Gordon Christopher M, Dugan Victoria, Hörmann Christina, Montoya Pedro
CIT Research Institute, 70597 Stuttgart, Germany.
Fascia Research Group, Division of Neurophysiology, University of Ulm, 89081 Ulm, Germany.
J Clin Med. 2024 Nov 28;13(23):7226. doi: 10.3390/jcm13237226.
Chronic low back pain (CLBP) is highly prevalent and relevant in all medical fields. This study evaluated the safety and effectiveness of interdisciplinary fascia therapy (IFT) for CLBP, focusing on its potential to reduce pain intensity, disability, and regulate autonomic nervous system (ANS) activity. Nine participants with CLBP each underwent nine sessions of IFT, twice weekly. The intervention involved a 12-grip manual sequence targeting deep paravertebral myofascial structures, complemented by heart rate variability (HRV) biofeedback training twice daily for 15 min. Pain and quality-of-life measures were assessed using the Brief Pain Inventory (BPI) questionnaire at baseline, mid-treatment (4th session), and post-treatment (9th session). HRV metrics were monitored with a 24 h ECG Holter device before and after the treatment period. Statistical analyses included paired -tests, Wilcoxon signed-rank tests, and Cohen's d for effect size. Significant reductions in pain levels were observed across all subjective BPI measures, including momentary, strongest, minimal, and average pain scores ( < 0.001), with 83% and 87% reductions in pain intensity and disability, respectively. Quality-of-life indicators such as mood, sleep, and enjoyment of life showed significant improvements ( < 0.001). While only one HRV metric (rMSSD) achieved statistical significance, other HRV measures indicated medium to large effect sizes, suggesting favorable trends in ANS regulation. IFT demonstrated significant effects on subjective BPI pain reduction and quality of life, alongside potential regulatory impacts on ANS activity in individuals with CLBP. These results support the use of IFT as an effective intervention for pain management in CLBP and ANS regulation, meriting further exploration.
慢性下腰痛（CLBP）在所有医学领域都极为普遍且具有重要意义。本研究评估了跨学科筋膜疗法（IFT）治疗CLBP的安全性和有效性，重点关注其减轻疼痛强度、功能障碍以及调节自主神经系统（ANS）活动的潜力。9名CLBP患者每人接受了9次IFT治疗，每周两次。干预措施包括针对椎旁深层肌筋膜结构的12步手法操作序列，并辅以每日两次、每次15分钟的心率变异性（HRV）生物反馈训练。在基线、治疗中期（第4次治疗）和治疗后（第9次治疗）使用简明疼痛评估量表（BPI）问卷评估疼痛和生活质量指标。在治疗期前后使用24小时心电图动态监测仪监测HRV指标。统计分析包括配对t检验、Wilcoxon符号秩检验以及用于效应量的Cohen's d。在所有主观BPI测量指标中均观察到疼痛水平显著降低，包括瞬时、最强、最小和平均疼痛评分（P<0.001），疼痛强度和功能障碍分别降低了83%和87%。生活质量指标如情绪、睡眠和生活乐趣均有显著改善（P<0.001）。虽然只有一个HRV指标（rMSSD）达到统计学显著性，但其他HRV测量指标显示出中等到较大的效应量，表明在ANS调节方面有良好趋势。IFT对主观BPI疼痛减轻和生活质量有显著影响，同时对CLBP患者的ANS活动有潜在调节作用。这些结果支持将IFT作为CLBP疼痛管理和ANS调节的有效干预措施，值得进一步探索。
