Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Carrer de Josep Trueta, Sant Cugat del Vallès, 08195 Barcelona, Spain.
ACTIUM Functional Anatomy Group, Carrer de Josep Trueta, Sant Cugat del Vallès, 08195 Barcelona, Spain.
Int J Environ Res Public Health. 2021 Jun 18;18(12):6554. doi: 10.3390/ijerph18126554.
Diacutaneous Fibrolysis is defined as specific instrumental intervention to normalize function in the musculoskeletal system. It is considered a treatment method for the mechanical alterations of the locomotor system, and it is widely used in sports for therapeutic and preventive purposes. Despite the clinical benefits observed in different musculoskeletal conditions, the action mechanism of diacutaneous fibrolysis remains uncertain. There are no studies evaluating the neuromuscular response on the posterior muscular chain of the lower extremity in athletes, where overload, stiffness, and injury incidence are high.
To evaluate the immediate, and 30 min post treatment effects of a single diacutaneous fibrolysis session on passive neuromuscular response and mechanosensitibity on hamstring and gluteus in athletes with shortening.
A randomized within participant clinical trial.
Sixty-six athletes with hamstring shortening were included (PKE < 160). The lower limbs were randomized between the experimental limb and control limb, regardless of dominance. A single session of diacutaneous fibrolysis was applied to the posterior gluteus maximus, biceps femoris, and semitendinosus of the experimental lower limb whereas the control limb was not treated. Viscoelastic muscle properties (myotonometry), contractile muscle properties (tensomiography), and mechanosensitivity (algometry) were tested before treatment (T0), after treatment (T1), and 30 min post treatment (T2).
Regarding viscoelastic properties, in the intra-group analysis we found statistically significant differences in the experimental limb at T1, decreasing muscle stiffness in gluteus maximus ( < 0.042), in biceps femoris ( < 0.001) and in semitendinosus ( < 0.032). We also observed statistically significant differences in Tone decrease ( < 0.011) and relaxation increase ( < 0.001) in biceps femoris. At T2, the decrease in stiffness in all tested muscles was maintained ( < 0.05). There were statistically significant inter-groups differences in stiffness on gluteus ( < 0.048) and biceps femoris ( < 0.019) and in tone on biceps femoris ( < 0.009) compared to the control limb. For contractile properties, we only found statistically significant differences on maximal radial displacement (Dm) in gluteus, both control and experimental at T2 ( < 0.05) and in biceps femoris control ( < 0.030). No changes were found in the mechanosensitivity.
A single session of diacutaneous fibrolysis produces changes in some parameters related to viscoelasticity properties of the biceps femoris and gluteus. There were no changes on contractile properties on semitendinosus. Only small changes on the contractile properties on the gluteus maximus and biceps femoris were found. No effect was found on the mechanosensitivity of the posterior chain muscles in athletes with hamstring shortening.
经皮纤维松解术被定义为一种特定的仪器干预手段，用于使骨骼肌肉系统的功能正常化。它被认为是治疗运动系统力学改变的一种方法，在运动医学中被广泛用于治疗和预防目的。尽管在不同的骨骼肌肉疾病中观察到了临床益处，但经皮纤维松解术的作用机制仍不确定。目前尚无研究评估运动员下肢后肌链的神经肌肉反应，而下肢后肌链容易出现超负荷、僵硬和受伤。
评估单次经皮纤维松解术对运动员缩短的腘绳肌和臀肌的被动神经肌肉反应和机械敏感性的即时和 30 分钟治疗后影响。
一项随机的参与者内临床试验。
共纳入 66 名患有腘绳肌缩短的运动员（PKE < 160）。将下肢随机分为实验组和对照组，无论优势侧如何。实验组的后臀肌、股二头肌和半腱肌接受单次经皮纤维松解治疗，而对照组则不接受治疗。在治疗前（T0）、治疗后（T1）和治疗后 30 分钟（T2）分别测试粘弹性肌肉特性（肌振图）、收缩性肌肉特性（张力描记术）和机械敏感性（压痛计）。
在组内分析中，我们发现实验组在 T1 时存在统计学上显著的差异，即臀大肌（ < 0.042）、股二头肌（ < 0.001）和半腱肌（ < 0.032）的肌肉僵硬度降低。我们还观察到股二头肌的 Tone 下降（ < 0.011）和放松增加（ < 0.001）存在统计学上显著差异。在 T2 时，所有测试肌肉的僵硬度下降仍维持（ < 0.05）。与对照组相比，实验组在臀肌（ < 0.048）和股二头肌（ < 0.019）的僵硬度以及股二头肌的 Tone （ < 0.009）方面存在统计学上显著的组间差异。对于收缩性特性，我们仅在 T2 时发现臀肌（ < 0.05）和股二头肌（ < 0.030）的最大径向位移（Dm）方面存在统计学显著差异。在对照组和实验组中，股二头肌的收缩性特性均未发生变化。在机械敏感性方面未发现任何变化。
单次经皮纤维松解术可改变一些与股二头肌和臀肌粘弹性特性相关的参数。半腱肌的收缩性特性无变化。仅观察到臀大肌和股二头肌的收缩性特性有较小变化。在患有腘绳肌缩短的运动员中，对后链肌肉的机械敏感性没有影响。
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