Ożóg Piotr, Weber-Rajek Magdalena, Radzimińska Agnieszka
Department of Physiotherapy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Torun, Poland.
J Clin Med. 2023 Sep 23;12(19):6143. doi: 10.3390/jcm12196143.
Dysfunctions of the lumbosacral area and related pain syndromes, such as chronic low back pain (CLBP), are among the most common musculoskeletal problems in modern society. The purpose of this study was to evaluate the effectiveness of isolated myofascial release techniques (MFR) in the treatment of CLBP in adults. PubMed, Web of Science, Scopus, and Cochrane Library databases were searched for studies published from 1 January 2013 to 1 March 2023. We included English-language randomized controlled trials evaluating the effect of isolated MFR performed by a specialist on adults with CLBP. Only studies with a comparison group without treatment or with sham MFR were included. A total of 373 studies were detected, of which 6 studies were finally included in this review. There was a total of 397 CLBP patients aged 18-60 in all study groups. The studies evaluated the effects of a series of MFR treatments as well as a single intervention. After applying a series of treatments, a statistically significant reduction in pain intensity, improvement in the range of motion, reduction in the level of functional disability and fear-avoidance beliefs, as well as a decrease in the activity of paraspinal muscles at maximum trunk flexion were demonstrated. A single, 40-min complex intervention involving tissues at various depths significantly reduced the level of pain, improved the range of motion, and reduced the resting activity of paraspinal muscles in the standing position, but did not affect postural stability. The use of a single 5 min MFR technique did not affect pain intensity and sensitivity and functional disability. The findings suggest that the use of a series of isolated MFR improves the condition of patients with CLBP by reducing the intensity of pain, improving functional efficiency, and reducing the activity of the paraspinal muscles in the position of maximum forward bend. The use of a single intervention containing a set of techniques covering superficial and deep tissue also reduces the intensity of pain, improves mobility, and reduces the resting activity of the paraspinal muscles in a standing position. Given the small number of eligible studies with limitations, conclusions should be interpreted with caution and avoid overgeneralizing the benefits of isolated MFR based on limited or mixed evidence.
腰骶部功能障碍及相关疼痛综合征，如慢性下腰痛（CLBP），是现代社会中最常见的肌肉骨骼问题之一。本研究的目的是评估孤立性肌筋膜松解技术（MFR）在治疗成人CLBP中的有效性。检索了PubMed、Web of Science、Scopus和Cochrane图书馆数据库中2013年1月1日至2023年3月1日发表的研究。我们纳入了评估专家实施的孤立性MFR对成人CLBP疗效的英文随机对照试验。仅纳入设有未治疗对照组或假MFR对照组的研究。共检索到373项研究，其中6项研究最终纳入本综述。所有研究组共有397例年龄在18 - 60岁的CLBP患者。这些研究评估了一系列MFR治疗以及单次干预的效果。在进行一系列治疗后，疼痛强度在统计学上显著降低，运动范围改善，功能障碍水平和恐惧回避信念降低，并且在最大躯干前屈时椎旁肌活动减少。一项涉及不同深度组织的40分钟综合单次干预显著降低了疼痛水平，改善了运动范围，并降低了站立位时椎旁肌的静息活动，但未影响姿势稳定性。使用单次5分钟的MFR技术未影响疼痛强度、敏感性和功能障碍。研究结果表明，使用一系列孤立性MFR可通过降低疼痛强度、提高功能效率以及减少最大前屈位时椎旁肌的活动来改善CLBP患者的状况。使用包含一组覆盖浅部和深部组织技术的单次干预也可降低疼痛强度，改善活动能力，并降低站立位时椎旁肌的静息活动。鉴于符合条件的研究数量较少且存在局限性，应谨慎解释结论，避免基于有限或混合证据过度概括孤立性MFR的益处。
