1
|
Baroncini A, Maffulli N, Schäfer L, Manocchio N, Bossa M, Foti C, Klimuch A, Migliorini F. Physiotherapeutic and non-conventional approaches in patients with chronic low-back pain: a level I Bayesian network meta-analysis. Sci Rep 2024; 14:11546. [PMID: 38773302 PMCID: PMC11109223 DOI: 10.1038/s41598-024-62276-9] [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: 09/12/2023] [Accepted: 05/15/2024] [Indexed: 05/23/2024] Open
Abstract
Chronic low back pain (cLBP) is a major cause of disability and healthcare expenditure worldwide. Its prevalence is increasing globally from somatic and psychosocial factors. While non-pharmacological management, and in particular physiotherapy, has been recommended as a first-line treatment for cLBP, it is not clear what type of physiotherapeutic approach is the most effective in terms of pain reduction and function improvement. This analysis is rendered more difficult by the vast number of available therapies and a lack of a widely accepted classification that can effectively highlight the differences in the outcomes of different management options. This study was conducted according to the PRISMA guidelines. In January 2024, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase. All the randomised controlled trials (RCTs) which compared the efficacy of physiotherapy programs in patients with cLBP were accessed. Studies reporting on non-specific or mechanical cLPB were included. Data concerning the Visual Analogic Scale (VAS) or numeric rating scale (NRS), Roland Morris Disability Questionnaire (RMQ) and Oswestry Disability Index (ODI). Data from 12,773 patients were collected. The mean symptom duration was 61.2 ± 51.0 months and the mean follow-up was 4.3 ± 5.9 months. The mean age was 44.5 ± 9.4 years. The mean BMI was 25.8 ± 2.9 kg/m2. The Adapted Physical Exercise group evidenced the lowest pain score, followed by Multidisciplinary and Adapted Training Exercise/Complementary Medicine. The Adapted Physical Exercise group evidenced the lowest RMQ score followed by Therapeutic Exercises and Multidisciplinary. The Multidisciplinary group evidenced the lowest ODI score, followed by Adapted Physical Exercise and Physical Agent modalities. Within the considered physiotherapeutic and non-conventional approaches to manage nonspecific and/or mechanic cLBP, adapted physical exercise, physical agent modalities, and a multidisciplinary approach might represent the most effective strategy to reduce pain and disability.
Collapse
Affiliation(s)
- Alice Baroncini
- GSpine4, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milano, Italy
| | - Nicola Maffulli
- Department of Orthopaedics, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
- School of Pharmacy and Bioengineering, Faculty of Medicine, Keele University, Stoke on Trent, ST4 7QB, UK
- Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, E1 4DG, UK
| | - Luise Schäfer
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, 52074, Aachen, Germany
| | - Nicola Manocchio
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, Rome, Italy
| | - Michela Bossa
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, Rome, Italy
| | - Calogero Foti
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, Rome, Italy
| | - Alexandra Klimuch
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, 52074, Aachen, Germany
| | - Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, 52074, Aachen, Germany.
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, 39100, Bolzano, Italy.
| |
Collapse
|
2
|
Unalmis Y, Muniroglu S. Examination of the effect of fascial therapy on some physical fitness parameters in taekwondo athletes. SPORTS MEDICINE AND HEALTH SCIENCE 2023; 5:299-307. [PMID: 38314051 PMCID: PMC10831376 DOI: 10.1016/j.smhs.2023.09.010] [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: 04/23/2023] [Revised: 09/09/2023] [Accepted: 09/21/2023] [Indexed: 02/06/2024] Open
Abstract
One of the objectives of this study is to determine the effect of the eight-week fascial therapy program on flexibility, vertical jump, standing long jump, speed and anaerobic strength parameters in taekwondo athletes. Another aim of the research is to create a therapy protocol that can be used in athletes related to performance development through the relaxation of the fascial system, which is considered an indicator of physical fitness and has numerous functions in the body. This study included 32 taekwondo players who were licensed, actively attending taekwondo training. In the study, two groups were formed as fascial therapy group (FTG) (n = 16) and control group (CG) (n = 16). After the groups were randomized, fascial relaxation techniques were applied to the fascial therapy group for eight weeks, up to twice a week, and for 30 min. According to the findings obtained as a result of the research, FTG ([-0.36 ± 0.17] seconds [s]) for the 20 m (m) Sprint (T2-T1) had a lower mean time than CG (0.00 ± 0.07) s, FTG (0.06 ± 1.95) for the Flamingo Balance Test (T2-T1) had a lower mean fall than CG (1.25 ± 1.13), FTG ([3.56 ± 2.37] centimeters [cm]) for the Sit & Reach Test (T2-T1) had a lower mean fall than CG ([-0.19 ± 1.28] cm), FTG ([5.75 ± 2.54] cm) had a higher jump distance than CG ([1.88 ± 8.11] cm) according to the results of Vertical Jump Test (T2-T1) and finally FTG ([9.13 ± 5.56] cm) had a longer distance than CG ([-0.31 ± 1.85] cm) according to the results of Standing Long Jump Test (T2-T1). The result of our study has shown that fascial techniques can be used safely by experienced physiotherapists and can be included in the training program. It is recommended that coaches of sports disciplines work with experienced physiotherapists on this subject and include fascial methods in their training programs.
