness of a fascial treatment (FT) compared to manual therapy (MT) and to no intervention (control group, CG) in patients with CNP. METHODS Sixty participants with CNP were randomized into three groups. Primary outcome parameters were pain intensity as measured by the visual analogue scale (VAS), and severity of illness as measured by the Neck Pain and Disability Scale (NPAD). Secondary outcome parameter was the range of motion (ROM) of the cervical spine. RESULTS Repeated measures t-tests demonstrated significant decreases with medium to large effect sizes for the FT (VAS: dRM= 1.14; NPAD: dRM= 0.51) and for the MT (VAS: dRM= 1.15; NPAD: dRM= 0.72). CONCLUSION Our results confirmed the effectiveness of MT on pain and severity of illness in the treatment of patients suffering from CNP. Furthermore, the results demonstrated the effectiveness and clinical relevance of FT for this population.
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Affiliation(s)
- Katrin Brück
- Praxis für Osteopathie und Naturheilkunde, Geestland, Germany.,Praxis für Osteopathie und Naturheilkunde, Geestland, Germany
| | - Kirsten Jacobi
- Faszium GbR, Altenholz, Germany.,Praxis für Osteopathie und Naturheilkunde, Geestland, Germany
| | - Tobias Schmidt
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany.,Osteopathie-Schule Deutschland (OSD), Hamburg, Germany
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Manipulative therapy of sacral torsion versus myofascial release in patients clinically diagnosed posterior pelvic pain: a consort compliant randomized controlled trial. Spine J 2021; 21:1890-1899. [PMID: 33991702 DOI: 10.1016/j.spinee.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 04/29/2021] [Accepted: 05/01/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Chronic low back pain represents a health care problem with substantial costs. It is generally accepted that approximately 10% to 25% of patients with persistent chronic low back pain may have pain arising from the sacroiliac joints. PURPOSE This study aimed to analyze the effects of manipulative therapy of sacral torsion versus myofascial release on disability, pain intensity, and mobility in patients with chronic low back pain and sacroiliac joints. STUDY DESIGN/SETTING A prospective, single-blinded randomized clinical trial. PATIENT SAMPLE Sixty-four patients (mean±SD age: 51±9; 60% female) with chronic low back pain and sacroiliac joints comprised the patient sample. No participant withdrew because of adverse effects. OUTCOME MEASURES Self-reported disability (primary), pain intensity, scale of kinesiophobia, quality of life, isometric endurance of trunk flexor muscles, and lumbar mobility in flexion were assessed at baseline, pos-treatment, and one month follow-up. METHODS Participants were randomly assigned to a sacral torsion manipulation group or myofascial release group, receiving a total of 12 sessions (once weekly). RESULTS ANCOVA did not showed a statistically significant difference between groups for disability (95% CI -2.40-1.90, p=.177). Effect sizes were large in both groups at both follow-up periods. Similar results were achieved for all secondary outcomes (p˂. 05). The linear model longitudinal analyses showed significant improvements in both groups over time for all outcomes with the exception of fear of movement (manipulative: Minimum within-groups change score 1.91, p˂.001; myofascial: 1.66, p˂.001). CONCLUSION Manipulative and myofascial release therapy in patients with clinically diagnosed sacroiliac joints syndrome resulted in a similar short-term benefits on patient reported disability. Both groups experienced similar decrease in the intensity of pain over time, although no clinically meaningful effects were demonstrated in either group.
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Effects of myofascial release on flexibility and electromyographic activity of the lumbar erector spinae muscles in healthy individuals. J Bodyw Mov Ther 2021; 27:322-327. [PMID: 34391252 DOI: 10.1016/j.jbmt.2021.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 02/26/2021] [Accepted: 03/13/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the effects of myofascial release on the flexibility and electromyographic activity of the lumbar erector spinae muscle in healthy individuals. METHODS Ten healthy subjects were recruited to an intervention protocol of myofascial release techniques: (1) superficial myofascial release; (2) deep myofascial release apply along 10 sessions, twice a week, with 40 min per sessions. The outcomes evaluated were flexibility (Toe-Touch Test) and electromyography activity (EMG) of the lumbar erector spinae muscle (Iliocostalis and Longissimus bilaterally) during the movement of extension-flexion of the trunk. Paired t-test was used to compare the electromyographic outcomes, while the Wilcoxon test was used to compare the flexibility outcomes. RESULTS The myofascial release techniques increased the flexibility (p = 0.005; r = 0.88) and have no influence over the electromyographic activity of the right iliocostalis (p = 0.179; r = 0.43), right longissimus (p = 0.877; r = 0.05), left iliocostalis (p = 0.386; r = 0.29) and left longissimus (p = 0.418; r = 0.27). CONCLUSIONS The application of myofascial release techniques increase flexibility and did not influence over the electromyographic activity of the lumbar erector spinae muscles in healthy individuals. Further studies should include a larger sample with a sham group and/or compare EMG activity of the lumbar erector spinae muscles with patients with low back pain during the movement of extension-flexion of the trunk.
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Wu Z, Wang Y, Ye X, Chen Z, Zhou R, Ye Z, Huang J, Zhu Y, Chen G, Xu X. Myofascial Release for Chronic Low Back Pain: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:697986. [PMID: 34395477 PMCID: PMC8355621 DOI: 10.3389/fmed.2021.697986] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/05/2021] [Indexed: 01/04/2023] Open
Abstract
Background: Chronic low back pain (CLBP) is one of the most common musculoskeletal diseases in the elderly, which has a severe impact on the health of the elderly. However, CLBP treatment is very challenging, and more effective treatment methods are needed. Myofascial release may be an effective therapy for the management of chronic musculoskeletal pain. It is widely used clinically to treat CLBP, but its clinical efficacy is still controversial. Objective: This study aims to systematically evaluate the effectiveness of myofascial release for patients with CLBP. Methods: We selected PubMed, Cochrane Library, EMBASE database, and Web of Science database articles published until April 5, 2021. Randomized controlled trials (RCTs) of myofascial release for CLBP were included. Outcome measures included pain, physical function, quality of life, balance function, pain pressure-threshold, trunk mobility, and mental health. For each outcome, Standardized mean differences (SMD) or mean differences (MD) and 95% confidence intervals (CIs) were calculated. Results: Eight RCTs (n = 375) were included based on inclusion and exclusion criteria. The meta-analysis showed that the overall efficacy of myofascial release for CLBP was significant, including two aspects: pain [SMD = -0.37, 95% CI (-0.67, -0.08), I 2 = 46%, P = 0.01] and physical function [SMD = -0.43, 95% CI (-0.75, -0.12), I 2 = 44%, P = 0.007]. However, myofascial release did not significantly improve quality of life [SMD = 0.13, 95% CI (-0.38, 0.64), I 2 = 53%, P = 0.62], balance function [SMD = 0.58, 95% CI (-0.49, 1.64), I 2 = 82%, P = 0.29], pain pressure-threshold [SMD = 0.03,95% CI (-0.75, 0.69), I 2 = 73%, P = 0.93], trunk mobility [SMD = 1.02, 95% CI (-0.09, 2.13), I 2 = 92%, P = 0.07] and mental health [SMD = -0.06, 95% CI (-0.83, 0.71), I 2 = 73%, P = 0.88]. Conclusions: In this study, we systematically reviewed and quantified the efficacy of myofascial release in treating CLBP. The meta-analysis results showed that myofascial release significantly improved pain and physical function in patients with CLBP but had no significant effects on balance function, pain pressure-threshold, trunk mobility, mental health, and quality of life. However, due to the low quality and a small number of included literature, more and more rigorously designed RCTs should be included in the future to verify these conclusions.
