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Fascial plasticity - A new neurobiological explanation. Part 2
Abstract
Part 1 of this two part article showed that immediate fascial responsiveness to manipulation cannot be explained by its mechanical properties alone. Fascia is densely innervated by mechanoreceptors which are responsive to myofascial manipulation. They are intimately connected with the central nervous system and specially with the autonomic nervous system. Part 2 of the article shows how stimulation of these receptors can trigger viscosity changes in the ground substance. The discovery and implications of the existence of fascial smooth muscle cells are of special interest in relation to fibromyalgia, amongst other conditions. An attitudinal shift is suggested, from a mechanical body concept towards a cybernetic model, in which the practitioner's intervention are seen as stimulation for self-regulatory processes within the client's organism. Practical implications of this approach in myofascial manipulation will be explored.
... On the other hand, fascial restrictions obviously decrease blood flow by vascular compression [24]. It is known from previous studies that fascial blood flow and oxygen saturation are dependent on individual physical activity (PA), age, and body mass index (BMI) [10,20,22,23,25,26]. Neurological factors also play an important role in the blood supply to fascia [5,6,16]. ...
... In MFR treatment, the myofascial tissue is treated with a mechanical shearing motion (combination of compression and stretching) with low force and slow speed [27]. This is thought to result in a lasting change in the morphology of the fascia and also its hydration [25,26,29,30], because fascial tissue response to balanced, sustained stretching is more likely than to intermittent, uneven loads [31]. In addition, the numerous free nerve endings that act as proprioceptors, nociceptors, or nerve structures that innervate blood vessels could trigger a range of neuromuscular and neurovascular reflexes [5,32]. ...
... Therefore, in addition to altering skin receptors, MFR techniques could also stimulate free nerve endings with mechanoceptive, nociceptive, autonomic, and vascular functions in the fascial tissue under the skin. In contrast, the much gentler touch of PLC treatment likely affects only skin receptors [5,16,25,26]. ...
(1) Background: Inflammatory processes in the thoracolumbar fascia (TLF) lead to thickening, compaction, and fibrosis and are thought to contribute to the development of nonspecific low back pain (nLBP). The blood flow (BF) of fascial tissue may play a critical role in this process, as it may promote hypoxia-induced inflammation. The primary objective of the study was to examine the immediate effects of a set of myofascial release (MFR) techniques on the BF of lumbar myofascial tissue. The secondary objectives were to evaluate the influence of TLF morphology (TLFM), physical activity (PA), and body mass index (BMI) on these parameters and their correlations with each other. (2) Methods: This study was a single-blind, randomized, placebo-controlled trial. Thirty pain-free subjects (40.5 ± 14.1 years) were randomly assigned to two groups treated with MFR or a placebo intervention. Correlations between PA, BMI, and TLFM were calculated at baseline. The effects of MFR and TLFM on BF (measured with white light and laser Doppler spectroscopy) were determined. (3) Results: The MFR group had a significant increase in BF after treatment (31.6%) and at follow-up (48.7%) compared with the placebo group. BF was significantly different between disorganized and organized TLFM (p < 0.0001). There were strong correlations between PA (r = −0.648), PA (d = 0.681), BMI (r = −0.798), and TLFM. (4) Conclusions: Impaired blood flow could lead to hypoxia-induced inflammation, possibly resulting in pain and impaired proprioceptive function, thereby likely contributing to the development of nLBP. Fascial restrictions of blood vessels and free nerve endings, which are likely associated with TLFM, could be positively affected by the intervention in this study.
... We hypothesize that OCM may affect pain and cervical spine aROM by the manual stimulation of mechanoreceptors contained inside the fascial system, leading to tonus changes in the motor unit that are mechanically linked to the tissue under the practitioner's hand. 20 We propose that cranial techniques could induce physiological movement of the spine and decreased pain, interacting with the central nervous system via the fascial tissue. 20 Cervicogenic headache following whiplash injury may be referred pain from the cervical spine. ...
... 20 We propose that cranial techniques could induce physiological movement of the spine and decreased pain, interacting with the central nervous system via the fascial tissue. 20 Cervicogenic headache following whiplash injury may be referred pain from the cervical spine. 21 Physiologically, cervicogenic pain is analogous to shoulder, chest wall, buttock, or lower limb pain referred from spinal sources. ...