Collapse
Affiliation(s)
- Yagmur Unalmis
- Ankara University, Faculty of Sport Sciences, Dögol Caddesi 06100 Beşevler, Ankara, Turkey
| | - Surhat Muniroglu
- Ankara University, Faculty of Sport Sciences, Dögol Caddesi 06100 Beşevler, Ankara, Turkey
| |
Collapse
|
3
|
Stecco A, Bonaldi L, Fontanella CG, Stecco C, Pirri C. The Effect of Mechanical Stress on Hyaluronan Fragments' Inflammatory Cascade: Clinical Implications. Life (Basel) 2023; 13:2277. [PMID: 38137878 PMCID: PMC10744800 DOI: 10.3390/life13122277] [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: 10/09/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
It is a common experience, reported by patients who have undergone manual therapy that uses deep friction, to perceive soreness in treatment areas; however, it is still not clear what causes it and if it is therapeutically useful or a simple side effect. The purpose of this narrative review is to determine whether manual and physical therapies can catalyze an inflammatory process driven by HA fragments. The literature supports the hypothesis that mechanical stress can depolymerize into small pieces at low molecular weight and have a high inflammatory capacity. Many of these pieces are then further degraded into small oligosaccharides. Recently, it has been demonstrated that oligosaccharides are able to stop this inflammatory process. These data support the hypothesis that manual therapy that uses deep friction could metabolize self-aggregated HA chains responsible for increasing loose connective tissue viscosity, catalyzing a local HA fragment cascade that will generate soreness but, at the same time, facilitate the reconstitution of the physiological loose connective tissue properties. This information can help to explain the meaning of the inflammatory process as well as the requirement for it for the long-lasting resolution of these alterations.
Collapse
Affiliation(s)
- Antonio Stecco
- Department of Physical Medicine and Rehabilitation, New York University School of Medicine, New York, NY 10016, USA;
| | - Lorenza Bonaldi
- Department of Civil, Environmental and Architectural Engineering, University of Padova, 35131 Padova, Italy;
| | | | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padua, 35121 Padova, Italy;
| | - Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padua, 35121 Padova, Italy;
| |
Collapse
|
4
|
Bellotti S, Busato M, Cattaneo C, Branchini M. Effectiveness of the Fascial Manipulation Approach Associated with a Physiotherapy Program in Recurrent Shoulder Disease. Life (Basel) 2023; 13:1396. [PMID: 37374178 DOI: 10.3390/life13061396] [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: 05/09/2023] [Revised: 06/03/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Shoulder pain is a serious clinical disease frequently related to absence from work. It is characterized by pain and stiffness, probably connected to the presence of an inflammatory substrate involving gleno-humeral capsule and collagen tissues. A physiotherapy program has shown to be effective for the conservative treatment of this disorder. Our aim is to assess if a manual treatment directed to fascial tissues could obtain better improvement regarding pain, strength, mobility, and function. A total of 94 healthcare workers with recurrent shoulder pain were recruited and then randomized in two groups: the control group (CG) underwent a five-session physiotherapy program; the study group (SG) underwent three sessions of physiotherapy and two sessions of fascial manipulation (FM) technique. At the end of the treatment phase, both groups improved every outcome. Despite few statistical differences between groups, at the follow-up visit, a greater percentage of subjects in SG overcame the minimal clinical important difference (MCID) in every outcome. We conclude that FM is effective for treatment of shoulder pain and further studies should better assess how to manage this treatment to obtain better results.