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Affiliation(s)
- Zugui Wu
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Wang
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangling Ye
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zehua Chen
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Rui Zhou
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zixuan Ye
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinyou Huang
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Yue Zhu
- Baishui Health Center, Qujing, China
| | - Guocai Chen
- Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xuemeng Xu
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
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Cardoso R, Meneses RF, Lumini-Oliveira J, Pestana P. Myofascial Release Effects in Teachers' Posture, Muscle Tension and Voice Quality: A Randomized Controlled Trial. J Voice 2021:S0892-1997(21)00119-3. [PMID: 34024696 DOI: 10.1016/j.jvoice.2021.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/21/2021] [Accepted: 03/23/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Myofascial release (MFR) comprises a set of manual therapeutic techniques applied to many conditions, but specific evidence concerning its effects on body posture, muscle tension and voice has been lacking. Thus, the aim of this study was to verify the effects of MFR in teachers' posture, muscular tension and voice quality. STUDY DESIGN Randomized controlled trial - crossover. METHODS Twenty-four teachers, after completing a Sociodemographic and Clinical Questionnaire and providing written informed consent, were randomly distributed into two groups designated Group 1 (G1; n = 12; received MFR first) and Group 2 (G2; n = 12; belong to control group first). All participants received treatment and were into control group, since, after a 14 day period, procedures were switched between groups. Photogrammetry, muscle tension assessed through palpation, algometry, aerodynamic assessment of voice, acoustic and auditory-perceptual analysis of voice were performed before and after interventions. RESULTS Regarding voice, statistically significant differences were found when intervention was applied to both groups for maximum phonation time (MPT) (G1 P = 0.019; G2 P = 0.004). The acoustic variables did not differ. Concerning the auditory-perceptual analysis of voice statistically significant differences were found when intervention was applied in both groups for Grade in G2 (P = 0.046) and for Roughness in G1 (P = 0.025). Regarding the photogrammetry assessment statistically significant differences were found when intervention was applied to both groups in many parameters while as control group they did not. Concerning the algometry and muscle tension assessed through palpation statistically significant differences were found when intervention was applied in all muscles. CONCLUSIONS Findings indicated that MFR seems to be an effective therapy in improving MPT, two subscales (Grade and Roughness) of the GRABASH scale, muscle tension assessed through palpation and algometry. Regarding photogrammetry, MFR had an immediately effect in improvement of the posture, especially related with head.
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Affiliation(s)
- Ricardo Cardoso
- Fernando Pessoa University, Porto, Portugal; Transdisciplinary Center of Consciousness Studies of Fernando Pessoa University, Porto, Portugal.
| | - Rute F Meneses
- Fernando Pessoa University, Porto, Portugal; Transdisciplinary Center of Consciousness Studies of Fernando Pessoa University, Porto, Portugal; Longevity and Development Observatory of Fernando Pessoa University, Porto, Portugal
| | - José Lumini-Oliveira
- Fernando Pessoa University, Porto, Portugal; CIAFEL - Research Centre in Physical Activity, Health and Leisure, Porto University, Porto, Portugal; LABIOMEP - Porto Biomechanics Laboratory, Porto University, Porto
| | - Pedro Pestana
- Fernando Pessoa University, Porto, Portugal; PMP terapia, Esposende, Portugal
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Chen Z, Wu J, Wang X, Wu J, Ren Z. The effects of myofascial release technique for patients with low back pain: A systematic review and meta-analysis. Complement Ther Med 2021; 59:102737. [PMID: 33984499 DOI: 10.1016/j.ctim.2021.102737] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/06/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The purpose of this meta-analytic review was to quantitatively examine the effects of myofascial release technique (MFR) on pain intensity, back disability, lumbar range of motion, and quality of life in patients with low back pain (LBP). METHODS Potential articles were retrieved using five electronic databases (Web of Science, PubMed, Scopus, China National Knowledge Infrastructure, and Wanfang). The search period was from inception to January 27, 2021. Two researchers independently completed record retrieval and selection, data extraction, and methodological quality assessment. Randomized controlled trials (RCTs) assessing the effect of MFR on pain intensity, back disability, lumbar range of motion, and quality of life in LBP patients were included. Pooled effect sizes were calculated using random effects models and 95 % confidence interval (95 % CI). RESULTS Data from eight RCTs (386 patients with back pain) meeting the inclusion criteria were extracted for meta-analysis with methodological quality assessment scores ranging from 6 to 10. Compared to the control intervention, MFR induced significant decrease in back disability (SMD = -0.35, 95 % confidence interval [CI] = -0.68, -0.02, P = 0.04, I² = 46 %, n = 284). MFR induced non-significant decrease in the pain intensity (SMD = -0.12, 95 % confidence interval[CI] = -0.35, 0.11, P = 0.32, I² = 0%, n = 294), non-significant improvement in quality of life (SMD = -0.09, 95 % confidence interval [CI] = -0.46, 0.28, P = 0.62, I² = 0%, n = 114), and non-significant improvement in lumbar range of motion (Flexion SMD = 0.57,95 % confidence interval [CI] = -0.09, 1.24, P = 0.09, I² = 54 %, n = 80) (Extension SMD = 0.68, 95 % confidence interval[CI] = -0.72, 2.08, P = 0.34, I² = 89 %, n = 80) (Right flexion SMD = 0.05, 95 % confidence interval[CI] = -0.90, 0.99, P = 0.92, I² = 78 %, n = 80) (Left flexion SMD = 0.14, 95 % confidence interval[CI] = -0.59, 0.88, P = 0.70, I² = 64 %, n = 80). CONCLUSION The findings suggest that MFR can improve the effect of physical therapy alone and exercise therapy alone, and that MFR can be an effective adjuvant therapy. Meta-analysis showed that MFR has a significant effect on reducing back disability in patients with low back pain, but no significant effect on reducing pain intensity, improving quality of life, and improving lumbar range of motion.
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Affiliation(s)
- Ziyan Chen
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.
| | - Jinlong Wu
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.
| | - Xiaodong Wang
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.
| | - Jieqing Wu
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.
| | - Zhanbing Ren
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.
