Tension-dependent structures in a stretch-activated system

Neurofascialvascular training for the treatment of Raynaud's phenomenon: A case report

Primary Raynaud's phenomenon (PRP) is characterised by episodic, reversible, and disabling vasospasms of the peripheral arteries. In the most severe cases, it can lead to ulceration of the fingers and toes. Neuro fascial VascularTraining (NFVT) is a novel therapeutic approach for treating PRP. NFVT aims to enhance peripheral circulation and stimulate the autonomic nervous system (ANS) by engaging multiple physiological mechanisms simultaneously. This integrated approach works to reduce vasospasms and alleviate associated symptoms through neurodynamic and myofascial interventions. A 54-year-old woman, who has experienced pain and hypoesthesia in her hands for 9 years, received a diagnosis of PRP without systemic sclerosis in 2014. The patient reported daily colour changes in her fingers, along with pain and a temporary decrease in tactile sensitivity. The patient engaged in ten 30-minute exercise sessions, and the clinical outcomes were assessed based on several parameters. These included the frequency and duration of vasospastic attacks, evaluated using the Raynaud Condition Score, as well as pain and tingling, measured through the daily Numeric Rating Scale. The Composite Autonomic Symptom Score (COMPASS 31) was utilised to assess dysautonomia, while the frequency of medication use and the Disabilities of the Arm, Shoulder, and Hand questionnaire were also considered. The results indicated a significant improvement in symptoms. NFVT improved symptoms and motor dysfunction in a patient with Raynaud's syndrome, demonstrating how NFVT can increase peripheral blood flow, stimulate the ANS, and improve symptoms in PRP.

Neurofascialvascular training for carpal tunnel syndrome as an evolution of neurodynamic treatment: A case report

INTRODUCTION

In this case report a new approach called neurofascialvascular training (NFVT) is described. NFVT consists of two mechanisms which improve mechanosensitivity in carpal tunnel syndrome (CTS). The first involves increased blood flow in the nerve microcirculation, while the second stimulates the reciprocal sliding between the thin sheets of connective tissue inside the nerve. The goal of these two actions is to squeeze, mobilize and reduce intraneural edema. The novelty of this approach is the simultaneous involvement of multiple physiological systems to reduce nerve mechanosensitivity. This case report describes the rehabilitation progress achieved by NFVT in a patient with CTS.

MAIN SYMPTOMS AND/OR IMPORTANT CLINICAL FINDINGS

A 64-year-old woman complaining of nocturnal pain and tingling with severe impairment of sleep quality for two years was diagnosed at CTS.

THERAPEUTIC INTERVENTIONS

The patient underwent nine 30-min exercise sessions of NFVT.

OUTCOMES

At each session and at the last follow-up 3 months after the end of treatment the following tests were performed: the upper limb neurodynamic test1 (ULNT1), the Hand Grip Meter and the Phdurkan test. Furthermore ultrasound, numerical rating scale and the Boston Carpal Tunnel Questionnaire (BCTQ) were also adopted.

CONCLUSION

NFVT can improve symptoms and motor dysfunction in a patient with CTS.

TAKE-AWAY LESSON

In the presence of mild carpal tunnel syndrome, active neurofascialvascular training that increases peripheral blood flow and targets fascial tissue within the peripheral nervous system can resolve symptoms and produce significant improvement within a few months of starting treatment.

Comparison of dry needling and kinesio taping methods in the treatment of myofascial pain syndrome: A single blinded randomised controlled study

OBJECTIVES

The aim of this study was to compare the effectiveness of kinesio taping (KT) and dry needling (DN) in the treatment of myofascial pain syndrome (MPS) of the trapezius muscle.

METHODS

The patients with MPS were divided into 3 groups as those who received exercise only (control group), those who received KT and exercise (KT group) and those who received DN and exercise (DN group) by using a sealed opaque envelope randomisation method. Visual Analog Scale (VAS), Pressure Pain Threshold (PPT), Neck Disability Index (NDI) and Global Perceived Effect Scale (GPES) were measured twice at baseline and at the end of the second week by blinded evaluator.

RESULTS

A total of 26 patients were assigned to KT group, 32 to DN group and 30 to control group. The results of the study showed that PPT, VAS and NDI scores were significantly improved in the KT (1.61 ± 1.25, -2.66 ± 1.24 and -7.08 ± 6.24, respectively) and DN (1.30 ± 1.13, -3.34 ± 1.40 and -10.63 ± 7.80 respectively) groups (P < .001 for all). In the control group, no significant improvement was found in the VAS (.10 ± 1.39) and NDI (-.83 ± 4.91) scores (P > .05), with a significant decrease in PPT (-.98 ± 1.92) (P = .014). KT and DN methods in MPS treatment have more positive effects in terms of pain, disability and global effect compared to the control group.

CONCLUSIONS

In the treatment of MPS, adding DN or KT to exercise programme may provide important contributions to the treatment.