Collapse
|
5
|
Facial Pain: RCT between Conventional Treatment and Fascial Manipulation ® for Temporomandibular Disorders. Bioengineering (Basel) 2022; 9:bioengineering9070279. [PMID: 35877330 PMCID: PMC9312324 DOI: 10.3390/bioengineering9070279] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background: To investigate the effectiveness of a specific manual therapy, Fascial Manipulation® (FM), in comparison with conventional treatments in temporomandibular disorders (TMD) patients using a two-arm randomized controlled trial. Methods: The study consisted of 28 patients that were divided in two groups (Group 1: Fascial Manipulation® vs. Group 2: conventional TMD treatment). The Verbal Rating Scale (VRS), RDC/TMD, electromyography (EMG) and Pression/Pain Evaluation on Masseter and Temporalis Muscle were assessed with different times. Results: In both groups, the improvement in pain was evident on the VRS scale (p < 0.0001) and pain-free opening (p < 0.001). In Group 1, the recovery of the function was faster; maximum unassisted opening T0 vs. T1 (p = 0.001). Conclusions: FM® can be used as an effective method for facial pain, being a rapid, safe and cost-effective approach to reduce pain, gain function and mouth opening that can be used prior to occlusion stabilization appliances.
Collapse
|
6
|
Hughes E, Koenig J, Lee R, McDermott K, Freilicher T, Pitcher M. Pilot study assessing the effect of Fascial Manipulation on fascial densifications and associated pain. Eur J Transl Myol 2022; 32. [PMID: 35244363 PMCID: PMC8992677 DOI: 10.4081/ejtm.2022.10369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/22/2022] [Indexed: 11/24/2022] Open
Abstract
We assessed effectiveness of Fascial Manipulation (FM) in reducing densification thickness and associated acute pain in normal humans. Fascial densifications were identified using palpation and measured with diagnostic ultrasound within self-reported painful somatic regions. Pain intensity ratings were obtained in response to deep palpation of the self-reported painful somatic region before and after a brief FM intervention. Brief FM resulted in reduced densification thickness as well pain intensity. Sex differences were found neither in densification thickness nor pain intensity at any time point. However, a statistically significant positive correlation between densification thickness and pain intensity was observed in females but not males at both pre-FM and post-FM time points. As such, FM may be an effective therapeutic approach for acute pain associated with fascial densifications. While males and females exhibited comparable densification thickness and pain intensity levels at both pre-FM and post-FM time points, only females showed a statistically significant relationship between pain and densification, suggesting that females may be better able to perceive subtle differences in the magnitude of noxious sensory input.
Collapse
Affiliation(s)
- Emmett Hughes
- School of Chiropractic, College of Health Sciences, University of Bridgeport, CT.
| | - Jessica Koenig
- Vascular Laboratory, Department of Surgery, Northport VA Medical Center, Northport, NY.
| | - Robert Lee
- Well Integrative Care Chiropractic, Acupuncture and Rehabilitation, Syosset, NY.
| | - Kena McDermott
- School of Chiropractic, College of Health Sciences, University of Bridgeport, CT.
| | - Tina Freilicher
- College of Health Sciences, University of Bridgeport, Bridgeport, CT.
| | - Mark Pitcher
- College of Health Sciences, University of Bridgeport, Bridgeport, CT.
| |
Collapse
|
7
|
Biz C, Stecco C, Fantoni I, Aprile G, Giacomini S, Pirri C, Ruggieri P. Fascial Manipulation Technique in the Conservative Management of Morton's Syndrome: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157952. [PMID: 34360245 PMCID: PMC8345745 DOI: 10.3390/ijerph18157952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 11/16/2022]
Abstract
Background and Objective: Morton’s syndrome (MS) is a common cause of neuropathic chronic forefoot pain, characterised by the development of a swelling of the common digital plantar nerve, whose aetiology is not fully known. There is currently no gold standard of treatment; nonoperative management commonly involves manual therapies, orthoses therapy and infiltrative techniques, while surgery is indicated after failure of conservative measures. The present preliminary study prospectively evaluates patients affected by MS treated by Fascial Manipulation technique (FM), a noninvasive manual therapy, focused on the release of the deep fascia, reducing its stiffness. Materials and Methods: Patients with clinical and sonographic diagnosis of MS with at least a 4-month history of neuropathic symptoms underwent a cycle of three weekly FM sessions. Clinical follow-up, including VAS and AOFAS scores, was performed 21 days (T1) and 3 months (T2) after treatment. Results: Nine patients, among 28 recruited initially, completed the manual therapy sessions and relative follow-up points. This noninvasive pain treatment led to significant improvement of VAS (p = 0.0034) and AOFAS scores (p = 0.0240) at the first follow-up (T1). At 3-month follow-up (T2), both scores decreased slightly, remaining however superior to the pre-treatment values. Only VAS was still significant (p = 0.0184). Conclusions: Despite the small size of the case series, this pilot study is unique in supporting Fascial Manipulation in the nonoperative treatment of MS. Further studies are needed with a large cohort of gender balanced patients to confirm the encouraging results obtained.
