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Fascial manipulation vs. standard physical therapy practice for low back pain diagnoses: A pragmatic study

Journal: Journal of Bodywork and Movement Therapies Date: 2019/01, 23(1):Pages: 115-121. doi: Subito , type of study: clinical trial

Full text    (http://www.sciencedirect.com/science/article/pii/S1360859218304492)

Keywords:

fascia [261]
fascial manipulation [5]
low back pain [413]
motor unit [1]
clinical trial [612]

Abstract:

Background Connective tissue mobility alters motor unit recruitment, but the restoration of fascial mobility allows for optimal motor function. The Fascial Manipulation® (FM®) method is a multiplanar approach that assesses and treats the mobility of deep fascia in specific anatomical locations where motor units converge. Objectives To assess the effects of FM® vs. standard physical therapy treatment (SPT) in patients with low back pain (LBP). Design Six-months controlled clinical trial. Method 102 participants with LBP received SPT or FM®. Numeric Pain Rating Scale (NPRS), 15- point Global Rating of Change (GROC), and Oswestry Disability Index (ODI) were used to monitor progress. Results The FM® group had a significantly lower ODI (p < 0.009) and NPS scores (p < 0.0001) and significantly higher GROC scores (p < 0.003) once their means were adjusted for initial scores. When comparing the SPT to FM®, the final ODI decreased by at least 1 category in 48.9% of the SPT cases, while in 36.2% of the cases was no change. ODI minimal clinical importance difference (MCID) change of 10% decrease in scores occurred in 70.2% of the SPT group compared to 96% of the FM® group (p = 0.003). ODI MCID change of 50% decrease in scores occurred in 40% of the SPT group compared to 64.6% of the FM® group (p = 0.02) 44.7% of the participants in the SPT group had final GROC values above +5 at discharge, compared to 92% of the participants from the FM® group (p = 0.0001). The FM® subjects had almost three times the change in NPRS compared to SPT counterparts (-4.3 ± 2.2 to -1.5  ± 2.4, p=0.0001). Conclusions FM® appears to improve NPRS, GROC, and ODI more than SPT. FM® may provide an effective treatment technique for LBP.


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