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.

Effectiveness of myofascial release in treatment of chronic musculoskeletal pain: a systematic review

“…The search process is reported in Figure 1. Of 513 records, finally 8 were considered relevant for qualitative analysis 21 –28 (Figure 1 and Supplementary Table 3).…”

“…The duration of follow-up ranged from immediate assessment after the end of treatment 28 up to one year. 27 The risk of bias was considered high in five of eight trials 21–23,25,28 (Supplementary Table 3). Three RCTs were conducted in the outpatient clinic of Myofascial Therapy and Research Foundation, 21 –23 two samples involved the members of Fibromyalgia Association, 26,27 one sample was gathered in a physiotherapy outpatient department, 28 and two in tertiary outpatient clinics.…”

“…Three RCTs were conducted in the outpatient clinic of Myofascial Therapy and Research Foundation, 21 –23 two samples involved the members of Fibromyalgia Association, 26,27 one sample was gathered in a physiotherapy outpatient department, 28 and two in tertiary outpatient clinics. 24,25 The control procedures included sham myofascial release, 23,24 sham ultrasound, 21,22,27 or sham magnetotherapy. 26 Two studies focused on adding myofascial release to manual or physiotherapy 25,28 (Table 1).…”

“…24,25 The control procedures included sham myofascial release, 23,24 sham ultrasound, 21,22,27 or sham magnetotherapy. 26 Two studies focused on adding myofascial release to manual or physiotherapy 25,28 (Table 1).…”

Comparative Effectiveness of Chuna Manipulative Therapy for Non-Acute Lower Back Pain: A Multi-Center, Pragmatic, Randomized Controlled Trial

“…A study reported that successful average NRS changes (2.66) in lumbar spine surgery patients are well above the minimal clinically important difference (MCID) range (0.28-4.5) [40][41][42][43][44]. The NRS difference in this study from baseline to 7 weeks was 3.02, which is a meaningful value compared with other studies and is in the MCID range.…”