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Can a Single Trial of a Thoracolumbar Myofascial Release Technique Reduce Pain and Disability in Chronic Low Back Pain? A Randomized Balanced Crossover Study. J Clin Med 2021; 10:jcm10092006. [PMID: 34067152 PMCID: PMC8125255 DOI: 10.3390/jcm10092006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/25/2021] [Accepted: 04/30/2021] [Indexed: 01/14/2023] Open
Abstract
Although manual therapy for pain relief has been used as an adjunct in treatments for chronic low back pain (CLBP), there is still the belief that a single session of myofascial release would be effective. This study was a crossover clinical trial aimed to investigate whether a single session of a specific myofascial release technique reduces pain and disability in subjects with CLBP. 41 participants over 18 years old were randomly enrolled into 3 situations in a balanced and crossover manner: experimental, placebo, and control. The subjects underwent a single session of myofascial release on thoracolumbar fascia and the results were compared with the control and placebo groups. The outcomes, pain and functionality, were evaluated using the numerical pain rating scale (NPRS), pressure pain threshold (PPT), and Oswestry Disability Index (ODI). There were no effects between-tests, within-tests, nor for interaction of all the outcomes, i.e., NPRS (η 2 = 0.32, F = 0.48, p = 0.61), PPT (η2 = 0.73, F = 2.80, p = 0.06), ODI (η2 = 0.02, F = 0.02, p = 0.97). A single trial of a thoracolumbar myofascial release technique was not enough to reduce pain intensity and disability in subjects with CLBP.
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29
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Bhat P V, Patel VD, Eapen C, Shenoy M, Milanese S. Myofascial release versus Mulligan sustained natural apophyseal glides' immediate and short-term effects on pain, function, and mobility in non-specific low back pain. PeerJ 2021; 9:e10706. [PMID: 33777508 PMCID: PMC7971081 DOI: 10.7717/peerj.10706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/14/2020] [Indexed: 11/20/2022] Open
Abstract
Background Myofascial release (MFR) and Mulligan Sustained Natural Apophyseal Glides (SNAGs) are manual therapy techniques routinely practiced in the management of non-specific low back pain (NSLBP). As a solo intervention or along with other therapies, both methods have reported positive results for individuals with NSLBP. However, which technique improves NSLBP-related pain, restricted range of motion (ROM) and disability, warrants further research. Objective To study the comparative effects of MFR and SNAGs on pain, disability, functional ability, and lumbar ROM in NSLBP. Method A parallel-group study was conducted at tertiary care hospitals. Sixty-five Sub-acute or chronic NSLBP patients were allocated to receive strengthening exercises along with either MFR (n = 33) or SNAGs (n = 32) for six treatment sessions over one week. An independent assessor evaluated outcome measures such as the Visual Analog Scale (VAS), Patient-Specific Function Scale (PSFS), and ROM at baseline, immediate (after 1st treatment), and short-term (post-sixth day of the intervention). The Modified Oswestry disability index (MODI) was assessed at baseline and short-term. Results Within-group analysis found clinically and statistically significant (p < 0.05) changes for VAS and PSFS at immediate and short-term for both the groups. The lumbar extension also showed improvement immediately and in the short-term. Improvement in Lumbar flexion was seen only in the SNAGs group over the short-term. A statistically significant improvement was seen for MODI in both the groups but was not clinically significant in the MFR group. The analysis observed no statistically significant difference (p < 0.05) between the groups at both the immediate and short-term. Conclusions Pain and restricted function associated with NSLBP can be improved using SNAGs or MFR, along with strengthening exercises. For limited lumbar flexion ROM, Mulligan SNAGs have a better outcome than MFR over the short-term. Hence, both manual therapy techniques can be incorporated along with exercises for immediate and short-term management of sub-acute to chronic NSLBP. Clinical Trial Registration. CTRI/2018/12/016787 (http://ctri.nic.in/Clinicaltrials/).
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Affiliation(s)
- Vignesh Bhat P
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India
| | - Vivek Dineshbhai Patel
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India
| | - Charu Eapen
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India
| | - Manisha Shenoy
- Department of Physical Therapy, Hamad Medical Corporation, Doha, Qatar
| | - Steve Milanese
- International Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, Australia
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Bellido-Fernández L, Jiménez-Rejano JJ, Chillón-Martínez R, Lorenzo-Muñoz A, Pinero-Pinto E, Rebollo-Salas M. Clinical relevance of massage therapy and abdominal hypopressive gymnastics on chronic nonspecific low back pain: a randomized controlled trial. Disabil Rehabil 2021; 44:4233-4240. [PMID: 33587856 DOI: 10.1080/09638288.2021.1884903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To determine the clinical relevance of the effects that Massage-Therapy (MT) and Abdominal-Hypopressive-Gymnastics (AHG) and the combination of both procedures have on the disability, pain intensity, quality of life, and lumbar mobility of patients with chronic nonspecific low back pain (CNSLBP). METHODS A randomized controlled-trial with parallel-groups, concealed allocation, assessor blinding, and intention-to-treat analysis was carried out. The sample included 60 adults with CNSLBP. The participants received MT (n = 20), AHG (n = 20), or MT + AHG (n = 20). Each group received 8 interventions. RESULTS The ODI change scores were significantly higher (p < 0.05) in the MT + AHG group than in the other two groups. Significant differences were found in the results of NRS, Schober's test, and SF-12 PCS (p < 0.05) in each group. There were significant differences (p < 0.05) between the values of SF-12 MCS in AHG and MT + AHG groups. CONCLUSIONS Massage Therapy and Abdominal Hypopressive Gymnastics reduce pain levels, increase the mobility of the lumbar spine, and improve disability and quality of life (PCS) in patients with CNSLBP in the short term. Likewise, AHG and MT + AHG improve quality of life (MCS). The combination of both therapies provides more benefits in terms of lumbar disability in patients with CNSLBP in the short term. This improvement is clinically relevant. TRIAL REGISTRATION ClinicalTrials.gov (NCT02721914). IMPLICATIONS FOR REHABILITATIONMassage Therapy (MT) and Abdominal Hypopressive Gymnastics (AHG), reduce pain, improve mobility and quality of life, and reduce disability in the short term.These results are clinically relevant.The combination of manual and active therapy (MT + AHG) seems to be more effective and produces clinically relevant changes.
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França MED, Sinhorim L, Martins DF, Schleip R, Machado-Pereira NAMM, de Souza GM, Horewicz VV, Santos GM. Manipulation of the Fascial System Applied During Acute Inflammation of the Connective Tissue of the Thoracolumbar Region Affects Transforming Growth Factor-β1 and Interleukin-4 Levels: Experimental Study in Mice. Front Physiol 2020; 11:587373. [PMID: 33424619 PMCID: PMC7793886 DOI: 10.3389/fphys.2020.587373] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/29/2020] [Indexed: 12/27/2022] Open
Abstract
Fascia can become rigid and assume a fibrotic pattern due to inflammatory processes. Manipulation of the fascial system (MFS), manual technique targeting connective tissues, is commonly used in clinical practice in pain management. We aimed to verify MFS effects on the connective tissue inflammatory changes in mice. Swiss Mus musculus male mice (n = 44) were distributed into groups: carrageenan without treatment (Car, n = 11), carrageenan with MFS (Car + MFS, n = 12), saline without treatment (n = 10), and saline with MFS (saline + MFS, n = 11). Interleukin 4 (IL-4), IL-6, tumor necrosis factor (TNF), transforming growth factor β1 (TGF-β1), and monocyte chemoattractant protein 1 (MCP-1) levels were verified by enzyme-linked immunosorbent assay. Neutrophil (Ly-6G), macrophage (F4/80), and nitric oxide synthase 2 (NOS-2) were identified using Western blot. The MFS protocol was applied from the first to the third day after inflammation of the connective tissue of the thoracolumbar region. There was a significant MFS effect on IL-4 (p = 0.02) and TGF-β1 (p = 0.04), without increasing MCP-1, TNF, and IL-6 levels (p > 0.05) on thoracolumbar region from Car + MFS, in comparison with saline. Ly-6G in Car + MFS presented lower levels when compared with saline (p = 0.003) or saline + MFS (0.003). NOS-2 levels were lower in Car + MFS than in saline + MFS (p = 0.0195) or saline (p = 0.003). MFS may have an anti-inflammatory effect, based on TGF-β1 and IL-4. IL-4 may have inhibited neutrophil migration. Lower levels of NOS-2 may be linked to the lack of macrophages, which are responsible for NOS-2 expression.
