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肌筋膜松解术对腰椎微循环的即时影响:一项随机、安慰剂对照试验

Immediate Effects of Myofascial Release Treatment on Lumbar Microcirculation: A Randomized, Placebo-Controlled Trial.

作者信息

Brandl Andreas, Egner Christoph, Reer Rüdiger, Schmidt Tobias, Schleip Robert

机构信息

Department of Sports Medicine, Institute for Human Movement Science, Faculty for Psychology and Human Movement Science, University of Hamburg, 20148 Hamburg, Germany.

Department for Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany.

出版信息

J Clin Med. 2023 Feb 4;12(4):1248. doi: 10.3390/jcm12041248.

Abstract

(1) Background: Inflammatory processes in the thoracolumbar fascia (TLF) lead to thickening, compaction, and fibrosis and are thought to contribute to the development of nonspecific low back pain (nLBP). The blood flow (BF) of fascial tissue may play a critical role in this process, as it may promote hypoxia-induced inflammation. The primary objective of the study was to examine the immediate effects of a set of myofascial release (MFR) techniques on the BF of lumbar myofascial tissue. The secondary objectives were to evaluate the influence of TLF morphology (TLFM), physical activity (PA), and body mass index (BMI) on these parameters and their correlations with each other. (2) Methods: This study was a single-blind, randomized, placebo-controlled trial. Thirty pain-free subjects (40.5 ± 14.1 years) were randomly assigned to two groups treated with MFR or a placebo intervention. Correlations between PA, BMI, and TLFM were calculated at baseline. The effects of MFR and TLFM on BF (measured with white light and laser Doppler spectroscopy) were determined. (3) Results: The MFR group had a significant increase in BF after treatment (31.6%) and at follow-up (48.7%) compared with the placebo group. BF was significantly different between disorganized and organized TLFM ( < 0.0001). There were strong correlations between PA (r = -0.648), PA (d = 0.681), BMI (r = -0.798), and TLFM. (4) Conclusions: Impaired blood flow could lead to hypoxia-induced inflammation, possibly resulting in pain and impaired proprioceptive function, thereby likely contributing to the development of nLBP. Fascial restrictions of blood vessels and free nerve endings, which are likely associated with TLFM, could be positively affected by the intervention in this study.

摘要

(1) 背景:胸腰筋膜(TLF)中的炎症过程会导致其增厚、致密化和纤维化,被认为与非特异性下腰痛(nLBP)的发生有关。筋膜组织的血流(BF)可能在此过程中起关键作用,因为它可能促进缺氧诱导的炎症。本研究的主要目的是检查一组肌筋膜松解(MFR)技术对腰部肌筋膜组织血流的即时影响。次要目的是评估胸腰筋膜形态(TLFM)、身体活动(PA)和体重指数(BMI)对这些参数的影响及其相互之间的相关性。(2) 方法:本研究是一项单盲、随机、安慰剂对照试验。30名无疼痛受试者(40.5±14.1岁)被随机分为两组,分别接受MFR或安慰剂干预。在基线时计算PA、BMI和TLFM之间的相关性。确定MFR和TLFM对BF(用白光和激光多普勒光谱法测量)的影响。(3) 结果:与安慰剂组相比,MFR组治疗后BF显著增加(31.6%),随访时增加(48.7%)。紊乱型和有序型TLFM之间的BF有显著差异(<0.0001)。PA(r = -0.648)、PA(d = 0.681)、BMI(r = -0.798)和TLFM之间存在强相关性。(4) 结论:血流受损可能导致缺氧诱导的炎症,可能导致疼痛和本体感觉功能受损,从而可能导致nLBP的发生。本研究中的干预可能会对可能与TLFM相关的血管和游离神经末梢的筋膜限制产生积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fe3/9959802/a88e5b31347f/jcm-12-01248-g001.jpg

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