Acute effects of myofascial induction technique in plantar fascia complex in patients with myofascial pain syndrome on postural sway and plantar pressures: A quasi-experimental study

Myofascial induction technique changes plantar pressures variables compared to a simulated laser. A randomized clinical trial

BACKGROUND

The fascial system is made up of large number of mechanoreceptors and cells that regulate their tension, such as myofibroblasts, in addition to an extracellular matrix. The treatment of myofascial induction has shown in the static imprint in a quasi-experimental study comparing the effect before and after the technique, but there are no studies compared with a control with no real intervention. The objective of this research is to check the effects of the myofascial Induction technique, compared with a simulated Laser in plantar footprint variables in asymptomatic subjects.

METHODS

Thirty-six healthy participants were recruited to carry out a single-blind clinical study in randomizated two groups. Experimental intervention group performed a bilateral plantar fascia of Myofascial Induction technique. Control intervention group performed a simulated Laser. The time of application of the techniques were 5 min for both interventions. The variables recorded were Surface, mean pressure and maximum pressure for each region of the foot, rear foot, midfoot and fore foot.

RESULTS

Both groups were homogeneous prior to the interventions. The significant differences found later were in the forefoot surface variable (p = 0.026) where there was an increase in the area in the experimental group.

CONCLUSIONS

The myofascial induction technique shows effects on the static plantar footprint by increasing the surface of the forefoot compared to the application of a simulated laser. Registration in ClinicalTrial.gov (ID: NCT04628299) Registered in clinicalTrials.govhttps://clinicaltrials.gov/ct2/show/NCT04628299.

Acute Effects of Myofascial Release on Foot Mobility and Performance in Basketball Players with Hypomobile Feet-A Randomized Controlled Trial

Hypomobility in the foot structure causes functional limitations. These functional limitations affect sportive performance negatively, especially in basketball, where dynamic movements such as jumping and sudden changes in direction are very intense. In this context, reducing hypomobility is important in terms of eliminating performance disorders caused by hypomobility. The purpose of this study was to investigate the acute effects of myofascial release on foot mobility and sportive performance in basketball players with hypomobile feet. This study was designed as randomized controlled experimental research. Twenty-four male basketball players (23.46 ± 2.81 years) participated in this study. The athletes were first subjected to foot mobility, balance and vertical jump tests. Then, the participants were divided into two groups: myofascial release (MR) and placebo myofascial release (PMR). Myofascial release (Graston technique) was applied to the MR group, and placebo myofascial release was applied to the PMR group. After application, foot mobility and performance measurements were performed again, and the results were analyzed. It was observed that there was a significant difference in right foot mobility (d = 4), left foot mobility (d = 6), vertical jump (d = 1.13) and dynamic balance (d = 1.03) parameters after application in the MR group. It was also determined that the acute effects of the intervention on foot mobility lasted for at least two hours (p < 0.001). There was no change in any parameter after application in the PMR group (p > 0.05). The results of this study show that a single session of myofascial release applied to the plantar sole temporarily increased foot mobility and improved vertical jump and dynamic balance performance in basketball players with chronic hypomobility.

Effects of neural mobilization of sciatic nerve and its branches in plantar foot pressures and stabilometry

Benefits of neural mobilization (NM) have been described in musculoskeletal patients. The effects of NM on balance appear to be unclear in research, and no studies have tested the possible effects of NM on plantar pressures. Eighteen subjects were evaluated pre and post bilateral gliding of the sciatic nerve and its branches posterior tibial nerve, lateral dorsocutaneous, medial and intermediate dorsocutaneous nerves. Static variables of the plantar footprint and stabilometric variables were measured in a pre-post study. We found no differences in plantar pressure variables, Rearfoot maximum pressure (p = 0.376), Rearfoot medium pressure (p = 0.106), Rearfoot surface (p = 0.896), Midfoot maximum pressure (p = 0.975), Midfoot medium pressure (p = 0.950), Midfoot surface (p = 0.470) Forefoot maximum pressure (p = 0.559), Forefoot medium pressure(p = 0.481), Forefoot surface (p = 0.234), and stabilometric variables either, X-Displacement eyes-open (p = 0.086), Y-Displacement eyes-open (p = 0.544), Surface eyes-open (p = 0.411), Medium speed latero-lateral displacement eyes-open (p = 0.613), Medium speed anteroposterior displacement eyes-open (p = 0.442), X Displacement eyes-closed (p = 0.126), Y-Displacement eyes-closed (p = 0.077), Surface eyes-closed (p = 0.502), Medium speed latero-lateral displacement eyes-closed (p = 0.956), Medium speed anteroposterior displacement eyes-closed (p = 0.349). All variables don´t have significant differences however the measurements had a high reliability with at least an ICC of 0.769. NM doesn´t change plantar pressures or improve balance in healthy non-athletes subjects. NCT05190900.