The Immediate Effect of Informational Manual Therapy for Improving Quiet Standing and Bodily Pain in University Population

Background: The Informational Manual Therapy (IMT) is a therapeutic touch. This study aims to assess the effect of IMT on quiet standing, pain and health status in university population. Methods: An experiment was conducted on subjects utilizing a comparative paired analysis both before and after the intervention. One IMT session was performed on 57 healthy individuals aged from 18 to 65 years. The primary outcome was quiet standing assessed by the Satel 40 Hz stabilometric force platform. Secondary outcomes were bodily pain assessed by the 36-Item Short Form Survey (SF-36) and health status by EQ-5D-3L. The primary outcome was evaluated before and immediately after treatment. Results: The individuals were divided into 3 age groups, 18–35 (52.6%), 35–50 (29.8%) and 51–65 (17.6%). Statistically significant differences were immediately observed after the session ended when comparing the pre-post quiet stance scores in a number of length parameters: L, Lx, Ly and stabilometry amplitude on Y-axis with eyes open and closed. Significant differences were also found when testing bodily pain (SF-36) and anxiety (5Q-5D-3L). Conclusion: One session of IMT produced positive effects when testing quiet standing with eyes open and eyes closed, as well as a significant reduction in pain and anxiety for those tested. Further research is suggested.

Structural Integration Case Report: a Global Intervention Challenging the Limitations of Local Rehabilitation

BACKGROUND

Conventional rehabilitation for musculoskeletal injuries post-surgery is generally site-specific and aims to return the person to 'normal' function. Commonly, conventional treatment focuses locally and little or no attention is given to comorbidities, other symptoms, postural compensations, or adaptations either pre-existing or resulting from the injury. Structural Integration (SI) is a manual therapy applied to and focusing on fascial continuities throughout the whole body. This case report explores SI as a global, whole-body intervention for rehabilitation.

PURPOSE

To examine the effects of a whole-body approach that addresses local and global symptoms following ankle surgery.

METHODS

The Anatomy Trains Structural Integration (ATSI formerly KMI) 12-series protocol was applied and a selection of outcome measures were used to track progress and assess the efficacy of SI. Ankle mobility and function was assessed primarily using Weight-Bearing Lunge Test and Lower Extremity Functional Scale. Local pain was reported using the McGill Pain Questionnaire. General well-being was evaluated using subjective questioning and the WHO Quality of Life Questionnaire.

RESULTS

Local results included increased mobility and function to affected leg, and reduced pain and swelling. Global results included an improvement in physical and psychological well-being, with the reduction of pain and dysfunction in other areas.

CONCLUSION

This case report demonstrates global benefits of a whole-body approach when structural integration is applied during rehabilitation. More clinical research that includes SI is needed to determine if the local and global results shown in this case study can be demonstrated in additional rehabilitation populations.

The Hypothesis of Biotensegrity and D. D. Palmer's Hypothesis on Tone: A Discussion of Their Alignment

OBJECTIVE

The purpose of this article is to compare D. D. Palmer's hypothesis of tone with the modern hypothesis of biotensegrity.

DISCUSSION

Although researchers have been using the hypothesis of biotensegrity for over 40 years to explain the mechanics of movement within biological systems, it has experienced revived support in the last 25 years. Biotensegrity as a concept is applied at the molecular, cellular, tissue, and organ levels, revealing a different understanding of the architecture of biological organisms. Biotensegrity offers a way of exploring the human body in the field of functional anatomy. The model has become popular among bodywork and movement practitioners, as it recognizes the wholeness of the human body. D. D. Palmer used tone to explain the origin of disease; biotensegrity, instead, explains why certain diseases may develop.

CONCLUSION

The concept of tone hypothesized by D. D. Palmer is different from the modern concept of biotensegrity. Although biotensegrity offers a different way of seeing how the human body functions, using it as a theoretical framework to explain the effects of manual therapies such as chiropractic may be premature. The use of the biotensegrity hypothesis requires further research and investigation before application in clinical settings.

A Review of the Theoretical Fascial Models: Biotensegrity, Fascintegrity, and Myofascial Chains

The fascial tissue includes solid and liquid fascia (body fluids such as blood and lymph). The fascia's nomenclature is the subject of debate in the academic world, as it is classified starting from different scientific perspectives. This disagreement is not a brake but is, in reality, the real wealth of research, the multidisciplinarity of thought and knowledge that leads to a deeper understanding of the topic. Another topic of discussion is the fascial model to conceptualize the human body, that is, how the fascial tissue fits into the living. Currently, there are some models: biotensegrity, fascintegrity, and myofascial chains. Biotensegrity is a mechanical model, which takes into consideration the solid fascia; fascintegrity considers the solid and the liquid fascia. Myofascial chains converge attention on the movement and transmission of force in the muscle continuum. The article is a reflection on fascial models and how these are theoretical-scientific visions that need to be further investigated.

The Shape and Function of Solid Fascias Depend on the Presence of Liquid Fascias

Scientific research is not a showcase of his own talent or own resources, it is a chance to improve common knowledge on certain topics for the collective well-being. A researcher should use multidisciplinarity to observe a phenomenon in its entirety and not only its alignment of thought, federations, committees, and knowledge; to get to understand it is necessary to exploit more tools and more disciplines. The article discusses the importance of the fluids (or liquid fascia) in maintaining the shape and function of the human body, as, currently, many texts forget how much body fluids are fundamental for understanding structural dynamics (bones and muscles, fibrils, and cells). By revisiting the current literature, the text wishes to highlight how the liquid fascia determines body adaptation in the presence of mechanical stress. Without fluids, there would be no body shape that we know.