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Affiliation(s)
- Maria Elisa Duarte França
- Posture and Balance Laboratory (LAPEQ), College of Health Sciences and Sports, Santa Catarina State University (UDESC), Florianópolis, Brazil
| | - Larissa Sinhorim
- Posture and Balance Laboratory (LAPEQ), College of Health Sciences and Sports, Santa Catarina State University (UDESC), Florianópolis, Brazil.,Neurosciences Experimental Laboratory (LANEX), Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina, Palhoça, Brazil
| | - Daniel Fernandes Martins
- Neurosciences Experimental Laboratory (LANEX), Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina, Palhoça, Brazil
| | - Robert Schleip
- Department of Sport and Health Sciences, Associate Professorship of Conservative and Rehabilitative Orthopedics, Technical University of Munich, Munich, Germany.,Department for Medical Professions, DIPLOMA Hochschule Bad Sooden-Allendorf, Bad Sooden-Allendorf, Germany
| | - Nicolas A M M Machado-Pereira
- Posture and Balance Laboratory (LAPEQ), College of Health Sciences and Sports, Santa Catarina State University (UDESC), Florianópolis, Brazil
| | - Gabriel Melo de Souza
- Posture and Balance Laboratory (LAPEQ), College of Health Sciences and Sports, Santa Catarina State University (UDESC), Florianópolis, Brazil
| | - Verônica Vargas Horewicz
- Neurosciences Experimental Laboratory (LANEX), Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina, Palhoça, Brazil
| | - Gilmar Moraes Santos
- Posture and Balance Laboratory (LAPEQ), College of Health Sciences and Sports, Santa Catarina State University (UDESC), Florianópolis, Brazil
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França MED, Sinhorim L, Martins DF, Schleip R, Machado-Pereira NAMM, de Souza GM, Horewicz VV, Santos GM. Manipulation of the Fascial System Applied During Acute Inflammation of the Connective Tissue of the Thoracolumbar Region Affects Transforming Growth Factor-β1 and Interleukin-4 Levels: Experimental Study in Mice. Front Physiol 2020. [DOI: 10.58737310.3389/fphys.2020.587373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Fascia can become rigid and assume a fibrotic pattern due to inflammatory processes. Manipulation of the fascial system (MFS), manual technique targeting connective tissues, is commonly used in clinical practice in pain management. We aimed to verify MFS effects on the connective tissue inflammatory changes in mice. Swiss Mus musculus male mice (n = 44) were distributed into groups: carrageenan without treatment (Car, n = 11), carrageenan with MFS (Car + MFS, n = 12), saline without treatment (n = 10), and saline with MFS (saline + MFS, n = 11). Interleukin 4 (IL-4), IL-6, tumor necrosis factor (TNF), transforming growth factor β1 (TGF-β1), and monocyte chemoattractant protein 1 (MCP-1) levels were verified by enzyme-linked immunosorbent assay. Neutrophil (Ly-6G), macrophage (F4/80), and nitric oxide synthase 2 (NOS-2) were identified using Western blot. The MFS protocol was applied from the first to the third day after inflammation of the connective tissue of the thoracolumbar region. There was a significant MFS effect on IL-4 (p = 0.02) and TGF-β1 (p = 0.04), without increasing MCP-1, TNF, and IL-6 levels (p > 0.05) on thoracolumbar region from Car + MFS, in comparison with saline. Ly-6G in Car + MFS presented lower levels when compared with saline (p = 0.003) or saline + MFS (0.003). NOS-2 levels were lower in Car + MFS than in saline + MFS (p = 0.0195) or saline (p = 0.003). MFS may have an anti-inflammatory effect, based on TGF-β1 and IL-4. IL-4 may have inhibited neutrophil migration. Lower levels of NOS-2 may be linked to the lack of macrophages, which are responsible for NOS-2 expression.
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Dal Farra F, Risio RG, Vismara L, Bergna A. Effectiveness of osteopathic interventions in chronic non-specific low back pain: A systematic review and meta-analysis. Complement Ther Med 2020; 56:102616. [PMID: 33197571 DOI: 10.1016/j.ctim.2020.102616] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Chronic low back pain (CLBP) is a frequent cause of disability and it represents a medical, social and economic burden globally. Therefore, we assessed effectiveness of osteopathic interventions in the management of NS-CLBP for pain and functional status. METHODS A systematic review and meta-analysis were conducted. Findings were reported following the PRISMA statement. Six databases were searched for RCTs. Studies were independently assessed using a standardized form. Each article was assessed using the Cochrane risk of bias (RoB) tool. Effect size (ES) were calculated at post-treatment and at 12 weeks' follow up. We used GRADE to assess quality of evidence. RESULTS 10 articles were included. Studies investigated osteopathic manipulative treatment (OMT, n = 6), myofascial release (MFR, n = 2), craniosacral treatment (CST, n = 1) and osteopathic visceral manipulation (OVM, n = 1). None of the study was completely judged at low RoB. Osteopathy revealed to be more effective than control interventions in pain reduction (ES: -0.59; 95% CI: -0.81, -0.36; P < 0.00,001) and in improving functional status (ES: -0.42; 95% 95% CI: -0.68, -0.15; P = 0.002). Moderate-quality evidence suggested that MFR is more effective than control treatments in pain reduction (ES: -0.69; 95% CI: -1.05, -0.33; P = 0.0002), even at follow-up (ES: -0.73; 95% CI: -1.09, -0.37; P < 0.0001). Low-quality evidence suggested superiority of OMT in pain reduction (ES: -0.57; 95% CI: -0.90, -0.25; P = 0.001) and in changing functional status (ES: -0.34; 95% CI: -0.65, -0.03; P = 0.001). Very low-quality evidence suggested that MFR is more effective than control interventions in functional improvements (ES: -0.73; 95% CI: -1.25, -0.21; P = 0.006). CONCLUSION Results strengthen evidence that osteopathy is effective in pain levels and functional status improvements in NS-CLBP patients. MFR reported better level of evidence for pain reduction if compared to other interventions. Further high-quality RCTs, comparing different osteopathic modalities, are recommended to produce better-quality evidence.
