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Effects of a myofascial technique on the structure and biomechanical properties of the thoracolumbar fascia in chronic low back pain adults assessed by sonoelastography and myotonometry: a study protocol

Journal: Journal of Complementary and Integrative Medicine Date: 2023/06, 20(2):Pages: eA46. doi: Subito , type of study: randomized controlled trial

Full text    (https://www.degruyter.com/document/doi/10.1515/jcim-2020-2120/html)

Keywords:

biomechanics [55]
chronic pain [204]
conference abstract [108]
elasticity [9]
fascia [261]
low back pain [413]
OMT [2951]
osteopathic manipulative treatment [2973]
randomized controlled trial [710]
thickness [3]
thoracic spine [56]

Abstract:

Background: Non-specific low back pain is a global problem that remains poorly understood. Several authors have focused on the role that fascia may play in chronic low back pain. Some changes in the structure and biomechanical properties of the thoracolumbar fascia have been documented in this population: increase in thickness, decrease in gliding ability and increase in stiffness. These tissue changes could lead to compression or irritability of nerve endings contributing to pain. Myofascial techniques are commonly used in manual therapy by practitioners of various backgrounds. However, there is paucity of evidence on their effects on tissue state. Objectives To explore the immediate mechanical effects of a standardized myofascial technique (MFT) in comparison to a simulated MFT on the structure and biomechanical properties of the myofascia. Methods A before-after experimental study protocol is proposed. A total of 48 participants with chronic nonspecific low back pain will be recruited and randomly assigned to a standardized MFT group or a simulated MFT group. MFTs will be performed by an experienced osteopath. Outcomes will be collected by a physiotherapist blinded to group assignation, with state-of-the-art instruments and validated procedures and will include: 1- biomechanical properties characterized by stiffness (shear wave elastography); shear strain (ultrasound); tone, elasticity, dynamic stiffness, creep, stress-relaxation time (myotonometry); 2- structure characterized by thickness (ultrasound); 3- pain intensity (visual analogue scale). Paired t-test and repeated measures ANOVA will allow comparisons before/after the procedure and between groups. Expected results: We hypothesize that MFT will lead to a decrease in myofascia thickness and stiffness, an increase in shear strain and a decrease in pain intensity in comparison to simulated MFT. Conclusions This project will allow a better understanding of the effects of a therapeutic approach that is commonly taught and used in manual therapy but whose mechanisms of action remain poorly understood.


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