How much time is required to modify a fascial fibrosis?
A new study by Italian researchers Ercole Borgini , Antonio Stecco, Julie Ann Day and Carla Stecco fund that it took an average of 3.24 minutes to modify a fascial fibrosis using the Fascial Manipulation technique. The study is being published in Journal of Bodywork and Movement Therapies
Various authors suggest that trauma or overuse syndromes can alter the connective tissue and that, in particular, it could become tighter, altering its histological, physiological and biomechanical characteristics. Some suggest an alteration of the collagen fibre composition, while others evidence the alteration of the fibroblasts with their transformation into myofibroblasts, meanwhile others suggest an alteration in the ground substance due to neurophysiological influences and changes in biochemical fluid relationships could be involved.
It is also theorized that different manual and physical techniques could restore the normal physiological state of the fascia, but there is very little scientific evidence about the mode of action of manual therapies in general.
The perception of what appears to be connective tissue fibrosis, and its consequent modification during therapy, is a daily experience for most manual therapists.
The researchers evaluated the time required to modify a palpatory sensation of fibrosis of the fascia in correlation with changes in levels of patient discomfort in 40 subjects with low back pain utilizing the Fascial Manipulation technique.
This study evidenced, for the first time, that the time required to modify an apparent fascial density differs in accordance with differences in characteristics of the subjects and of the symptoms. In particular, the mean time to halve the pain was 3.24 minutes; however, in those subjects with symptoms present from less than 3 months (sub-acute) the mean time was lesser (2.58 min) with respect to the chronic patients (3.29 min).
Glucosamine appears to provide little benefit for chronic low-back pain
Even though it is widely used as a therapy for low back pain, a randomized controlled trial finds that patients with chronic low back pain (LBP) and degenerative lumbar osteoarthritis (OA) who took glucosamine for six months showed little difference on measures of pain-related disability, low back and leg pain and health-related quality of life, compared to patients who received placebo, according to a study in the July 7 issue of JAMA.
Philip Wilkens, M.Chiro., of Oslo University Hospital and University of Oslo, Norway, and colleagues investigated the effect of a 6-month intake of glucosamine in reducing pain-related disability by conducting a randomized, placebo-controlled trial with 250 patients older than 25 years of age with chronic LBP (for longer than 6 months) and degenerative lumbar OA. 125 patients took either 1,500 mg. of oral glucosamine or placebo daily for 6 months, with effects assessed after the 6-month intervention period and at 1 year. The primary outcome was pain-related disability as measured with the Roland Morris Disability Questionnaire (RMDQ). Secondary outcomes were numerical scores from pain-rating scales of patients at rest and during activity and a quality-of-life measure. Data collection occurred at the beginning of the trial and at 6 weeks, 3 and 6 months, and at 1 year.
At the beginning of the trial, the average RMDQ score was 9.2 for the glucosamine group and was 9.7 for the placebo group. The 6-month average RMDQ score was 5.0 for both the glucosamine and placebo group, and 1-year score was 4.8 for the glucosamine group, and 5.5 for the placebo group. No statistically significant difference in change between groups was found when assessed after the 6-month intervention period and at 1 year for RMDQ, and for measures of LBP at rest, LBP during activity and quality-of-life. Mild adverse events were reported in 40 patients in the glucosamine group and 46 patients in the placebo group.
“Based on our results, it seems unwise to recommend glucosamine to all patients with chronic LBP and degenerative lumbar OA. Further research is needed to clarify whether glucosamine is advantageous in an alternative LBP population,” the authors conclude.
Differences in practitioners’ proficiency affect the effectiveness of massage therapy
A study in Japan was conducted to evaluate how differences in the proficiency of massage practitioners can affect the physical and psychological states on clients.
Eight healthy 50-year-old females, suffering from chronic neck and shoulder stiffness, were recruited and four interventions were conducted: three 40-minute massage therapy interventions, one each by a freshman and a student studying massage therapy, and one by their instructor, and one rest on the massage table. Visual analogue scale score for muscle stiffness in the neck and shoulder, state anxiety score, and salivary cortisol concentration levels and secretory immunoglobulin A, were measured pre- and post- interventions.
The results showed that Massage by experienced instructor give a lower pain scale of neck and shoulder stiffness after massage compared to massage conducted by freshman or student. Furthermore the score of state anxiety was lower than that after resting.
Reference: Differences in practitioners’ proficiency affect the effectiveness of massage therapy on physical and psychological states Donoyama, N., Shibasaki, M. 2010 Journal of Bodywork and Movement Therapies 14 (3), pp. 239-244
Massage impairs postexercise muscle blood flow and lactic acid removal
A study tested the hypothesis that one of the ways sports massage aids muscle recovery from exercise is by increasing muscle blood flow to improve “lactic acid” removal.
Twelve subjects performed 2 min of strenuous isometric handgrip (IHG) exercise at 40% maximum voluntary contraction to elevate forearm muscle lactic acid. Forearm blood flow and deep venous forearm blood lactate and H concentration were measured every minute for 10 min post-IHG under three conditions: passive (passive rest), active (rhythmic exercise at 10% maximum voluntary contraction), and massage (effleurage and pétrissage).
Results showed that Forearm Blood Flow for 10 min after handgrip was significantly higher in passive versus massage. Meanwhile Lactate flow was higher in passive condition when compared to treatment with massage. Hydrogen concentration flow was also greater in passive versus massage.
The authors concluded that massage impairs Lactate and Hydrogen ion removal from muscle after strenuous exercise by mechanically impeding blood flow.
Massage impairs postexercise muscle blood flow and “lactic Acid” removal Wiltshire, E.V., Poitras, V., Pak, M., Hong, T., Rayner, J., Tschakovsky, M.E. 2010 Medicine and Science in Sports and Exercise 42 (6), pp. 1062-1071
The effect of manual therapy on masseter muscle pain and spasm in TMJ
Orofacial pain and pain in the muscles of mastication are frequent symptoms of temporomandibular disorder. The masseter is the closet masticatory muscle to the surface and has the function of raising and retracting the mandible. This muscle has considerable strength and is one of the main muscles involved in the shredding of food It is therefore of utmost importance in the masticatory cycle and generally the most affected by pain and spasms.
The study was conducted to analyze the effect of manual therapy with transversal and circular movements on pain and spasm in the masseter muscle, using electromyography and a visual analogue pain scale (VAPS). Eight women who experienced pain upon palpation of the masseter greater than 6 on the pain scale were selected for participation in the study, which employed electromyography.
The statistical analysis revealed a reduction in pain, but there was no significant difference in electromyographic activity The authors concluded that massage therapy was effective on pain symptoms, but was not capable of altering the electrical activity of the masseter muscle.
The effect of manual therapy on masseter muscle pain and spasm Albertin, A., Kerppers, I.I., Amorim, C.F., Costa, R.V., Corrêa, J.C.F., Oliveira, C.S. 2010 Electromyography and Clinical Neurophysiology 50 (2), pp. 107-112
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