... 21 Physiologically, cervicogenic pain is analogous to shoulder, chest wall, buttock, or lower limb pain referred from spinal sources. 20 The hypothesized mechanism underlying the pain involves convergence between the cervical and trigeminal afferents in the trigeminocervical nucleus. In this nucleus, nociceptive afferents from C1-C2 and C3 spinal nerves converge onto second-order neurons that also receive afferents from adjacent cervical nerves and from the first division of the trigeminal nerve via the trigeminal nerve spinal tract. ...
Objective
The purpose of this case report is to describe the immediate effects of osteopathic cranial manipulation on pain and cervical motion in a patient with whiplash-associated disorder.
Clinical Features
A 74-year-old man reported daily cervicogenic headaches after a whiplash injury caused by a traffic accident 3 months prior. Physical examination and osteopathic assessment identified tissue texture alteration, positional asymmetry, limited range of motion, and tenderness. The resulting diagnosis was somatic dysfunction of the head and the cervical region.
Intervention and Outcome
Osteopathic manipulative treatment was administered to the occipital area. The patient reported an immediate improvement in pain. Accessory movement of the cervical spine was improved.
Conclusion
This patient responded favorable to osteopathic cranial manipulation with improved symptoms and ranges of motion.
... De nombreuses recherches sur le fascia (Findley, Chaudhry, Stecco, Roman, 2012 ;Willard, Vleeming, Schuenke, Danneels, Schleip, 2003, 2003a) ont par ailleurs confirmé la plupart des intuitions de D. Bois qui a été l'un des premiers à diffuser et à modéliser en France la fasciathérapie, thérapie manuelle ciblée sur le fascia. Dans ses premiers ouvrages (1984,1985,1995), D. Bois soulignait l'unité dynamique de fonction de ce tissu particulier : « Ainsi, l'être humain est une unité dynamique de fonction dont chaque partie est intégrée aux autres par cette membrane vivante qu'est le fascia ; ce dernier apparaît comme étant l'outil essentiel capable de transformer les individualités anatomiques en une unité fonctionnelle. ...
... » 1990. Aujourd'hui les chercheurs évoquent l'existence d'une contractilité fasciale faisant du fascia un tissu vivant, actif et interconnecté avec le système nerveux (Schleip, 2003(Schleip, , 2003a. La présence de cellules contractiles (myofibroblastes) dans les tissus fasciaux sains et pathologiques (Findley, Schleip, 2007, Schleip, 2003, Schleip et al, 2005 (Bois, 1984, 1985, Quéré, 2004. ...
... La présence de cellules contractiles (myofibroblastes) dans les tissus fasciaux sains et pathologiques (Findley, Schleip, 2007, Schleip, 2003, Schleip et al, 2005 (Bois, 1984, 1985, Quéré, 2004. Nous trouvons également un apport scientifique sur le lien qui existerait entre le tonus du fascia et le tonus psychique (dénommé psychotonus Bois, 2006, Courraud, 2004, 2007a, Quéré, 2010 Schleip (2003Schleip ( , 2003a. Selon cet auteur, la forme du fascia ne peut être modifiée par une action manuelle mais la main peut entraîner une auto-régulation locale et générale par activation du système nerveux central expliquant les sensations de relâchement perçues par le praticien : ...
The study of the professional identity which is developed in this thesis addresses the themes of profession, professionalization and professional identity, which are all current issues in the present background of modernization and job mobility. This research is taking place in the the field of French physiotherapy, a profession which has undergone different phases of transformations and identity changes. The other field carried out by this research is fasciatherapy Danis Bois Method, a manual therapy originated in osteopathy which has long been part of the physiotherapy environment. The research question was formulated in order to address this cross section between physiotherapy and fasciatherapy: « How and in what ways do physiotherapists who practice fasciatherapy are led to reconfigure their professional identity ? » In view of bringing answers to such questioning, a quantitative survey was conducted using a self-administered questionnaire on 446 physiotherapists practicing fasciatherapy. This survey brought numerous results and information which allow a better understanding of the identity of the investigated physiotherapists, with regards to their reference profession. It reveals the existence of three identity profiles amongst physiotherapists practicing fasciatherapy, and also documents identity reconfiguring processes depending on the profile. This piece of work forms a scientific basis for further characterization and assessment of fasciatherapy specificities with regards to its professional and institutional acknowledgement.
... More recently, a complex interplay of biomechanical and neurophysiological mechanisms have been suggested as an appropriate and worthy concept as a potential mechanism of action for manual therapy including MFR (Bialosky et al. 2009) and (Bialosky et al. 2018). This correlates with the concept discussed by Dr Schleip for almost two decades and is a current and on-going area of fascia research (Schleip 2003). ...
