EFFECTIVENESS OF MYOFASCIAL RELEASE IN TREATMENT OF CHRONIC MUSCULOSKELETAL PAIN: A SYSTEMATIC REVIEW

Review written by Dr Sandy Hilton info

BACKGROUND & OBJECTIVE

Problems with connective tissue and fascia (the sheets of connective tissue througout the body), are purported to be an underlying cause of chronic musculoskeletal pain. Myofascial release techniques are said to be able to change the tension and mobility of connetive tissue in order to eliminate pain and restore function. Previous reviews include case studies and low quality/highly biased studies. The objective of this study was to look at the evidence of myofascial release in relieving pain, improving joint mobility, function, and quality of life for patients suffering with chronic musculoskeletal pain.

METHODS

Search criteria for this systematic review followed the PICO framework (Population, Intervention, Comparison, and Outcome). The search terms were limited to "myofascial release" and "self myofascial release" (direct or indirect techniques) and excluded myofascial trigger point treatment, non-specific massage, or other types of manual theraphy. 513 records were identified, 124 records met the screening criteria, 14 full-text articles were assessed for eligibility, and 8 studies were included in qualitative and quantitative analysis. Two separate groups completed the reviews, with a third reviewer in case of conflict. The methodological quality was assessed using the Cochrane Collaboration's guidelines and rated on a standardized assessment of bias. The scores for each RCT were graded as low, high, or unclear risk. This review looked at the minimal clinically important difference (MCID) of each included study to describe the clinical relevance of the findings. No meta-analysis could be completed due to the high variability between the included studies.

RESULTS

The 8 RCTs included 457 participants. The duration of follow-up varied from immediate assessment after treatment to up to one year. The risk of bias was high for 5 of the 8 studies, 3 of which where done in the

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