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Affiliation(s)
- Fulvio Dal Farra
- SOMA - Istituto Osteopatia Milano, Viale Sarca 336 F, 20126 Milan, Italy.
| | | | - Luca Vismara
- SOMA - Istituto Osteopatia Milano, Viale Sarca 336 F, 20126 Milan, Italy; Division of Neurology and Neurorehabilitation, IRCCS Institute Auxologico Italiano 28824, Piancavallo-Verbania, Italy; Department of Neurosciences "Rita Levi Montalcini", University of Torino, 10126 Torino, Italy.
| | - Andrea Bergna
- SOMA - Istituto Osteopatia Milano, Viale Sarca 336 F, 20126 Milan, Italy.
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Effect of Adding Neural Mobilization Versus Myofascial Release to Stabilization Exercises after Lumbar Spine Fusion: A Randomized Controlled Trial. Arch Phys Med Rehabil 2020; 102:251-260. [PMID: 32827553 DOI: 10.1016/j.apmr.2020.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 07/16/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To test the effect of adding neural mobilization (NM) versus myofascial release (MFR) to stabilization exercises (SE) on disability, pain, and lumbar range of motion (ROM) in patients with lumbar spine fusion (LSF). DESIGN A single blinded, parallel groups, randomized controlled trial. SETTING Outpatient public and governmental hospital clinics. PARTICIPANTS Patients (N=60) who had undergone LSF were randomly assigned into 3 equal groups. INTERVENTION Group I received NM plus SE, group II received MFR and SE, and group III received SE only. Each group visited the hospital 3 times a week for 4 weeks. MAIN OUTCOME MEASURES Oswestry disability index (ODI), visual analog scale, and back range of motion (BROM) were assessed before starting treatment, immediately after finishing treatment, and 1 month later. RESULTS There were statistically significant differences among the groups regarding the ODI and pain (P<.05) in favor of the study groups, but no statistically significant differences were found among groups regarding the BROM outcome (P>.05). Regarding the within-group effect, statistically significant differences were found in all outcomes after 1 month of treatment, as well as after 1 month of follow-up in each group (P<.05). CONCLUSIONS Patients who received NM or MFR combined with SE demonstrated better improvement, in favor of the NM group, regarding disability and pain than patients who received SE alone after LSF. No differences were found among the groups regarding lumbar ROM.
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Creighton A, Stecco A, Whitelaw A, Probst D, Hunt D. Fascial Manipulation method as a treatment for pain, atrophy and skin depigmentation after pes anserine bursa corticosteroid injection: A case report. J Bodyw Mov Ther 2020; 24:280-285. [PMID: 33218523 DOI: 10.1016/j.jbmt.2020.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/07/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Andrew Creighton
- Department of Physical Medicine and Rehabilitation, Hospital for Special Surgery, New York City, NY, USA
| | - Antonio Stecco
- Rusk Rehabilitation, New York University School of Medicine, New York City, NY, USA
| | - Amy Whitelaw
- Sports Therapy and Rehabilitation (STAR), Barnes Jewish West County Hospital, St. Louis, MO, USA
| | - Daniel Probst
- Division of Neurorehabilitation, Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Devyani Hunt
- Washington University School of Medicine, Departments of Orthopaedic Surgery and Neurology, Division of Physical Medicine and Rehabilitation, 660 S. Euclid Ave., Campus Box 8233, St. Louis, MO, USA.
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Abstract
PURPOSE OF REVIEW Myofascial pain syndrome (MPS) is a musculoskeletal pain condition that stems from localized, taut regions of skeletal muscle and fascia, termed trigger points. The purpose of this comprehensive review is to provide updated information on prevalence, pathophysiology, and treatment modalities with a focus on interventional modalities in managing MPS. RECENT FINDINGS Though MPS can present acutely, it frequently presents as a chronic condition, affecting up to 85% of adults during their lifetime. MPS is an often-overlooked component of pain with overarching effects on society, including patient quality of life, physical and social functioning, emotional well-being, energy, and costs on health care. The prevalence of MPS is generally increased among patients with other chronic pain disorders and has been associated with various other conditions such as bladder pain syndrome, endometriosis, and anxiety. MPS is poorly understood and remains a challenging condition to treat. Non-pharmacologic treatment modalities such as acupuncture, massage, transcutaneous electrical stimulation, and interferential current therapy may offer relief to some patients with MPS. Additional studies are warranted to get a better understanding of managing myofascial pain.
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Pérez-Llanes R, Meroño-Gallut J, Donoso-Úbeda E, López-Pina J, Cuesta-Barriuso R. Safety and effectiveness of fascial therapy in the treatment of adult patients with hemophilic elbow arthropathy: a pilot study. Physiother Theory Pract 2020; 38:276-285. [PMID: 32223585 DOI: 10.1080/09593985.2020.1744207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Hemophilic arthropathy is characterized by loss of function and chronic pain. Fascial therapy mobilizes the connective tissue and is thus involved in the condition of the injured fascial complex and the surrounding tissues.Objective: To evaluate the safety of a physiotherapy program using fascial therapy in patients with hemophilic elbow arthropathy.Methods: Fourteen adult patients with hemophilia were randomly assigned to a control group and an intervention group. The intervention consisted of three 45-min sessions of fascial therapy over a 3-week period. Assessment was carried out at baseline, after treatment, and at follow-up. The study variables were bleeding frequency using a self-registration of bleeding; joint pain using the visual analog scale; range of motion with a universal goniometer; and joint status assessed with Hemophilia Joint Health Score.Results: None of the patients developed joint bleeding during the experimental period. Joint pain in the experimental group decreased by 1.43 out of 2.43 (95% CI 0.52 to 2.33) and 2.14 out of 2.57 (95% CI 0.18 to 4.10) in right and left elbow, respectively, more than the control group by 3 weeks. Flexion increased by 3.57 degrees out of 129.14 (95% CI 5.48 to 1.65) in right elbow and joint condition improved by 1.14 points out of 6.0 (95% CI 0.01 to 2.26) more than the control group by 3 weeks.Conclusion: Fascial therapy does not appear to produce elbow hemarthrosis in patients with hemophilia. This treatment can improve joint pain, range of motion, and elbow status in patients with hemophilia.