... There are many models and hypotheses as to how MFR may mechanically work including piezoelectricity and the semi conductive nature of fascia (Oschman in Schleip at al. 2022 p188), thixotropy (Schleip 2003), viscoelasticity (Yahia 1993) and fluid dynamics (Meert in Schleip et al 2022, p294) and (Bordoni 2018). There are also many models regarding the structure of fascia including biotensegrity, chains, bags and lines. ...
All of us were taught about the nervous system in our manual therapy training. But, often anatomy and physiology (A&P) were taught as stand alone systems where their integrated workings were either missed or lost. This, for many of us, resulted in an inadequate understanding of how systems influence each other in health and disease.
... The objectives of each session are listed in Table 1. In addition to restoring fascial gliding, the intervention applied by the therapist aims to alter skin receptors and also mechanoreceptors in fascial tissue under the skin (e.g., in the epi/peri/endomysium, fascia profunda, tendons, and joint capsules) [17][18][19]. Jacobson et al. [16] also described an intense psycho-emotional effect of SI. Weinberg et Hunt [20] showed that SI is able to reduce state-trait anxiety. ...
... Here, SI treatment may have altered mechanoreceptors in fascial tissue (e.g., in the epi/peri/endomysium, fascia profunda, tendons, and joint capsules). These may have triggered changes in muscle tone, hydration, and neurological effects, which was likely achieved by the interventions in this study [17,19]. ...
Background:
Recent work has investigated significant force transmission between the components of myofascial chains. Misalignments in the body due to fascial thickening and shortening can therefore lead to complex compensatory patterns. For the treatment of such nonlinear cause-effect pathology, comprehensive neuromusculoskeletal therapy such as the Rolf Method of Structural Integration (SI) could be targeted.
Methods:
A total of 727 subjects were retrospectively screened from the medical records of an SI practice over a 23-year period. A total of 383 subjects who had completed 10 basic SI sessions met eligibility criteria and were assessed for active range of motion (AROM) of the shoulder and hip before and after SI treatment.
Results:
Shoulder flexion, external and internal rotation, and hip flexion improved significantly (all p < 0.0001) after 10 SI sessions. Left shoulder flexion and external rotation of both shoulders increased more in men than in women (p < 0.0001) but were not affected by age.
Conclusions:
An SI intervention could produce multiple changes in the components of myofascial chains that could help maintain upright posture in humans and reduce inadequate compensatory patterns. SI may also affect differently the outcome of some AROM parameters in women and men.
... Whilst there is scant evidence to detect how sensory cells adjust to mechanical stimuli [62], recent research [63] proposes that the investing visceral fascia that closely relates to organs and supports them, may be richly innervated by fibres from the autonomic nervous system, and thereby affect metabolic behaviour. Further studies have supported this view of manual manipulation of fascia globally affecting the autonomic nervous system [64,65]. ...
... One of the founding osteopathic principles identified by A.T. Still in 1910 is the "rule of the artery is supreme", such that any obstruction of blood supply may lead to disease. Osteopathic manipulation can affect blood flow via the autonomic nervous system, and by a reduction in tension via the fascia [64,65,73]. Arteries and veins pass through the fascia [74] and may be compromised by fascial restrictions. ...
Reflexology is a complementary therapy focusing mainly on the application of pressure on the feet, hands and ears. A small but growing evidence base suggests that positive outcomes can be gained in the management and improvement of symptoms across a range of conditions. Biological plausibility is a key concept in the determination of the usefulness of therapies. Research which tests for safety and efficacy alongside the underpinning mechanism of action are therefore important.
This paper explores the potential mechanism of action for the outcomes associated with reflexology treatment as reflected in the current evidence. The influences of therapeutic touch, relaxation, placebo effects and the similarities with other therapeutic methods of structural manipulation are considered. The lack of clarity around the precise definition of reflexology and the challenges of researching the therapy as a treatment tailored to individual need are discussed.
A deeper understanding of the mechanism of action for reflexology may help to further develop research into safety and efficacy. Such an understanding may lead to the integration of knowledge which may provide both symptomatic support and longer term preventative health benefits.
... SMR not only stretches muscles and scar tissue, but also provides benefits similar to those of stretching and massage [12]. SMR is well known to increase flexibility, either acutely or chronically [14,15]. ...
... In this study, trunk and shoulder flexibility significantly improved after performing one bout of foam rolling in both young and middle-aged women groups. Previous studies suggested that SMR increases flexibility by increasing blood flow and soft tissue circulation [14,21]. During SMR, when pressure increases, mechanical receptors (i.e., Golgi tendon organs, the Ruffini and Pacinian corpuscles) stimulate the nervous system, resulting in decreases in muscle tone and increases in flexibility [13,15]. ...