Collapse
Affiliation(s)
- Carlo Biz
- Department of Surgery, Oncology and Gastroenterology DiSCOG, Orthopaedic Clinic, University of Padova, 35128 Padova, Italy; (I.F.); (G.A.); (P.R.)
- Correspondence: ; Tel.: +39-049-821-3239
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (C.S.); (S.G.); (C.P.)
| | - Ilaria Fantoni
- Department of Surgery, Oncology and Gastroenterology DiSCOG, Orthopaedic Clinic, University of Padova, 35128 Padova, Italy; (I.F.); (G.A.); (P.R.)
| | - Gianluca Aprile
- Department of Surgery, Oncology and Gastroenterology DiSCOG, Orthopaedic Clinic, University of Padova, 35128 Padova, Italy; (I.F.); (G.A.); (P.R.)
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (C.S.); (S.G.); (C.P.)
| | - Stefano Giacomini
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (C.S.); (S.G.); (C.P.)
| | - Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (C.S.); (S.G.); (C.P.)
| | - Pietro Ruggieri
- Department of Surgery, Oncology and Gastroenterology DiSCOG, Orthopaedic Clinic, University of Padova, 35128 Padova, Italy; (I.F.); (G.A.); (P.R.)
| |
Collapse
|
8
|
Arumugam K, Harikesavan K. Effectiveness of fascial manipulation on pain and disability in musculoskeletal conditions. A systematic review. J Bodyw Mov Ther 2020; 25:230-239. [PMID: 33714501 DOI: 10.1016/j.jbmt.2020.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/17/2020] [Accepted: 11/04/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To review the effectiveness of Stecco's fascial manipulation technique in patients with musculoskeletal pain. DESIGN Systematic review of interventional studies. METHODS A systematic search of literatures was performed in the electronic databases: PubMed, Cochrane, Scopus, ScienceDirect, and Ovid from January 2005 to December 2019. Studies were included if they were followed stecco's fascial manipulation as an intervention for the musculoskeletal conditions. RCTs and Non RCTs both were included in this review. RESULTS Thirteen studies met the eligibility criteria [RCTs-8, Pre-Post studies-3, Case reports-2]. Stecco's FM technique was followed in all the included studies. Five studies applied FM technique alone, while two studies added exercise along with FM and one study substitute session with manual therapy. CONCLUSION This systematic review reported low to moderate quality evidence for the effect of FM in improving pain and disability in subjects with musculoskeletal pain conditions, when it is carried out as described in the Stecco's concept.
Collapse
Affiliation(s)
- Karthik Arumugam
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Bangalore, India
| | - Karvannan Harikesavan
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Bangalore, India.
| |
Collapse
|
9
|
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.