Correlated variables and changes in fascial stiffness and pelvic mobility following the myofascial induction method utilizing the crossed hands technique

BACKGROUND

Myofascial Induction Therapy (MIT) is a physiotherapeutic (PT) intervention addressing musculoskeletal disorders. Standardizing MIT as a manual PT intervention ensures consistency and replicability.

AIM

To describe correlated variables and changes in fascial stiffness and pelvic mobility after applying the Crossed Hands Technique based on MIT.

METHODS

A quasi-experimental study involved 15 PTs trained in myofascial induction and 15 healthy individuals. Environmental (ambient temperature, stretcher height, width), patient (subscapular fatty fold, BMI, height, chest length, lumbopelvic mobility, fascial stiffness), and PT variables (pressure, traction, hand temperature, kinematic changes) were assessed during lumbodorsal hands-cross at 1-min intervals for 5 min. Pelvic mobility was measured using kinovea photogrammetry and dorsolumbar stiffness using a durometer. Descriptive analysis and correlations were applied.

RESULTS

PTs had a mean 5.3 years of MIT experience. The average force was 5.5 N, traction force 0.39 N. Post-technique, individuals showed 4° increased pelvic mobility, minimal stiffness changes at T7 and L4 levels. Kinematic variables for the PTs revealed an average shoulder flexion of 40° and bilateral elbow flexion of 18°. Following the application of the technique, individuals who received MIT experienced a 4° increase in pelvic mobility, with only minor changes in stiffness observed at both the T7 and L4 levels.

CONCLUSIONS

The Crossed Hands Technique involves key variables like force and traction, varying over time. Clinical outcomes are influenced by patient and environmental factors. Notably, the physiotherapist's hand temperature, right shoulder internal rotation, right foot abduction, and fourth finger opening show significant correlations with tissue stiffness changes.

Dry needling, trigger point electroacupuncture and motor point electroacupuncture for the treatment of myofascial pain syndrome involving the trapezius: a randomised clinical trial

OBJECTIVE

The objective of this study was to compare trigger point (TrP) dry needling, TrP electroacupuncture and motor point electroacupuncture of the trapezius muscle for the treatment of myofascial pain syndrome (MPS).

METHODS

This randomised clinical trial included 90 patients divided into three groups. Group 1 was treated with dry needling of TrPs, group 2 with intramuscular electrical stimulation of TrPs, and group 3 with electroacupuncture of motor points and/or the spinal accessory nerve. Each group received seven treatment sessions. The outcomes were the pain score measured by visual analogue scale (VAS) and quality of life evaluated by the 12-item short form (SF-12) health questionnaire. We compared the pain outcome over serial time points using growth curve analysis methods.

RESULTS

Participants in the three groups experienced significant improvements in pain scores over time. The average pain level of participants in group 3 across the repeated assessments was 0.98 units lower than in group 1 (mean difference (95% confidence interval (CI) = 1.74-0.23)), p = 0.012). There were no significant differences in pain scores between participants in groups 1 and 2, and there were no significant differences in quality of life across the three groups at the end of the treatment period.

CONCLUSION

Our results provide evidence that electrical stimulation of motor points and/or of the spinal accessory nerve may be superior in terms of pain relief (but not quality of life) to dry needling and possibly electrical stimulation of trigger points for the management of MPS involving the trapezius.

TRIAL REGISTRATION NUMBER

TRIAL-RBR-43R7RF (Brazilian Clinical Trials Registry).

Effects of Myofascial Induction Therapy on Ankle Range of Motion and Pressure Pain Threshold in Trigger Points of the Gastrocnemius-A Clinical Trial

BACKGROUND

The myofascial induction technique (MIT) has been shown to increase shoulder range of motion (ROM) in breast cancer survivors and decrease pain pressure threshold over the radial nerve in patients with epicondylalgia. To the authors' best knowledge, no study on trigger points and MIT has been published to date. The effect on ROM of latent trigger points is also unknown.

METHODS

A total of 20 twins with one latent trigger point of the gastrocnemius muscle were evaluated pre- and post-MIT in the calf. We measured static footprint variables in a pre-post study.

RESULTS

We found differences in PPT (p = 0.001) and no differences in ROM with knee flexed (p = 0.420) or stretched (p = 0.069).

CONCLUSIONS

After Calf MIT, latent myofascial trigger points improve PPT but no change in ankle dorsiflexion with knee bent or knee flexed were found in non-restriction healthy subjects.