PURPOSE: Arterial stiffness is an independent risk factor for cardiovascular disease and inversely associated with flexibility. Self-myofascial release (SMR) using a foam roller is a popular intervention to improve flexibility, restore the muscles, fascia, tendons, and ligaments, and regain soft-tissue extensibility. This study aimed to investigate whether a single bout of SMR has a beneficial effect on arterial stiffness and the function of the autonomic nervous system and the relationships among these variables in young and middle-aged women by age.METHODS: Ten healthy young (23.20±0.59 years) and 10 middle-aged women (44.50±0.91 years) completed an instructed SMR using a foam roller. Brachial-ankle pulse wave velocity (baPWV), augmentation index (AIx), trunk flexibility, shoulder flexibility, heart rate variability, including standard deviation of normal R-R intervals (SDNN), and the root mean square of the standard deviation of the time between heartbeats (RMSSD) were measured before and after one 30-minutes bout of SMR.RESULTS: After one bout of SMR, trunk and shoulder flexibility increased in both groups of women, while AIx decreased significantly (from 6.9±2.9 to -1.9±4.6%, p=.0072, young women group; from 22.1±3.4 to 14.7±1.7%, p=.0049, middle-aged women group). However, the baPWV, RMSSD, and SDNN did not change. In the analysis of correlations between all measured variables, changes in AIx showed negative correlations with flexibility and SDNN.CONCLUSIONS: This study suggests that one bout of SMR using a foam roller positively affected arterial stiffness in women by reducing AIx and improving flexibility.
... At the same time, smooth muscle in the fascia has been demonstrated, implying that the fascia may have a system of tone adjustment, independent of muscle tone. [12] However, when assessing biomechanical properties by palpation or indentation testing, these two components are examined simultaneously. Therefore, some authors [9] suggest using the term "myofascial tone" instead when assessing it. ...
“Muscle tone” is a clinically important and widely used term and palpation is a crucial skill for its diagnosis. However, the term is defined rather vaguely, and palpation is not measurable objectively. Therefore, several methods have been developed to measure muscle tone objectively, in terms of biomechanical properties of the muscle. This article aims to summarize these approaches. Through database searches, we identified those studies related to objective muscle tone measurement in vivo, in situ. Based on them, we described existing methods and devices and compared their reliability. Furthermore, we presented an extensive list of the use of these methods in different fields of research. Although it is believed by some authors that palpation cannot be replaced by a mechanical device, several methods have already proved their utility in muscle biomechanical property diagnosis. There appear to be two issues preventing wider usage of these objective methods in clinical practice. Firstly, a high variability of their reliability, and secondly, a lack of valid mathematical models that would provide the observed mechanical characteristics with a clear physical significance and allow the results to be compared with each other.
... mechanoreceptors such as the Golgi tendon organ, Pacinian, Meissner, Ruffini corpuscules, and interstitial type III and IV receptors, hence yielding bottom-up regulations of autonomic nervous system activities. 49,50,61 This is a possible mechanism underlying MM use to promote well-being through enhanced psychophysiological relaxation states. 1 MM requires a trained practitioner to perform manual maneuvers such as effleurage, kneading, or sliding pressures. MM is thus a difficult intervention to scale, which represents a major obstacle to its democratization. ...
Background:
Manual massage (MM) interventions can improve psychophysiological states of relaxation and well-being. In this context, robotic massage (RM) represents a promising, but currently understudied, solution.
Hypothesis:
Both MM and RM would improve flexibility of the hamstrings and lumbopelvic muscles and promote a psychophysiological state of relaxation through decreased sympathetic activity.
Study design:
Single-blind randomized crossover trial.
Level of evidence:
Level 2.
Methods:
A total of 21 participants experienced 2 massage interventions targeting back soft tissues. During a first condition, the intervention was performed by a physical therapist, whereas during a second condition the intervention was performed by a robot. We collected objective and subjective indexes of performances and well-being before and after each massage intervention. We also collected physical therapists' self-reports of perceived fatigue, tension, and ability to maintain the massage routine.
Results:
Skin conductance decreased from the pretest to the posttest in both conditions (partial R2 = 0.44, 95% CI [0.30, 1.00], P < 0.01), although the decrease was more pronounced after MM. Whereas both interventions were associated with improved subjective sensations, eg, pain, warmth, well-being (partial R2 = 0.08, 95% CI [0.06, 1.00], P < 0.01), MM yielded additional benefits compared with RM. The physical therapist reported greater fatigue and tension and reduced perceived massage efficiency along with repeated massage interventions. MM outperformed RM to elicit a psychophysiological state of relaxation.
