IMMEDIATE BIOMECHANICAL, SYSTEMIC, AND INTEROCEPTIVE EFFECTS OF MYOFASCIAL RELEASE ON THE THORACIC SPINE: A RANDOMISED CONTROLLED TRIAL

Review written by Robin Kerr info

BACKGROUND & OBJECTIVE

Myofascial release (MFR) is a commonly used manual therapy technique that is increasingly embroiled in debate as to what mechanism(s) may possibly underlie its positive anecdotal treatment outcomes. This RCT attempted to explore the outcome effects of a MFR technique applied to the thoracic spine on Biomechanical, Systemic and Interoceptive Sensitivity factors. A further objective was to present a battery of outcome measures that measure pre and post MFR effects.

Biomechanical - plasticity, elasticity and viscosity of tissue.

  • Hypothesis 1: MFR may induce a more fluid state in the fascia with resultant increased range of motion compared to sham or control.

Systemic - local neurological responses and global autonomic reflex impacts may be reflected in pressure pain threshold (PPT) changes.

  • Hypothesis 2: MFR may lead to local and systemic neurological responses associated with an increase in the PPT compared to sham or control.

Interoceptive Sensitivity (IS) - Interoception refers to a set of neurological pathways which allow bodily signals to reach cognition and form bodily awareness.

  • Hypothesis 3: Baseline interoceptive sensitivity would be negatively correlated with PPT, plus there will also be a correlation between baseline IS & range of motion (ROM) with no predicted direction.

METHODS

This was a triple-blind, randomised, sham controlled, within subjects, crossover study design. 12 first year Welsh osteopathy students were recruited. Experimental intervention was MFR applied to T6-12 for 120 seconds.

  • Biomechanical: ROM obtained via inclinometer at T6 & S2.
  • Systemic: PPT obtained via pressure algometry at C7 & T10 erector spinae and tibialis anterior.
  • IS: obtained via ECG analysis - participants verbally estimated their heartbeats without an exteroceptive aid. This was then compared to the recorded score via a heart rate monitor.

RESULTS

Biomechanical effects (ROM): MFR had a significant positive effect on ROM. Pairwise comparisons -> MFR was significant when compared against sham and control. Systemic (PPT): Large effect sizes for MFR. PPT increased locally and outside the applied MFR area vs

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