Fernández-Lao Carolina, Cantarero-Villanueva Irene, Díaz-Rodríguez Lourdes, Fernández-de-las-Peñas César, Sánchez-Salado Carmen, Arroyo-Morales Manuel
Department Physical Therapy, Universidad de Granada, Spain.
J Manipulative Physiol Ther. 2012 Feb;35(2):94-100. doi: 10.1016/j.jmpt.2011.09.011. Epub 2011 Oct 21.
The purpose of this study was to evaluate the influence of patient's attitudes toward massage on pressure pain sensitivity and the immune effects of myofascial release in breast cancer survivors (BCS).
Twenty BCS participated. They presented to the laboratory at the same time of the day on 2 occasions separated by 2 weeks. At each session, they received either a myofascial release technique or control (special attention) intervention. Salivary flow rate, cortisol and immunoglobulin A (IgA) concentrations, and α-amylase activity were obtained before and immediately after intervention from saliva samples. Pressure pain thresholds (PPT) over the cervical spine and temporalis muscle were assessed bilaterally. The attitude toward massage (ATOM) scale was collected before the first session in all BCS.
The analysis of covariance revealed a significant intervention × time interaction for salivary flow rate (P = .010), but not α-amylase (P = .111), IgA (P = .655), and cortisol (P = .363) in favor of the experimental group: BCS exhibited an increase of salivary flow rate after myofascial release intervention. When the ATOM scale was included in the analysis, significant influence on IgA (P = .001) was found: BCS with positive attitude had a significant increase in IgA (P > .05). The analysis of covariance did not find a significant intervention × time interaction for PPT over the cervical spine or temporalis muscle, with no effect of ATOM scales for PPT (P > .05).
The current study suggests that myofascial release may lead to an immediate increase in salivary flow rate in BCS with cancer-related fatigue. We also found that the effect of myofascial release on immune function was modulated by a positive patient's attitude toward massage.
本研究旨在评估乳腺癌幸存者（BCS）对按摩的态度对压力疼痛敏感性以及肌筋膜放松免疫效果的影响。
20名BCS参与研究。她们在一天中的同一时间分两次前往实验室，两次间隔两周。在每次实验中，她们分别接受肌筋膜放松技术或对照（特别关注）干预。在干预前及干预结束后立即采集唾液样本，测定唾液流速、皮质醇和免疫球蛋白A（IgA）浓度以及α-淀粉酶活性。双侧评估颈椎和颞肌的压力疼痛阈值（PPT）。在所有BCS的第一次实验前收集其对按摩的态度（ATOM）量表。
协方差分析显示，唾液流速存在显著的干预×时间交互作用（P = .010），但α-淀粉酶（P = .111）、IgA（P = .655）和皮质醇（P = .363）不存在，且有利于实验组：BCS在接受肌筋膜放松干预后唾液流速增加。当将ATOM量表纳入分析时，发现对IgA有显著影响（P = .001）：态度积极的BCS的IgA显著增加（P > .05）。协方差分析未发现颈椎或颞肌PPT存在显著的干预×时间交互作用，ATOM量表对PPT无影响（P > .05）。
当前研究表明，肌筋膜放松可能会使患有癌症相关疲劳的BCS的唾液流速立即增加。我们还发现，患者对按摩的积极态度可调节肌筋膜放松对免疫功能的影响。
