Assessing muscle energy technique and foam roller self-myofascial release for low back pain management in two-wheeler riders

Pain in the lower back is a major concern in today's era due to prolonged sitting in two-wheeler riders, mainly due to hamstring tightness. It also creates physical disability and impairment in activities of daily living. The study aimed to compare the efficacy of muscle energy technique (MET) and self-myofascial release (SMFR) using the foam roller on hamstring flexibility, dynamic balance, and physical disability amongst two-wheeler riders with chronic low back pain (LBP). Participants were randomized into two intervention groups, MET and SMFR using the envelope method, with each group having 20 participants. Hamstring flexibility and range of motion for knee extension and the lower back were assessed using the active knee extension test (AKE-L and AKE-R) and sit and reach test (SRT), while the dynamic balance was assessed by the star excursion balance test (SEBT) and physical disability by Roland-Morris Disability Questionnaire, (RMDQ). Measurements were taken at baseline and after 4 weeks of intervention. This study demonstrated that both SMFR using a foam roller and MET are effective in enhancing hamstring muscle flexibility, (SRT-F(1, 38) = 299.5, p < 0.001; AKE-R-F(1, 38) = 99.53, p < 0.001; AKE-L-F(1, 38) = 89.67, p < 0.001). Additionally, these techniques significantly improved dynamic balance in various directions, including anterior (ANT), anteromedial (AMED), medial (MED), posteromedial (PMED), posterior (POST), posterolateral (PLAT), lateral (LAT), and anterolateral (ALAT) directions (p < 0.01). Furthermore, there was a significant reduction in physical disability (RMDQ-F(1, 38) = 1307, p < 0.001), among two-wheeler riders suffering from chronic LBP. Compared to MET, SMFR using foam rollers was found to be more effective in enhancing hamstring flexibility, improving balance, and decreasing disability level on the RMDQ after 4 weeks.

Soft-Tissue Mobilization and Pain Neuroscience Education for Chronic Nonspecific Low Back Pain with Central Sensitization: A Prospective Randomized Single-Blind Controlled Trial

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.

Myofascial Release for Chronic Low Back Pain: A Systematic Review and Meta-Analysis

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.

Effects of myofascial release or self-myofascial release and control position exercises on lower back pain in idiopathic scoliosis: A systematic review

BACKGROUND

Idiopathic scoliosis is associated, among others, to muscular imbalance, functional limitations, and the most prevalent, back pain. The treatments usually applied are exercise, bracing or surgery. The objective of corrective exercise is to reduce symptoms and improve functional capacity and quality of life. Myofascial release (MFR) or Self-Myofascial release (SMFR) are manual techniques, intended to restore optimal muscle and fascia length, decrease pain, and improve function.

PURPOSE

to analyze the effects of MFR and postural control programs in lower back pain and scoliosis curves.

METHODS

A systematic literature review was conducted in high quality databases to identify the existing evidence of the effects of MFR and postural control on reducing back pain and scoliosis curves.

RESULTS

Seventeen studies met inclusion criteria. 533 subjects and 94 MFR/SMFR applied interventions lasting one to 24 weeks/sessions were identified. Ten studies used MFR, six SMFR and one mixes techniques. Seven MFR and five SMFR studies shown positive result. One study using MFR and one using SMFR applied also postural control exercises. MFR was useful to reduce back pain in all studies included that aimed in that matter. In addition, 12 studies reported improvements in flexibility and/or stiffness reduction, and two studies observed improvements in postural control and balance.

CONCLUSIONS

The combination of MFR and postural control programs might be suitable for reducing scoliosis and back pain. However, due to the reduced number of studies and the relatively small sample sizes used, results may be carefully interpreted, and more studies are needed.