Conclusion:
RM exhibited a pattern of changes comparable with that of MM, for both objective and subjective indexes of relaxation and well-being.
Clinical relevance:
RM could represent a prophylactic option to prevent the onset of counterproductive fatigability in physical therapists.
... [32] The third objective of present study was to compare the pre and post effect of NDYT and IASTM with Tailored [28] Markovic et al. [49] explained that increasing temperature of the corresponding local region during application of stroking results in increased sliding of the fascia layer, and decreased collagen resistance. Furthermore, according to Schleip et al. [50] , muscle tone is lowered since the IASTM activates the mechanoreceptor of the inner layer of fascia and converts it into proprioceptive stimulation to affect the central nervous system. Simatou et al. [51] conducted a study which suggest that IASTM uses the narrow surface area so that deeper penetration into the target is performed, with stimulation strength of the mechanoreceptor being different from that of another intervention method. ...
Background: Stroke is the sudden loss of neurological function manifested by Motor deficits on one side mainly (altered tone and postural control). Post-stroke UE altered tone mainly Hypertonicity in which neuromuscular imbalance of agonist and antagonist strength, soft tissue stiffness which may be causing Abnormal postural limb patterns and severe functional limitations decreased quality of life. velocity-dependent increase in tonic stretch reflexes, can distinguish Spasticity from other similar movement disorders such as rigidity, hyperreflexia. NDYT reduces tension of neural tissue with neural sliding phenomenon, to inhibit hypertonic muscle and lengthen muscle fiber IASTM is used. Method: 39 Participants were selected on basis of inclusion criteria & exclusion criteria. Pre and post measurement of FMA-UE, MAL and MTS was administered for Shoulder adductors, elbow, wrist and finger flexors. 3 sessions per week for 2 weeks, all participants were given 40-minutes Tailored Protocol (TP), and 15-minute per session additionally for IASTM and NDYT group. Result: There is significant difference in all 4 domains of MTS (P<0.05) between three groups and no difference in FMA-UE and MAL scale. Conclusion: IASTM technique shows better improvement of upper extremity muscle tone and reduces spasticity.
... Additionally, an increase in lower limb muscle ROM after DS can be due to an increase in temperature that leads to a decrease in the viscous resistance of muscles (58) and enhances tissue extensibility (without entering pain-tolerated intensity) resulting in greater angular displacement (59,60). The foam roller is supposed to place direct and sweeping pressure on the soft tissue to stretch the tissue and give rise to friction between the soft tissue of the body and the foam roller, resulting in greater flexibility (29,61). The friction created between the fascia and foam roller causes warming of the fascia and generates fluid gel-like extracellular substance; the thixotropic property of fascia (21). ...
Nr 2023;13 (1):61-75 61 SUMMARY Background. Dynamic stretching (DS) and foam rolling (FR) are frequently being used as warm-up to improve bio-motor ability. The review aimed to compare the acute effects (immediate and five minutes post-intervention) of DS and FR on flexibility, jump height, and muscular strength in the athletic and physically active population. Methods. Electronic databases (Medline/PubMed, Web of Science, Scopus, Google Scholar, Cochrane Library, PEDro, and Hooked on evidence databases) were searched to obtain relevant studies. The methodological quality of the studies was assessed with the Physiotherapy evidence database (PEDro) scale. Meta-analysis was performed using the Rev Man 5.3 software to pool outcomes using the random-effects model, standardized mean difference (SMD) and 95% confidence interval (CI), and significance level set to p < 0.05. Results. 406 papers were found and eight were included (n = 174).There was no significant mean difference between FR and DS on flexibility (immediate) (SMD: 0.15 (95%CI 0.23-0.52); p = 0.45), flexibility (five-minute) (SMD: 0.11 (95%CI-0.26-0.48); p = 0.55), jump height (immediate) (SMD: 0.20 (95%CI 0.12-0.53); p = 0.22), leg extensor strength (immediate) (SMD: 0.28 (95%CI 0.34-0.89); p = 0.37) and leg flex-or strength (immediate) (SMD: 0.69 (95%CI 0.52-1.91); p = 0.26). The dosimetry from the qualitative summarization of studies suggests 2 sets (60 seconds each) of each FR and DS were performed on each muscle of the lower quadrant. Conclusions. FR and DS exert similar magnitude of effect on flexibility, jump height, and muscular strength. The findings could help clinicians plan mode of warm-up for athletes. Study registration. The study was registered in PROSPERO vide n. CRD42021225107.