| |
Collapse
|
10
|
Comparative Effectiveness of Chuna Manipulative Therapy for Non-Acute Lower Back Pain: A Multi-Center, Pragmatic, Randomized Controlled Trial. J Clin Med 2020; 9:jcm9010144. [PMID: 31948083 PMCID: PMC7019562 DOI: 10.3390/jcm9010144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/17/2019] [Accepted: 01/02/2020] [Indexed: 12/19/2022] Open
Abstract
Current evidence on the effectiveness and safety of Chuna manipulative therapy (CMT) for managing non-acute lower back pain (LBP) is insufficient. We investigated the comparative effectiveness and safety of CMT, a Korean style of manipulation, plus usual care (UC) compared to UC alone for non-acute LBP. We conducted a parallel, two-armed, multi-centered, assessor blinded, pragmatic, randomized controlled trial at four major Korean medical hospitals. Overall, 194 patients were randomly allocated to either CMT plus UC (n = 97) or UC alone (n = 97), for six weeks of treatment and six months follow-up. The primary outcome was measured using the numerical rating scale (NRS) of LBP intensity at 7 weeks. Secondary outcomes included NRS of leg pain, Oswestry Disability Index (ODI) for functional disability, patient global impression of change (PGIC) scale, and safety. A total of 194 patients were included in the intention-to-treat analysis, and 174 patients provided complete data for the primary outcome. At 7 weeks, clinically significant differences between groups were observed in the NRS of LBP (CMT + UC: −3.02 ± 1.72, UC: −1.36 ± 1.75, p < 0.001), ODI scores (CMT + UC: −5.65 ± 4.29, UC: −3.72 ± 4.63, p = 0.003), NRS of leg pain (CMT + UC: −2.00 ± 2.33, UC: −0.44 ± 1.86, p < 0.0001), and PGIC (CMT + UC: −0.28 ± 0.85, UC: 0.01 ± 0.66, p = 0.0119). Mild to moderate safety concerns were reported in 21 subjects. CMT plus UC showed higher effectiveness compared to UC alone in patients with non-acute LBP in reducing LBP and leg pain and in improving function with good safety results using a powered sample size and including mid-term follow-up.
Collapse
|
11
|
Cotti A, Del Corso M, Diana R, Cornale L, Sudanese A, Stecco A, Branchini M. Inter and Intra Operator Reliability of Motor and Palpation Evaluation in Fascial Manipulation in individuals with coxarthrosis. J Man Manip Ther 2019; 28:236-245. [PMID: 31668142 DOI: 10.1080/10669817.2019.1683675] [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] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE An inter and intra rater reliability (INTERR and INTRAR) study was designed. METHODS 71 subjects, with primary hip coxarthrosis, were included and randomly divided in a study group (SG= 36) and a control group (CG= 35) to assess the efficacy of the Fascial Manipulation® (FM®) method. The primary objective was the assessment of INTERR and INTRAR about movement verification (MV) and palpation verification (PV) of FM® performed by two physiotherapists (PtA and PtB). The secondary objective was evaluate the efficacy of FM® through MV, PV and pain score. Pain was assessed using the Numeric Rating Scale (NRS). SG received three weekly sessions of FM® byPtA. PtB re-evaluated all the subjects at the end of the study. RESULTS Results of the INTERR analysis showed for SG: MV (ICC= 0.92, k= 72.7%); PV (ICC= 0.91, k= 75.7%). For CG : MV (ICC= 0.95, k= 84.2%); PV (ICC= 0.90, k= 75%). Results of the INTRAR analysis for SG reported: MV (ICC= 0.82, k= 74,8%); PV (ICC= 0.60, k= 46.8%); for CG: MV (ICC= 0.93, k= 78.7%); PV (ICC= 0.84, k= 53.3%). Statistical significance were reported in NRS (p = 0.001), MV (p = 0.0003) and PV (p < 0.0001) with better results for SG using "Intention To Treat" method. DISCUSSION This study demonstrates that FM® assessment procedures have a high reliability even if applied by practitioners with basic experience. Furthermore FM® treatment can improve pain and ROM in individuals with primary coxarthrosis.
Collapse
Affiliation(s)
- Andrea Cotti
- Department of Rehabilitation, Rizzoli Orthopaedic Institute, Bologna, Italy
| | | | | | | | - Alessandra Sudanese
- Orthopaedic-Trauma and Prosthetic Surgery, Hip Revisions, Knee Implants, Rizzoli Institute, Bologna, Italy
| | - Antonio Stecco
- School of Medicine, New York University, New York, NY, USA
| | - Mirco Branchini
- Department of Hip and Knee Prosthesis Surgery Unit, Rizzoli Orthopaedic Institute, Bologna, Italy
| |
Collapse
|
12
|
Convergence and Divergence of Exercise-Based Approaches That Incorporate Motor Control for the Management of Low Back Pain. J Orthop Sports Phys Ther 2019; 49:437-452. [PMID: 31092126 DOI: 10.2519/jospt.2019.8451] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Many approaches for low back pain (LBP) management focus on modifying motor control, which refers to motor, sensory, and central processes for control of posture and movement. A common assumption across approaches is that the way an individual loads the spine by typical postures, movements, and muscle activation strategies contributes to LBP symptom onset, persistence, and recovery. However, there are also divergent features from one approach to another. This commentary presents key principles of 4 clinical physical therapy approaches, including how each incorporates motor control in LBP management, the convergence and divergence of these approaches, and how they interface with medical LBP management. The approaches considered are movement system impairment syndromes of the lumbar spine, Mechanical Diagnosis and Therapy, motor control training, and the integrated systems model. These were selected to represent the diversity of applications, including approaches using motor control as a central or an adjunct feature, and approaches that are evidence based or evidence informed. This identification of areas of convergence and divergence of approaches is designed to clarify the key aspects of each approach and thereby serve as a guide for the clinician and to provide a platform for considering a hybrid approach tailored to the individual patient. J Orthop Sports Phys Ther 2019;49(6):437-452. Epub 15 May 2019. doi:10.2519/jospt.2019.8451.