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Affiliation(s)
- Raúl Pérez-Llanes
- Department of Physiotherapy, Catholic University San Antonio-UCAM, Murcia, Spain
| | | | | | - José López-Pina
- Department of Basic Phycology and Methodology, University of Murcia, Murcia, Spain
| | - Rubén Cuesta-Barriuso
- Department of Physiotherapy, European University of Madrid, Madrid, Spain.,Real Fundación Victoria Eugenia, Instituto De Salud Carlos III, Madrid, Spain.,Fishemo CEE, Spanish Federation Oh Hemophilia, Madrid, Spain
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Bitenc-Jasiejko A, Konior K, Lietz-Kijak D. Meta-Analysis of Integrated Therapeutic Methods in Noninvasive Lower Back Pain Therapy (LBP): The Role of Interdisciplinary Functional Diagnostics. Pain Res Manag 2020; 2020:3967414. [PMID: 32256908 PMCID: PMC7109562 DOI: 10.1155/2020/3967414] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/07/2020] [Indexed: 12/12/2022]
Abstract
Introduction. Lower back pain (LBP) is almost a problem of civilizations. Quite often, it is a consequence of many years of disturbed distribution of tension within the human body caused by local conditions (injuries, hernias, stenoses, spondylolisthesis, cancer, etc.), global factors (postural defects, structural integration disorders, lifestyle, type of activity, etc.), or systemic diseases (connective tissue, inflammation, tumours, abdominal aneurysm, and kidney diseases, including urolithiasis, endometriosis, and prostatitis). Therefore, LBP rehabilitation requires the use of integrated therapeutic methods, combining the competences of interdisciplinary teams, both in the process of diagnosis and treatment. Aim of the Study. Given the above, the authors of the article conducted meta-analysis of the literature in terms of integrated therapeutic methods, indicating the techniques focused on a holistic approach to the patient. The aim of the article is to provide the reader with comprehensive knowledge about treating LBP using noninterventional methods. Material and Methods. An extensive search for the materials was conducted online using PubMed, the Cochrane database, and Embase. The most common noninterventional methods have been described, as well as the most relevantly updated and previously referenced treatment of LBP. The authors also proposed noninvasive (measurable) diagnostic procedures for the functional assessment of the musculoskeletal system, including initial, systematic, and cross-sectional control. All figures and images have been prepared by the authors and are their property. Results This review article goes beyond combining a detailed description of each procedure with full references, as well as a comprehensive discussion of this very complex and troublesome problem. Conclusions Lower back pain is a serious health problem, and this review article will help educate physicians and physiotherapists dealing with LBP in the options of evidence-based treatment. Ultimately, the article introduces and postulates the need to systematize therapeutic procedures in LBP therapy, with a long-term perspective.
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Affiliation(s)
- Aleksandra Bitenc-Jasiejko
- Department of Propedeutics, Physical Diagnostics and Dental Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | | | - Danuta Lietz-Kijak
- Department of Propedeutics, Physical Diagnostics and Dental Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland
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Gaowgzeh RAM. Low back pain among nursing professionals in Jeddah, Saudi Arabia: Prevalence and risk factors. J Back Musculoskelet Rehabil 2019; 32:555-560. [PMID: 30530963 DOI: 10.3233/bmr-181218] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Lower back pain (LBP) is often work-related and is commonly observed among nurses. LBP occurs below the 12th rib and above the gluteal fold. In nurses, back disorders are mainly associated with heavy physical activity, such as lifting and moving patients. OBJECTIVE The aim of the presented work is to evaluate the prevalence, risk factors, and associations of personal characteristics, general health status, and physical load with complaints of LBP. METHODS In this study, sixty nurses were randomly chosen to answer self-administered questionnaires. The results were analyzed using the SPSS system. RESULTS An incidence rate of 61.7% for LBP among nurses was noticed. Among the sites of injury, LBP predominated with a rate of 51.2%. Severity of injury mostly ranged between mild to moderate levels of severity, and 20% of the nurses with LBP were working in obstetrics and gynecology units. Our study also showed that 66.7% of the participating nurses had experienced LBP only after taking on nursing jobs. CONCLUSIONS The present study demonstrated that nurses working in Jeddah exhibit a high prevalence of lower back pain. In order to reduce the risk of work-related musculoskeletal disorders among nurses, the physical therapist's role is vital and nurses' practice of relaxation and stretching exercises in between work schedules is mandatory.
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Boff TA, Pasinato F, Ben ÂJ, Bosmans JE, van Tulder M, Carregaro RL. Effectiveness of spinal manipulation and myofascial release compared with spinal manipulation alone on health-related outcomes in individuals with non-specific low back pain: randomized controlled trial. Physiotherapy 2019; 107:71-80. [PMID: 32026838 DOI: 10.1016/j.physio.2019.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To investigate the effectiveness of spinal manipulation combined with myofascial release compared with spinal manipulation alone, in individuals with chronic non-specific low back pain (CNLBP). DESIGN Randomized controlled trial with three months follow-up. SETTING Rehabilitation clinic. PARTICIPANTS Seventy-two individuals (between 18 and 50 years of age; CNLBP ≥12 consecutive weeks) were enrolled and randomly allocated to one of two groups: (1) Spinal manipulation and myofascial release - SMMRG; n=36) or (2) Spinal manipulation alone (SMG; n=36). INTERVENTIONS Combined spinal manipulation (characterized by high velocity/low amplitude thrusts) of the sacroiliac and lumbar spine and myofascial release of lumbar and sacroiliac muscles vs manipulation of the sacroiliac and lumbar spine alone, twice a week, for three weeks. MAIN OUTCOME MEASURES Assessments were performed at baseline, three weeks post intervention and three months follow-up. Primary outcomes were pain intensity and disability. Secondary outcomes were quality of life, pressure pain-threshold and dynamic balance. RESULTS No significant differences were found between SMMRG vs SMG in pain intensity and disability post intervention and at follow-up. We found an overall significant difference between-groups for CNLBP disability (SMG-SMMRG: mean difference of 5.0; 95% confidence interval of difference 9.9; -0.1), though this effect was not clinically important and was not sustained at follow-up. CONCLUSIONS We demonstrated that spinal manipulation combined with myofascial release was not more effective compared to spinal manipulation alone for patients with CNLBP. CLINICAL TRIAL REGISTRATION NUMBER NCT03113292.
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Affiliation(s)
- Taise Angeli Boff
- Master in Rehabilitation Sciences, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil; Núcleo de Evidências e Tecnologias em Saúde (NETecS), Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil
| | - Fernanda Pasinato
- Núcleo de Evidências e Tecnologias em Saúde (NETecS), Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil; School of Physical Therapy, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil
| | - Ângela Jornada Ben
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, The Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, The Netherlands
| | - Maurits van Tulder
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, The Netherlands; Department Physiotherapy & Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Rodrigo Luiz Carregaro
- Master in Rehabilitation Sciences, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil; Núcleo de Evidências e Tecnologias em Saúde (NETecS), Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil; School of Physical Therapy, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil.
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Rajamani P, Shewade HD, Kundu D, Sekaran KK, Amalan SD, Pugazhendi S, Pugazhendi K. Completion Rates and Clinical Changes of Patients Seeking Non-Invasive Treatment for Low Back Pain in 13 Centres of a Sports Medicine Institute in India. Complement Med Res 2019; 27:89-96. [PMID: 31722360 DOI: 10.1159/000504015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 10/04/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIM Low back pain (LBP) is the major cause of disability worldwide. The existing treatments are expensive and associated with complications. The present study aimed to determine the proportion of patients completing therapy and rehabilitation phases and describe the changes in self-reported symptoms and functional disability among LBP patients enrolled in a private sports medicine institute. METHODS This is a cohort study involving review of case records. We studied 2 phases out of 3 of non-invasive treatment of LBP: therapy of around 10 days (myofascial trigger point release therapy, cryotherapy, aqua therapy and acupuncture) and rehabilitation of around 3 weeks (muscle strengthening exercises). RESULTS A total of 443 patients were enrolled; their mean (SD) age was 46 (15) years, 46% were male, and 193 (44%) presented with chronic (>6 months) pain. The numbers of patients who completed the therapy and rehabilitation phases were 327 (74%) and 115 (26%), respectively. The median (IQR) visual analogue scale pain scores were 7 (6-9) at entry, 2 (1-3) at completion of therapy and 1 (0-2) at completion of rehabilitation (p < 0.001). The median (IQR) functional disability scores were 32 (22-53) at entry, 15 (6-26) at completion of therapy and 4 (0-14) at completion of rehabilitation (p < 0.001). CONCLUSION Low completion rates were observed. Patients who completed therapy reported reduction in pain and improved functionalities.