... Nervensystem beeinfl usst werden. Um es einfacher auszudrücken: Jeder Eingriff in die Faszien ist auch ein Eingriff in das autonome System."[29] Diese faszinierende neue Hypothese motivierte unsere kleine Forschungsgruppe an der Universität Ulm dazu, die aktive kontraktile Kapazität des Fasziengewebes in umfangreichen Laboruntersuchungen über 10 Jahre lang weiter zu erforschen.In unseren abschließenden Veröffentlichungen dokumentierten wir, dass wir in allen untersuchten Faszien kontraktile Zellen fanden, wenn auch mit Unterschieden in ihrer Dichte.Interessanterweise wies die menschliche Fascia thoracolumbalis eine höhere Dichte solcher Zellen auf als andere menschliche Faszien oder die Lumbalfaszien von Tieren, die wir untersucht hatten. ...
... Nervensystem beeinfl usst werden. Um es einfacher auszudrücken: Jeder Eingriff in die Faszien ist auch ein Eingriff in das autonome System."[29] Diese faszinierende neue Hypothese motivierte unsere kleine Forschungsgruppe an der Universität Ulm dazu, die aktive kontraktile Kapazität des Fasziengewebes in umfangreichen Laboruntersuchungen über 10 Jahre lang weiter zu erforschen.In unseren abschließenden Veröffentlichungen dokumentierten wir, dass wir in allen untersuchten Faszien kontraktile Zellen fanden, wenn auch mit Unterschieden in ihrer Dichte.Interessanterweise wies die menschliche Fascia thoracolumbalis eine höhere Dichte solcher Zellen auf als andere menschliche Faszien oder die Lumbalfaszien von Tieren, die wir untersucht hatten. ...
Teil 1 der 2-teiligen Artikelserie zu diesem Thema. Teil 2 erscheint in der nächsten Ausgabe des Journals.
... Through deep tissue stimulation and localized vasodilation, MET suppresses sympathetic tone (17). Active muscle contraction has been shown to cause some changes in neurophysiological effects, including pain and stiffness which is followed by muscle stretched further (12,18). ...
Introduction and Aim: Muscle Energy Technique (MET) is a type of manual treatment that utilises the energy of the muscle in the form of a mild isometric contraction to stretch the muscle and relax the muscles through reciprocal or autogenic inhibition. An idiopathic ailment of the shoulder joint known as frozen shoulder is characterised by a rapid onset of shoulder discomfort and a limitation in mobility. Much research has been conducted to determine how various manual approaches affect shoulder discomfort. This study focuses on how MET affects pain and range of motion during the initial stages of rehabilitation. Materials and Methods: Patients who are diagnosed with frozen shoulders with fulfilling the inclusion and exclusion criteria were selected for the study. In the current study, thirty patients who had a prevalence of musculoskeletal complications of the frozen shoulder were selected. Out of which eighteen are male and twelve are female. To identify the prevalence each patient's range of motion and VAS Score for pain sensation were recorded. The same patients have been introduced to MET for another seven days. MET includes 5 repetitions/sets, 3 sets/session, and 1 session/day. A statistical test was performed to identify the significant difference between pre and post-values. Results: Most of the patients had an average range of motion (Flexion) (of 132±18.96), range of motion (Abduction) of (107.00±12.77), range of motion (Rotation) of (63.50±9.39) and VAS score was (5.96±1.29). Most patients showed the improvement in range of motion and a decrease in pain sensation as per the VAS Score. Conclusion: This study shows that MET effectively improves the range of motion and functional ability, relieving pain in Frozen Shoulder patients in the early stage of rehabilitation.
... According to leading fascia researcher Dr Robert Schleip "Fascia is the Cinderella of body tissues-systematically ignored, dissected out and thrown away in bits" [3]. Increased levels of interest in fascia anatomy has led to the production of two fascia atlases one by Professor of anatomy Carla Stecco published in 2015 entitled [4]. ...
... Consequently, temperature shifts occur that have been posited to influence skeletal muscles and fascial connective tissue for changes of biomechanical contraction and relaxation parameters and stretch responses (14). Regarding the increase in stretch tolerance and adaptations in the central nervous system, according to Schleip, the physiology behind the FRT can be attributed to the autonomic nervous system and the central nervous system (36,37). In FR, the increases in ROM may be attributed to an increased stretch tolerance (28). ...
