Fascial Manipulation® for chronic aspecific low back pain: a single blinded randomized controlled trial

Abstract

Background: The therapeutic approach to chronic aspecific low back pain (CALBP) has to consider the multifactorial aetiology of the disorder. International guidelines do not agree on unequivocal treatment indications. Recommendations for fascial therapy are few and of low level evidence but several studies indicate strong correlations between fascial thickness and low back pain. This study aims at comparing the effectiveness of Fascial Manipulation® associated with a physiotherapy program following guidelines for CALBP compared to a physiotherapy program alone. Methods: 24 subjects were randomized into two groups, both received eight treatments over 4 weeks. Outcomes were measured at baseline, at the end of therapy and at a 1 month and a 3 months follow-up. Pain was measured with the visual analogue scale (VAS) and the brief pain inventory (BPI), function with the Rolland-Morris disability questionnaire (RMDQ), state of well-being with the short-form 36 health-survey (SF-36). The mean clinical important difference (MCID) was also measured. Results: Patients receiving Fascial Manipulation® showed statistically and clinically significant improvements at the end of care for all outcomes, in the short (RMDQ, VAS, BPI) and medium term for VAS and BPI compared to manual therapy. The MCID show significant improvements in the means and percentage of subjects in groups in all outcomes post-treatment, in the short and medium term. Conclusion: Fascial tissues were implicated in the aetiology of CALBP and treatment led to decreased symptomatic, improved functional and perceived well-being outcomes that were of greater amplitude compared to manual therapy alone.

Investigation of fascial treatment effectiveness on pain, flexibility, functional level, and kinesiophobia in patients with chronic low back pain

“…Studies on the effectiveness of fascial mobilization are rare. Branchini et al [19] compared exercise and manual therapy with fascial mobilization therapy. They observed that there was a further decrease in pain, especially in the group treated by fascial mobilization.…”

Observation using thermography of post-operative reaction after fascial manipulation®

“…Fascia manipulation is conducted at strictly defined points in a specific area, so that the friction during manipulation would cause an increase in the temperature of the fascia tissue [9,10]. This leads to the destruction van der Waals and hydrophobic forces which hold together the hyalurnian chains [16]. The increase of the temperature in tissues causes decrease in hyalurnian viscosity [12,21] and an increase its ability to slide [14,22].…”

“…After movement and palpatory verification, receiving the most active points of cc (coordination centre) of the common plane, and balancing it with the points of the antagonistic plane, takes place [8,9]. Fascia manipulation causes shift of friction into heat and creates inflammation in the manipulated site and this, in consequence, leads to modification of the consistency of the primary substance [8,11,16].…”

Meta-Analysis of Integrated Therapeutic Methods in Noninvasive Lower Back Pain Therapy (LBP): The Role of Interdisciplinary Functional Diagnostics

“…A review of literature in this area clearly reveals that few authors treat fascia as a three-dimensional system [76][77][78]. Nevertheless, it has been repeatedly pointed out that manual therapy based on the concept of tensegration (structural integration) is one of the most effective methods of balancing tensions within the motor organ in LBP therapy [79,80].…”