Myofascial Release and Mobilization With Impulse Technique Torsion in Low Back Pain

Effects of Myofascial Soft Tissue Release and Mobilization With Impulse Technique Torsion in Subjects With Chronic Non-specific Low Back Pain: A Randomized Clinical Trial

The purpose of the current randomized clinical trial was to compare the effectiveness of myofascial soft tissue release versus mobilization with impulse technique torsion (anterior) on pain, disability, and kinesiophobia in individuals with chronic non-specific low back pain.

Design: Randomized Clinical Trial. Objective: to determine the effects of myofascial soft tissue release versus mobilization with impulse technique torsion (anterior) on pain, disability and kinesiophobia in individuals with chronic non-specific low back pain. Methods and Measures: sixty-four individuals will be randomly assigned to one of two groups. Intervention: For 12-week, the group 1 will undergo treatment comprising a myofascial soft tissue release protocol (1/week) and the group 2 will receive a mobilization with impulse technique torsion (anterior) (1/week). Main Outcome Measures: Intensity of pain, disability, fear of movement, isometric endurance of trunk flexor muscles and lumbar mobility in flexion data will be collected at baseline, and 24hr after the last manual therapy application. Mixed-model analyses of variance will be used to examine the effects of the treatment on each outcome measure.

Protocol: Transverse Plane-Level Clavicular Release. Diaphragmatic Transverse Plane Release. Square the Lumbar Fascia Release. Gluteal Fascia Release. Hint Of Pubic Region Release. Fascia Psoas Release. Lumbo-sacral Decompression. Pelvic Floor Release.

Subject in lateral decubitus with extension and lower limb traction contact the couch with contralateral lower limb was performed triple flexion and left trunk rotation. This technique reduces the slack (tension joints) of the ventral pelvis, head and into the contralateral side of the sacrum support (base) with the forearm.

Protocol: Transverse Plane-Level Clavicular Release. Diaphragmatic Transverse Plane Release. Square the Lumbar Fascia Release. Gluteal Fascia Release. Hint Of Pubic Region Release. Fascia Psoas Release. Lumbo-sacral Decompression. Pelvic Floor Release.

Subject in lateral decubitus with extension and lower limb traction contact the couch with contralateral lower limb was performed triple flexion and left trunk rotation. This technique reduces the slack (tension joints) of the ventral pelvis, head and into the contralateral side of the sacrum support (base) with the forearm.

This is a self-reported questionnaire consisting of 24 items reflecting limitations in different activities of daily living attributed to low back pain including walking, bending over, sitting, lying down, dressing, sleeping, self-care and daily activities.

The ODI has 10 items referring to activities of daily living that might be disrupted by low back pain. Each item is answered on a 6-point Likert scale ranging from "no problem at all" [0] to "not possible" [5]. The total score ranges from 0 to 50.

A 10-point Numerical Pain Rating Scale (NPRS; 0: no pain, 10: maximum pain) assesses the patients' current level of pain, and the worst and lowest level of pain experienced in the preceding 24 hours.

The Tampa Scale of Kinesiophobia (TSK) is a 17-item questionnaire developed to measure the fear of movement and (re)injury. Each item is scored on a four-point Likert scale ranging from "strongly disagree" [1] to "strongly agree" [4].

Inclusion Criteria: Score ≥4 on the Roland Morris Disability Questionnaire Inability to achieve lumbar muscle flexion-relaxation in trunk flexion Low back pain for ≥3 months Not undergoing another physical therapy treatment Exclusion Criteria: Disease of the central or peripheral nervous system Having previously undergone spinal manipulative therapy Contraindication to low back thrust manipulation A history of spinal surgery Treatment with corticosteroid in the past two weeks Clinical signs of radiculopathy Presence of lumbar stenosis Diagnosis of spondylolisthesis

Cymet TC. Osteopathic manual treatment and ultrasound therapy for chronic low back pain: an illustration of osteopathic semantic confusion. J Am Osteopath Assoc. 2014 Jan;114(1):6-7. doi: 10.7556/jaoa.2014.002. No abstract available.

Hidalgo B, Hall T, Nielens H, Detrembleur C. Intertester agreement and validity of identifying lumbar pain provocative movement patterns using active and passive accessory movement tests. J Manipulative Physiol Ther. 2014 Feb;37(2):105-15. doi: 10.1016/j.jmpt.2013.09.006. Epub 2014 Jan 6.

Ebert R, Campbell A, Kemp-Smith K, O'Sullivan P. Lumbar spine side bending is reduced in end range extension compared to neutral and end range flexion postures. Man Ther. 2014 Apr;19(2):114-8. doi: 10.1016/j.math.2013.08.004. Epub 2013 Sep 4.

Rabin A, Shashua A, Pizem K, Dickstein R, Dar G. A clinical prediction rule to identify patients with low back pain who are likely to experience short-term success following lumbar stabilization exercises: a randomized controlled validation study. J Orthop Sports Phys Ther. 2014 Jan;44(1):6-B13. doi: 10.2519/jospt.2014.4888. Epub 2013 Nov 21.

Zimney K, Louw A, Puentedura EJ. Use of Therapeutic Neuroscience Education to address psychosocial factors associated with acute low back pain: a case report. Physiother Theory Pract. 2014 Apr;30(3):202-9. doi: 10.3109/09593985.2013.856508. Epub 2013 Nov 19.

Haskins R, Osmotherly PG, Southgate E, Rivett DA. Physiotherapists' knowledge, attitudes and practices regarding clinical prediction rules for low back pain. Man Ther. 2014 Apr;19(2):142-51. doi: 10.1016/j.math.2013.09.005. Epub 2013 Oct 3.

Licciardone JC. Osteopathic manual treatment and ultrasound therapy for chronic low back pain: an illustration of osteopathic semantic confusion. Author reply. J Am Osteopath Assoc. 2013 Sep;113(9):661-2. doi: 10.7556/jaoa.2013.031. No abstract available.

Kumar S, Beaton K, Hughes T. The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews. Int J Gen Med. 2013 Sep 4;6:733-41. doi: 10.2147/IJGM.S50243.

Leysen P, Bombeke K, Remmen R. Osteopathic manual treatment and ultrasound therapy for chronic low back pain: an illustration of osteopathic semantic confusion. J Am Osteopath Assoc. 2013 Sep;113(9):660-1. doi: 10.7556/jaoa.2013.030. No abstract available.

Bachmann S, Oesch P. [Physiotherapy and rehabilitation for low back pain]. Ther Umsch. 2013 Sep;70(9):543-8. doi: 10.1024/0040-5930/a000444. German.

Hands-on treatment helps low back pain. Harv Womens Health Watch. 2013 Jun;20(10):8. No abstract available.

Eirikstoft H, Kongsted A. Patient characteristics in low back pain subgroups based on an existing classification system. A descriptive cohort study in chiropractic practice. Man Ther. 2014 Feb;19(1):65-71. doi: 10.1016/j.math.2013.07.007. Epub 2013 Aug 6.

Muir JM. Chiropractic management of a patient with low back pain and Castellvi type II lumbosacral transitional vertebrae. J Chiropr Med. 2012 Dec;11(4):254-9. doi: 10.1016/j.jcm.2012.02.005.

Donaldson M, Learman K, O'Halloran B, Showalter C, Cook C. The role of patients' expectation of appropriate initial manual therapy treatment in outcomes for patients with low back pain. J Manipulative Physiol Ther. 2013 Jun;36(5):276-83. doi: 10.1016/j.jmpt.2013.05.016.