Espí-López, GV, Ruescas-Nicolau, MA, Castellet-García, M, Suso-Martí, L, Cuenca-Martínez, F, and Marques-Sule, E. Effectiveness of foam rolling vs. manual therapy in postexercise recovery interventions for athletes: A randomized controlled trial. J Strength Cond Res XX(X): 000-000, 2022-Self-massage using foam rolling (FR) has been posited to have similar benefits as those traditionally associated with manual therapy (MT) but more economical, easy, and efficient. Despite the widespread use of this technique for the recovery of athletes, there is no evidence supporting the effectiveness of FR vs. MT. The purpose of this study was to assess the effects of FR self-massage in athletes after a high-intensity exercise session compared with a MT protocol. A randomized controlled trial was performed. Forty-seven volunteer amateur athletes (22.2 ± 2.5 years, 53.2% men) were divided into 3 groups: a FR group (n = 18, performed FR self-massage), a MT group (n = 15, received a MT protocol), and a control group (n = 14, passive recovery). After an intense exercise session, dynamic balance, lumbar and hip flexibility, and leg dynamic force were assessed before and after the intervention and 1 week later. Results showed that, in the FR group, dynamic balance scores increased for both limbs at postintervention (p = 0.001) and at follow-up (p = 0.001). These scores were higher for the FR group vs. the MT group at postintervention (right limb, p = 0.048) and at follow-up (right limb: p = 0.049; left limb: p = 0.048), although this variable differed at baseline. In all the groups, lumbar flexion increased at postintervention (p < 0.05), although it was only maintained in the FR group at follow-up (p = 0.048). In conclusion, self-massage with FR may be more effective than MT for the recovery of dynamic balance in athletes after intense exercise, although this result should be interpreted with caution. Foam rolling could have a relevant role in postexercise recovery to prevent injuries in athletes.
... The acute ROM increases observed as a consequence of stretching are generally attributed to a reduction in sensation [7], which may either reflect a psychological alteration or the willingness of each participant to tolerate greater torque since these expect that following stretching interventions an increase in ROM should occur. The mechanisms attributed to increased ROM after MFR are usually ascribed as either Golgi tendon organs mediated or by Ruffini and Pacini mechanoreceptors reflexes [50]. Despite these mechanisms had been also traditionally attributed to stretching, more recent evidence does not support these assumptions, suggesting that modulation of pain sensation occurs [51,52]. ...
Background
The aim of this study was to compare the positional transversal release (PTR) technique to stretching and evaluate the acute effects on range of movement (ROM), performance and balance.
Methods
Thirty-two healthy individuals (25.3 ± 5.6 years; 68.8 ± 12.5 kg; 172.0 ± 8.8 cm) were tested on four occasions 1 week apart. ROM through a passive straight leg raise, jumping performance through a standing long jump (SLJ) and balance through the Y-balance test were measured. Each measure was assessed before (T0), immediately after (T1) and after 15 min (T2) of the provided intervention. On the first occasion, no intervention was administered (CG). The intervention order was randomized across participants and comprised static stretching (SS), proprioceptive neuromuscular facilitation (PNF) and the PTR technique. A repeated measure analysis of variance was used for comparisons.
Results
No differences across the T0 of the four testing sessions were observed. No differences between T0, T1 and T2 were present for the CG session. A significant time × group interaction for ROM in both legs from T0 to T1 (mean increase of 5.4° and 4.9° for right and left leg, respectively) was observed for SS, PNF and the PTR. No differences for all groups were present between T1 and T2. No differences in the SLJ and in measures of balance were observed across interventions.
Conclusions
The PTR is equally effective as SS and PNF in acutely increasing ROM of the lower limbs. However, the PTR results less time-consuming than SS and PNF. Performance and balance were unaffected by all the proposed interventions.
... Muscle tissue consists of 40% to 50% of body weight and almost 85% of people in their lifetime will complain of muscle aches (Amanolahi Asadollah, 2009). Myofascial pain syndrome is the most common cause of skeletal muscle pain, with trigger points originating from one or more connective tissues about 30-70% of the time, as reported in various studies (Schleip, 2003). Trigger points can be referred to as pain in a special point of skeletal muscle or fascia muscle which is sensitive to touch such that exertion of pressure on that point can lead to sensitivity or reflective pain (Hou et al., 2002). ...