Collapse
|
13
|
Analgesic Effect of Extracorporeal Shock Wave Treatment Combined with Fascial Manipulation Theory for Adhesive Capsulitis of the Shoulder: A Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3450940. [PMID: 29581969 PMCID: PMC5822906 DOI: 10.1155/2018/3450940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 12/02/2017] [Accepted: 12/19/2017] [Indexed: 11/17/2022]
Abstract
Objectives This study aims to explore whether extracorporeal shockwave treatment (ESWT) based on the theory of fascial manipulation (FM) at select treatment points is superior to traditional local ESWT for pain relief in adhesive capsulitis of the shoulder. Methods Data from patients with adhesive capsulitis of the shoulder who received weekly ESWT according to fascial manipulation theory (ESWT-FM) or local extracorporeal shockwave treatment (L-ESWT) during a 5-week treatment period were evaluated. Pain-on-movement numeric rating scale (p-NRS) and range of motion (ROM) testing were performed before the treatment period, after the first treatment, and after the fifth treatment. Results There were significant reductions in pain scores in the ESWT-FM group (p < 0.05) after the first treatment, and after the fifth treatment, both groups had marked, significant improvement (p < 0.05), with a significantly greater reduction in pain (p-NRS) in the ESWT-FM group compared to the L-ESWT group (p < 0.05). There was no significant difference in terms of ROM in the L-ESWT group, while there was slight improvement of forward flexion in the ESWT-FM group after the fifth treatment. Conclusions ESWT-FM provided faster pain relief and slightly more notable improvement of function compared with L-ESWT for the patients with adhesive capsulitis of shoulder.
Collapse
|
14
|
DiMond ME. Rehabilitative Principles in the Management of Thoracolumbar Syndrome: A Case Report. J Chiropr Med 2017; 16:331-339. [PMID: 29276466 DOI: 10.1016/j.jcm.2017.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 10/12/2017] [Accepted: 10/12/2017] [Indexed: 01/07/2023] Open
Abstract
Objective The purpose of this case report was to describe the chiropractic management of thoracolumbar syndrome using multimodal therapies. Clinical Features A 33-year-old woman with 3 weeks of back pain presented to a chiropractic clinic. Nerve tension tests and local tenderness were present in a pattern described by Maigne, and she was diagnosed with thoracolumbar syndrome (Maigne syndrome) at her initial visit. Intervention and Outcomes The Oswestry Disability Index for low back pain (62%), STarT low back screen tool for clinical outcomes (6 points total, with a 2-point subscale), numeric pain rating scale (6/10 constant, 10/10 with provocation), and test-retest exercise audits were outcome measures. She received 3 treatment sessions, each with progressive exercise audits, and discharged with advice. At discharge, the patient scores substantially improved (Oswestry Disability Index: 8%, STarT: 1 point total, numeric pain rating scale: 1/10, 10% of the time), and she exhibited greater confidence in home care. Endurance tests were performed to establish baselines for future care, which included static back endurance test (timed 52 seconds) and side bridge endurance test (timed 43 seconds). Conclusion The patient responded positively to chiropractic care. After a short course of care, the patient reported reduced pain, alleviated symptoms, and improved physical function.
Collapse
Affiliation(s)
- Mathew E DiMond
- UB Clinics, University of Bridgeport, Bridgeport, Connecticut
| |
Collapse
|
15
|
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
| |
Collapse
|