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

Mirco Branchini, Francesca Lopopolo, Ernesto Andreoli, Ivano Loreti, Aurélie M Marchand, Antonio Stecco, Mirco Branchini, Francesca Lopopolo, Ernesto Andreoli, Ivano Loreti, Aurélie M Marchand, Antonio Stecco

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.

Keywords: low back pain; myofascial pain; nonspecific pain; thoracolumbar fascia.

Conflict of interest statement

Competing interests: The authors Francesca Lopopolo, Ernesto Andreoli, Ivano Loreti declare that there is no conflict of interest regarding the publication of this manuscript. Antonio Stecco, Aurelie Marie Marchand and Mirco Branchini are members of Fascial Manipulation Association. The Association is non-profit, with the objective of promoting and supporting research in the field of pain relief in general, and in particular, the field of anatomy and physiopathology of the fasciae.

Figures

Figure 1.
Figure 1.
a) VAS measures reported per time of evaluationb) BPI measures reported per time of evaluationc) RMDQ measures reported per time of evaluationd) SF-36 measures reported per time of evaluation.
Figure 2.. VAS values pre-treatment for each…
Figure 2.. VAS values pre-treatment for each treatment session.
Figure 3.. Mean differences in VAS for…
Figure 3.. Mean differences in VAS for each treatment sessions.

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