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Affiliation(s)
- Priyadarshini Rajamani
- Sports Performance Assessment Research Rehabilitation Counselling (SPARRC) Institute, Indian Institute of Sports Medicine, Chennai, India,
| | - Hemant Deepak Shewade
- International Union Against Tuberculosis and Lung Disease (The Union), South East Asia Office, New Delhi, India.,International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - Debashish Kundu
- International Union Against Tuberculosis and Lung Disease (The Union), South East Asia Office, New Delhi, India
| | - Kishore Kumar Sekaran
- Sports Performance Assessment Research Rehabilitation Counselling (SPARRC) Institute, Indian Institute of Sports Medicine, Chennai, India
| | - Santhanam Daniel Amalan
- Sports Performance Assessment Research Rehabilitation Counselling (SPARRC) Institute, Indian Institute of Sports Medicine, Chennai, India
| | - Sujatha Pugazhendi
- Sports Performance Assessment Research Rehabilitation Counselling (SPARRC) Institute, Indian Institute of Sports Medicine, Chennai, India
| | - Kannan Pugazhendi
- Sports Performance Assessment Research Rehabilitation Counselling (SPARRC) Institute, Indian Institute of Sports Medicine, Chennai, India
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Abstract
Surgeons face hazardous working conditions due to ergonomic deficiencies found throughout the operating room. More than 80% of surgeons have succumbed to a work-related injury or illness as a consequence of sustaining awkward or static positions throughout lengthy operations over a career. While the focus of the procedure is directed to the patient, there is little concurrent regard for proper posture or spinal stability. Even when symptoms of discomfort are experienced, they are often ignored. This results in decreased production and may ultimately threaten surgical careers. Surgeons are often unaware of recommendations or guidelines designed to improve their comfort while operating. Furthermore, there is a significant lack of any formal ergonomic education, especially for minimally invasive procedures. Several modifiable risk factors can be adjusted in the operating room to provide a safer working environment. In addition, strengthening, stability, and exercise programs directed by a trained therapist may be employed to improve the surgeon's musculoskeletal health.
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Affiliation(s)
| | - Justin A Maykel
- Division of Colon and Rectal Surgery, University of Massachusetts Memorial Medical Center, Worcester, Massachusetts
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Casato G, Stecco C, Busin R. Role of fasciae in nonspecific low back pain. Eur J Transl Myol 2019; 29:8330. [PMID: 31579477 PMCID: PMC6767839 DOI: 10.4081/ejtm.2019.8330] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 07/03/2019] [Indexed: 11/30/2022] Open
Abstract
More and more evidences show how the thoracolumbar fascia is involved with nonspecific low back pain. Additionally, recent studies about anatomy have shown the presence of a continuity between the thoracolumbar fascia and the deep fascia of the limbs; but actually, a dysfunction of just the thoracolumbar fascia or of the tightly contiguous myofascial tissue is generally recognized as possible cause of nonspecific low back pain. Five patients among those affected by nonspecific low back pain were manipulated just on those fascial spots that were painful, when palpated, and located in other areas of the body than the low back one. Each patient reported a clinically significant reduction of the painful symptoms (a Pain Numerical Rating Scale score difference ≥ 2) straight after the manipulation. A dysfunction of the myofascial tissue that is not tightly contiguous with the symptomatic area is then suggested to be taken into consideration among the causes of nonspecific low back-pain.
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Affiliation(s)
| | - Carla Stecco
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Padova, Italy
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Kobayashi D, Shimbo T, Hayashi H, Takahashi O. Shiatsu for chronic lower back pain: Randomized controlled study. Complement Ther Med 2019; 45:33-37. [PMID: 31331579 DOI: 10.1016/j.ctim.2019.05.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/16/2019] [Accepted: 05/15/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although Shiatsu, a kind of complementary alternative medicine, was developed in Japan and is practiced around the world, no experimental studies on Shiatsu have been conducted. The aim of this study is to investigate the efficacy of Shiatsu therapy for chronic lower back pain. METHOD We conducted a prospective, randomized, open, blinded-endpoint design study at St. Luke's International Hospital, Tokyo, Japan from 2015 to 2017. Patients with lower back pain for more than 12 weeks and a score of four or more on the Roland-Morris Disability Questionnaire (RMDQ) at baseline were included in this study. We excluded patients with severe conditions, such as bone metastasis, or dementia. Patients were randomly allocated to either Shiatsu therapy in addition to standard care or standard care only by computer randomization. Those allocated to Shiatsu received one-hour Shiatsu every week for four weeks. Our primary outcome was improvement of RMDQ, and secondary outcomes were improvement of Short-Form McGill Pain Questionnaire (SF-MPQ), Oswestry Disability Index (ODI) and EQ-5D after 4 weeks and 8 weeks. Bivariate analyses were applied for assessing statistical significance. RESULT Fifty-nine patients were included; 30 were allocated to Shiatsu, and 29 to the control group. None of the baseline characteristics were significantly different between groups. Twenty seven patients (90%) in the Shiatsu group and 24 patients (83%) in the control group completed the study. At week 4, Shiatsu group tended to show greater improvement only in EQ-5D (difference 0.068, p = 0.07), but not statistically significant, compared to control group, wheres other outcome measures were similar between the groups. At week 8, those in the Shiatsu group tended to have greater improvement in RMDQ (difference 1.7, p = 0.08) compared to the control group. The Shiatsu group showed greater improvement in present pain scale of SF-MPQ (difference 0.5, p < 0.05), ODI (difference 4.0, p < 0.01) and EQ-5D (difference 0.099, p = 0.01) compared to control group. CONCLUSION In our limited sample trail, Shiatsu therapy combined with standard care for lower back pain improves some symptoms and QOL shortly after Shiatsu therapy.
