Background:The deep fascia is increasingly recognized as a potential source of pain, with densification manifesting as discomfort at myofascial points. Central sensitization (CS) significantly influences pain sensitivity, resulting in temporal, spatial, and threshold alterations in both acute and chronic pain conditions. Purpose:This case series investigates the immediate effects of fascial manipulation (FM) on pain at myofascial densified points (MDPs) and on clinical measures of CS. Methods:A total of 10 patients, aged 18-45 years, experiencing pain at MDPs were screened and selected based on specific criteria. Baseline measurements for the Visual Analog Scale (VAS) and the Central Sensitization Inventory (CSI) were collected. Densification points were identified and treated in a single session following the Stecco FM guidelines. Post-intervention values were recorded immediately after FM. Results:The study demonstrated a significant reduction in pain following FM (p ≤ 0.05). Mean VAS scores decreased from 07.33 ± 00.82 pre-intervention to 01.16 ± 01.17 post-intervention, while mean CSI scores decreased from 50.33 ± 07.65 to 30.00 ± 05.17. Conclusion:The findings of this case series suggest that FM may produce immediate reductions in pain in patients presenting with myofascial densification and features of CS.
Background:Plantar fasciitis (PF) is a common foot condition characterized by heel pain. Deep friction massage and Graston technique (GT) are manual therapy techniques used to manage PF. This scoping review aimed to assess the effectiveness of these techniques on pain, disability, and function in individuals with PF, as measured by the Foot Function Index (FFI). Methods:A comprehensive literature search was conducted in electronic databases (PubMed, PEDro, EBSCOhost, Cochrane Library) using relevant keywords. Studies were included if they involved adult participants with PF, utilized deep friction massage and/or GT as the intervention, and employed the FFI as an outcome measure. Data were extracted on study characteristics, participants, interventions, and outcomes. Results:Six studies (five randomized controlled trials and one quasi-experimental study) involving 299 participants were included. All studies indicated statistically significant changes or improvements in within-group FFI after deep friction massage or GT. Four studies showed absolute changes in FFI measure beyond the minimal clinically important difference (defined as ≥7 points for the total FFI), which indicates some clinical significance regarding a functional change. However, between-group differences varied, and some studies reported no difference between the two treatments. Conclusion:The findings suggest that both deep friction massage and GT may be effective in managing PF. Further research with larger, well-designed studies is needed to assess long-term effects and optimize treatment for diverse patient characteristics. A multimodal approach, considering patient-specific factors, may be necessary to achieve optimal outcomes in PF management.
Background:Commonly, Bell's palsy has been treated with conventional therapy, which can cause secondary effects. On the other hand, manual lymph drainage Vodder (MLDV) is an intervention aimed at reducing edema in lymphatic cases. The use of MLDV as an intervention for Bell's palsy has not been extensively studied. Objectives:The objective of this study was to investigate the effect of MLDV on facial function in patients with Bell's palsy. Methods:This was a retrospective study conducted on 125 patients with Bell's palsy, comparing group 1 (MLDV) with group 2 (standard interventions). The study was conducted in Surabaya, Indonesia, from 2017 to 2024. The interventions were administered three times a week for 40-50 min until the patient was declared recovered. The measurements in this study were facial function (House-Brackmann (HB)) and facial muscle strength (manual muscle test). Results:Statistical analysis using the Wilcoxon test for each group consistently showed p < 0.05 in both facial functional assessment and facial muscle strength. The Mann-Whitney analysis between groups also consistently indicated p < 0.05 for both functional and muscle strength assessments of the face. However, the mean difference was greater in group 1 than in group 2. The mean HB difference in group 1 was -2.11, while in group 2 it was -0.61. The mean muscle strength differences in group 1 was 2.43 and that in group 2 was 0.56. Conclusions:MLDV can be used to improve facial function in Bell's palsy cases without the potential for side effects compared to conventional therapy.
Background:Plantar fasciitis is characterized by degenerative changes and irritation at the origin of the plantar fascia, primarily involving the medial calcaneal tuberosity and the surrounding perifascial soft tissues. Common causes include overuse from activities such as running, prolonged standing, or walking on hard surfaces, which can lead to small tears in the fascia. Other contributing factors include wearing unsupportive footwear, obesity, and foot conditions such as pes planus or cavus. Methods:Fifty-eight subjects with plantar fasciitis were selected and randomly assigned to two groups. Both groups underwent an intervention. The intervention group received myofascial release, while those in the traditional group received calf stretching. Both interventions were administered three sessions per week for 8 weeks. The Functional Foot Index (FFI) and Numeric Pain Rating Scale (NPRS) were used to assess outcomes before and after the intervention. The significance of the changes observed before and after the intervention was evaluated using the Wilcoxon signed-rank test and the Mann-Whitney U test. Result:The Wilcoxon signed-rank test demonstrated a significant reduction in NPRS following both the interventional therapy (Z = -4.898, p < 0.001) and traditional therapy (Z = -4.522, p < 0.001). The Mann-Whitney U test revealed no significant difference between groups at baseline (p = 0.77); however, a significant difference was observed post-intervention (p = 0.002), favoring interventional therapy. Effect sizes for the NPRS were r = 0.32 (small) at baseline and r = 0.58 (large) post-intervention. Similarly, FFI scores demonstrated a significant post-intervention difference between groups (p = 0.005), with effect sizes of r = 0.39 (small) at baseline and r = 0.52 (large) post-intervention. Conclusion:According to the study, myofascial release helps individuals with plantar fasciitis by improving function and reducing pain and disability, with no reported adverse effects. This technique appears to be a more effective treatment than traditional physiotherapy, thereby strengthening the evidence base for physical therapy protocols.
Background:After giving birth, women may experience postpartum neck pain, which is frequently brought on by hormonal changes, physical strain during labor, or bad posture while tending to the newborn. In order to encourage relaxation, lessen pain, and enhance general well-being, craniosacral therapy (CST) is a gentle, hands-on method that focuses on releasing tension in the craniosacral system, which includes the fluid and membranes surrounding the brain and spinal cord. Purpose:To assess immediate effects of CST on postpartum neck pain. It sought to evaluate changes in the intensity of neck pain and neck muscle contraction prior to treatment and 24 hours following CST. Pain severity was assessed using the Numerical Pain Rating Scale (NPRS) and neck muscle contraction was assessed using a pressure biofeedback unit (PBU). Setting:Maternity wards of a tertiary-care hospital in Karnataka, India. Participants:Postpartum women aged 21-40 years who were experiencing neck pain in the early puerperal period. Research design:A single-group pre- and post-intervention experimental study. Intervention:A single 30-min session of CST. Main outcome measures:NPRS and craniocervical flexion test against PBU. Assessments were conducted pre-intervention and 24 h post-intervention. The data analysis was carried out using SPSS 29.0 software and Microsoft Excel 2019. Results:CST resulted in a statistically significant reduction in postpartum neck pain, with the NPRS median score decreasing from 6 to 1 (76.14% reduction, p < 0.01). Additionally, there was a 4.40% increase in deep neck flexor muscle activation, as indicated by the PBU median value increasing from 27 mmHg to 28 mmHg (p < 0.01). Conclusion:A single 30-min CST session significantly reduced postpartum neck pain and improved deep neck flexor muscle activation. These findings highlight CST as an effective immediate intervention for pain relief and muscle function enhancement in postpartum women.
