http://dx.doi.org/10.1016/j.jbmt.2014.06.001

Summary

Introduction

Myofascial release (MFR) is a form of manual therapy that involves the application of a low load, long duration stretch to the myofascial complex, intended to restore optimal length, decrease pain, and improve function. Anecdotal evidence shows great promise for MFR as a treatment for various conditions. However, research to support the anecdotal evidence is lacking..

Objective

To critically analyze published randomized controlled trials (RCTs) to determine the effectiveness of MFR as a treatment option for different conditions.

Data sources

Electronic databases: MEDLINE, CINAHL, Academic Search Premier, Cochrane library, and Physiotherapy Evidence Database (PEDro), with key words myofascial release and myofascial release therapy. No date limitations were applied to the searches.

Study selection

Articles were selected based upon the use of the term myofascial release in the abstract or key words. The final selection was made by applying the inclusion and exclusion criteria to the full text. Studies were included if they were English-language, peer-reviewed RCTs on MFR for various conditions and pain.

Data extraction

Data collected were number of participants, condition being treated, treatment used, control group, outcome measures and results. Studies were analyzed using the PEDro scale and the Center for Evidence-Based Medicine's Levels of Evidence scale.

Conclusions

The literature regarding the effectiveness of MFR was mixed in both quality and results. Although the quality of the RCT studies varied greatly, the result of the studies was encouraging, particularly with the recently published studies. MFR is emerging as a strategy with a solid evidence base and tremendous potential. The studies in this review may help as a respectable base for the future trials.

Full text available here.

doi: http://dx.doi.org/10.1016/j.ijosm.2014.04.003

Abstract

Objectives

To investigate the effectiveness of a series of osteopathic treatments in patients with pain due to primary dysmenorrhoea.

Design and settings

Multi-centered randomised controlled trial with an osteopathic intervention group and an untreated (“waiting list”) control group.

Subjects

Women aged 14 years and older with a regular menstrual cycle, diagnosed with primary dysmenorrhoea.

Intervention

Six osteopathic treatments over a period of three menstrual cycles or no osteopathic treatment. At each treatment session, dysfunctional structures were tested and treated based on osteopathic principles. In both groups, pain medication on demand was allowed, but was documented.

Outcome measures

Primary outcome measures were average pain intensity (API) during menstruation, assessed by the Numeric Rating Scale (NRS), and days of dysmenorrhoeal pain exceeding 50% of NRS maximum (DDP). Main secondary outcome measure was health-related quality of life.

Results

A total of 60 individuals (average age 33 years) were randomised, seven patients dropped out. API decreased in the intervention group from 4.6 to 1.9 (95%CI = −1.9 to −3.5), and from 4.3 to 4.2 in controls (95%CI = −0.7 to 0.5); between group difference of means (BGDoM): 2.6, 95%CI = 1.7 to 3.6; p < 0.005. DDP decreased from 2.2 to 0.2 days in the intervention group (95%CI = −2.5 to −1.3), and from 2.3 to 1.9 in controls (95%CI = −1.0 to 0.2); BGDoM 1.5; 95%CI = 0.6 to 2.3; p = 0.002. A positive impact on quality of life (physical component score) could be observed in the osteopathic treatment group only.

Conclusions

A series of osteopathic treatments might be beneficial for women suffering from primary dysmenorrhoea.

Full text available here.