The influence of myofascial release on pain and selected indicators of flat foot in adults: a controlled randomized trial

Flat foot pain is a common complaint that requires therapeutic intervention. Currently, myofascial release techniques are often used in the therapy of musculoskeletal disorders. A group of 60 people suffering from flat feet with associated pain. Patients were assigned to four groups (15 people each): MF-myofascial release, E-the exercise program, MFE-myofascial release and the exercise program, C-no intervention. The rehabilitation program lasted 4 weeks. The NRS scale was used to examine pain intensity and FreeMed ground reaction force platform was used to examine selected static and dynamic foot indicators. Statistically significant pain reduction was obtained in all research. A static test of foot load distribution produced statistically significant changes only for selected indicators. In the dynamic test, statistically significant changes were observed for selected indicators, only in the groups subjected to therapeutic intervention. Most such changes were observed in the MF group. In the dynamic test which assessed the support phase of the foot, statistically significant changes were observed only for selected subphases. Most such changes were observed in the MFE group. Both exercise and exercise combined with myofascial release techniques, and especially myofascial release techniques alone, significantly reduce pain in a flat foot. This study shows a limited influence of both exercises and myofascial release techniques on selected static and dynamic indicators of a flat foot.

Myofascial Treatment for Microcirculation in Patients with Postural Neck and Shoulder Pain

Vascular impairment is a crucial factor associated with chronic muscle pain, but relevant research from the microcirculatory aspect is lacking. Here, we investigated the differences in neck muscle microcirculation detected through laser-doppler flowmetry (LDF) and cervical biomechanics by a videofluoroscopic image in asymptomatic participants and patients with postural neck and shoulder pain. To understand the mechanism behind the effect of myofascial treatment, transverse friction massage (TFM) was applied and the immediate effects of muscular intervention on microcirculation were monitored. In total, 16 asymptomatic participants and 22 patients (mean age = 26.3 ± 2.4 and 25.4 ± 3.2 years, respectively) were recruited. Their neck muscle microcirculation and spinal image sequence were assessed. The differences in the baseline blood flow between the asymptomatic and patient groups were nonsignificant. However, the standard deviations in the measurements of the upper trapezius muscle in the patients were significantly larger (p < 0.05). Regarding the TFM-induced responses of skin microcirculation, the blood flow ratio was significantly higher in the patients than in the asymptomatic participants (p < 0.05). In conclusion, postintervention hyperemia determined through noninvasive LDF may be an indicator for the understanding of the mechanism underlying massage therapies and the design of interventions for postural pain.

Can a Single Trial of a Thoracolumbar Myofascial Release Technique Reduce Pain and Disability in Chronic Low Back Pain? A Randomized Balanced Crossover Study

Although manual therapy for pain relief has been used as an adjunct in treatments for chronic low back pain (CLBP), there is still the belief that a single session of myofascial release would be effective. This study was a crossover clinical trial aimed to investigate whether a single session of a specific myofascial release technique reduces pain and disability in subjects with CLBP. 41 participants over 18 years old were randomly enrolled into 3 situations in a balanced and crossover manner: experimental, placebo, and control. The subjects underwent a single session of myofascial release on thoracolumbar fascia and the results were compared with the control and placebo groups. The outcomes, pain and functionality, were evaluated using the numerical pain rating scale (NPRS), pressure pain threshold (PPT), and Oswestry Disability Index (ODI). There were no effects between-tests, within-tests, nor for interaction of all the outcomes, i.e., NPRS (η ² = 0.32, F = 0.48, p = 0.61), PPT (η² = 0.73, F = 2.80, p = 0.06), ODI (η² = 0.02, F = 0.02, p = 0.97). A single trial of a thoracolumbar myofascial release technique was not enough to reduce pain intensity and disability in subjects with CLBP.

Flexor Digitorum Brevis Muscle Dry Needling Changes Surface and Plantar Pressures: A Pre-Post Study

BACKGROUND

The effects of the dry needling technique and pain reduction have been demonstrated in numerous quality studies. However, the mechanical effects of dry needling are largely unknown.

METHODS

A total of 18 subjects with flexor digitorum brevis muscle myofascial trigger point were evaluated pre- and post-deep dry needling. We measured static footprint variables in a pre-post study.

MAIN FINDINGS

We found differences in rearfoot maximum pressure (119.22-111.63 KPa; p = 0.025), midfoot maximum pressure (13.68-17.26 KPa; p = 0.077), midfoot medium pressure (4.75-6.24 KPa; p = 0.035) and forefoot surface (86.58-81.75 cm²; p = 0.020). All variables with significant differences decrease, with the exception of forefoot surface which showed an increase.

CONCLUSIONS

After flexor digitorum brevis muscle dry needling, midfoot plantar pressures (maximum and medium) and forefoot surface were increased, and rearfoot maximum pressure was decreased.