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Affiliation(s)
- Daiki Kobayashi
- Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan; Department of Epidemiology, St. Luke's International University Graduate School of Public Health, Tokyo, Japan; Fujita Health University, Toyoake, Japan.
| | | | | | - Osamu Takahashi
- Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan; Department of Epidemiology, St. Luke's International University Graduate School of Public Health, Tokyo, Japan
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Arguisuelas MD, Lisón JF, Doménech-Fernández J, Martínez-Hurtado I, Salvador Coloma P, Sánchez-Zuriaga D. Effects of myofascial release in erector spinae myoelectric activity and lumbar spine kinematics in non-specific chronic low back pain: Randomized controlled trial. Clin Biomech (Bristol, Avon) 2019; 63:27-33. [PMID: 30784788 DOI: 10.1016/j.clinbiomech.2019.02.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/11/2019] [Accepted: 02/13/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Flexion-relaxation response of the lumbar erector spinae has been previously studied after different interventions such as exercise programs or spinal manipulation, in subjects with chronic low back pain. The objective of the study was to investigate the effects of an isolated myofascial release protocol on erector spinae myoelectric activity and lumbar spine kinematics in chronic low back pain. METHODS Thirty-six participants, with nonspecific chronic low back pain, were randomized to myofascial release group (n = 18) receiving four sessions of myofascial treatment, each lasting 40 min, and to control group (n = 18) receiving a sham myofascial release. Electromyographic and kinematic variables as well as pain and disability questionnaires were analyzed. FINDINGS There was a bilateral reduction of the flexion relaxation ratio in individuals receiving myofascial release and who did not show myoelectric silence at baseline (right difference M = 0.34, 95% CI [0.16, 0.33], p ≤ .05 and left difference M = 0.45, 95% CI [0.16, 0.73], p ≤ .05). There was also a significant reduction in pain in the myofascial release group (difference M = -9.1, 95% CI [-16.3, -1.8], p ≤ .05) and disability (difference M = -5.6, 95% CI [-9.1, -2.1], p ≤ .05), compared with control group. No significant differences between groups were found for the kinematic variables. INTERPRETATION The myofascial release protocol contributed to the normalization of the flexion- relaxation response in individuals who did not show myoelectric silence before the intervention, and also showed a significant reduction in pain and disability compared with the sham group.
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Affiliation(s)
- M D Arguisuelas
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain.
| | - J F Lisón
- Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain; CIBER of Physiopathology of Obesity and Nutrition CIBERobn, CB06/03 Carlos III Health Institute, Spain
| | - J Doménech-Fernández
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain; Department of Orthopaedic Surgery, Hospital Arnau de Vilanova, Valencia, Spain
| | - I Martínez-Hurtado
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - P Salvador Coloma
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - D Sánchez-Zuriaga
- Department of Anatomy and Human Embryology, Universitat de València, Valencia, Spain
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Shi J, Xu X, Sun J, Wang Y, Kong Q, Shi G. Theory of Bowstring Disease: Diagnosis and Treatment Bowstring Disease. Orthop Surg 2019; 11:3-9. [PMID: 30834704 PMCID: PMC6430461 DOI: 10.1111/os.12417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 08/24/2018] [Indexed: 01/06/2023] Open
Abstract
Bowstring disease (BSD) is a new classification of spine disease caused by axial stretched lesion on nerve roots and the spinal cord, which is differentiated from disc herniation and canal stenosis in that it is caused by nerve compression lesions. BSD could be caused by mismatched growth rates between the spine and nerve roots (the juvenile type), or by imbalanced degenerative rates between the spine column and nerve roots (degenerative type). Here, we propose that there are several self-adjust mechanisms to relieve axial nerve tension: (i) nerve growth; (ii) posture adjustment and low back pain; (iii) autogenous degeneration of intervertebral disc; and (iv) idiopathic and degenerative scoliosis. Iatrogenic lesions could also result in BSD, which could be presented as adjacent segment degeneration, leading to adding-on effects and other neurological symptoms. The diagnosis criteria are proposed based on symptoms, physical examination, and radiological presentations. To remove axial tension on nerve roots, lumbar surgery should aim to restore the coordination of spine and cord units. Capsule surgery, shortening the spine column, could decompress cord and nerve roots 3-dimensionally.
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Affiliation(s)
- Jian‐gang Shi
- Department of Orthopedic Surgery, Spine CenterChangzheng Hospital, Second Military Medical University
| | - Xi‐ming Xu
- Department of Orthopedic Surgery, Spine CenterChangzheng Hospital, Second Military Medical University
| | - Jing‐chuan Sun
- Department of Orthopedic Surgery, Spine CenterChangzheng Hospital, Second Military Medical University
| | - Yuan Wang
- Department of Orthopedic Surgery, Spine CenterChangzheng Hospital, Second Military Medical University
| | - Qing‐jie Kong
- Department of Orthopedic Surgery, Spine CenterChangzheng Hospital, Second Military Medical University
| | - Guo‐dong Shi
- Department of Orthopedic Surgery, Spine CenterChangzheng Hospital, Second Military Medical University
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The efficacy of interventions for low back pain in nurses: A systematic review. Int J Nurs Stud 2018; 77:222-231. [DOI: 10.1016/j.ijnurstu.2017.10.015] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 10/19/2017] [Accepted: 10/23/2017] [Indexed: 12/13/2022]
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Effects of Myofascial Release on Pressure Pain Thresholds in Patients With Neck Pain: A Single-Blind Randomized Controlled Trial. Am J Phys Med Rehabil 2017; 97:16-22. [PMID: 28678033 DOI: 10.1097/phm.0000000000000790] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aimed to investigate the efficacy of myofascial release therapy (MRT) for improving pressure pain thresholds (PPTs) and pain in patients with mechanical neck pain. DESIGN Forty-one participants with neck pain were randomly allocated to either a MRT group (five sessions) or a physical therapy (PT) group (ten sessions) for 2 wks. The multimodal PT program included ultrasound therapy (US), transcutaneous electric nerve stimulation, and massage. Visual analog scale (VAS) and PPTs in suboccipital and upper trapezius muscles were measured at baseline, at the end of treatment, and at 1 month follow-up. RESULTS At the end of treatment, significant mean differences in VAS (-0.99, 95% confidence interval [CI] = -1.82 to -0.16), in both left (0.28, 95% CI = 0.06 to 0.50) and right (0.40, 95% CI = 0.16 to 0.63) suboccipital PPTs and in the right trapezius PPT (0.38, 95% CI = 0.07 to 0.69) were observed. At 1-month follow-up, significant mean differences were found for VAS (-1.85, 95% CI = -2.76 to -0.94) and both left (0.46, 95% CI = 0.12 to 0.80) and right (0.38, 95% CI = 0.06 to 0.69) suboccipital PPTs. CONCLUSIONS This study provides evidence that MRT could be better than a multimodal PT program for short-term improvement of pain and PPTs in patients with neck pain.
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Laimi K, Mäkilä A, Bärlund E, Katajapuu N, Oksanen A, Seikkula V, Karppinen J, Saltychev M. Effectiveness of myofascial release in treatment of chronic musculoskeletal pain: a systematic review. Clin Rehabil 2017; 32:440-450. [DOI: 10.1177/0269215517732820] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Katri Laimi
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Annika Mäkilä
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Esa Bärlund
- Turku University of Applied Sciences, Turku, Finland
| | | | - Airi Oksanen
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Valpuri Seikkula
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland
- Department of Expert Services, Turku University Hospital and University of Turku, Turku, Finland
| | - Jari Karppinen
- Department of Expert Services, Turku University Hospital and University of Turku, Turku, Finland
| | - Mikhail Saltychev
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland
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