Background: The purpose of this research was studying the impact of 8 weeks selected corrective exercises on neck pain, range of motion in the shoulder and neck of lifesaver women who suffering from forward head posture and myofascial pain syndrome. Methods: The method of research is semi-experimental. The population consists of 30 lifesaver women who suffering from forward head posture and myofascial pain syndrome who they placed randomly in two groups of experimental (33±2.2) and control (33±2.5). Research plan was as the pre-test and post-test with control group. The exercise protocol was carried out by experimental groups for 8 weeks, 3 sessions per week, each session lasting 45 minutes. Studied variables include myofascial pain in the neck, shoulder and neck range of motion. The mean and standard deviation were used as descriptive statistics and in the section of inferential statistics analysis of covariance was used. Results: Results of research indicated that, the protocol on the reform exercise of neck pain (P=0.001), range of motion of shoulder joint (P=0.001) and neck range of motion (P=0.001) has significant difference. Conclusion: Therefore, lifesavers women can benefit from it as a training program to improve and prevent damage caused by head forward and myofascial pain syndrome.
... Manual therapies are thought to influence myofascial tissues such as the TLF through stretch and manual pressure, by disrupting adhesions, improving or stimulating lymphatic and vascular circulation, and reducing abnormally high muscle tone [19][20][21]. Hyaluronan, a glycosoaminoglycan polymer, which normally functions as a lubricant between fascial layers, is compromised with immobility, inflammation, and tissue injury [22][23][24]. Manual therapies temporarily alter intercellular fluid pressures [25], promoting redistributed hyaluronan within and between fascial layers [23,26,27], and potentially serving as a mechanical catalyst for self-resolving inflammation [28]. ...
Background
Thoracolumbar fascia mobility observed with ultrasound imaging and calculated as shear strain is lower in persons with chronic low back pain. This pilot and feasibility trial assessed thoracolumbar shear strain in persons with chronic low back pain following spinal manipulation and over an 8-week course of multimodal chiropractic care.
Methods
Adults self-reporting chronic low back pain ≥ 1 year participated between September 2019 and April 2021 in a trial using ultrasound imaging to measure thoracolumbar shear strain. Ultrasound imaging occurred 2–3 cm lateral to L2-3 while participants relaxed prone on an automated table moving the lower extremities downward 15 degrees, for 5 cycles at 0.5 Hz. Pain intensity on an 11-point numerical rating scale, disability, pain interference, and global improvement were also collected. Participants received 8-weeks of twice-weekly chiropractic care including spinal manipulation, education, exercise, self-management advice and myofascial therapies. Shear strain was computed using 2 methods. The highest shear strain from movement cycles 2, 3, or 4 was averaged over right and left sides for each participant. Alternately, the highest shear strain from movement cycle 3 was used. All data were analyzed over time using mixed-effects models. Estimated mean changes are reported.
Results
Of 20 participants completing 8-weeks of chiropractic care (female n = 11), mean (SD) age was 41 years (12.6); mean BMI was 28.5 (6.2). All clinical outcomes improved at 8-weeks. Mean (95% confidence interval) pain intensity decreased 2.7 points (− 4.1 to − 1.4) for females and 2.1 points (− 3.7 to 0.4) for males. Mean Roland–Morris disability score decreased by 5 points (− 7.2 to − 2.8) for females, 2.3 points (− 4.9 to 0.2) for males. Mean PROMIS pain interference T-score decreased by 8.7 points (− 11.8 to − 5.5) for females, 5.6 points (− 9.5 to − 1.6) for males. Mean shear strain at 8-weeks increased in females 5.4% (− 9.9 to 20.8) or 15% (− 0.5 to 30.6), decreasing in males 6.0% (− 24.2 to 12.2) or 2% (− 21.0 to 16.8) depending on computational method.
Conclusion
Spinal manipulation does not likely disrupt adhesions or relax paraspinal muscles enough to immediately affect shear strain. Clinical outcomes improved in both groups, however, shear strain only increased in females following 8-weeks of multimodal chiropractic care.
Trial registration ClinicalTrials.gov registration is NCT03916705.
... Fascia is densely innervated with mechanoreceptors and nociceptors (Langevin, 2006, Schleip, 2003a, Schleip, 2003b. The mechanoreceptors, such as Pacini corpucles, Ruffini organs and free-nerve endings, maintain muscular coordination via the constant feedback from ligaments. ...
Postural disorders are common among preschool and school-age children. In regard to gen�der and age distribution, children are characterized by different indicators of body posture. Posture
for different professionals has different importance, and from a standpoint of one physiatrist it rep�resents a measure of the efficiency of muscular balance and neuromuscular coordination. Bad pos�ture represents a functional deviation from normal posture status without structural changes to the
spine or lower extremities. Evaluation and treatment of postural disorders requires knowledge of
basic principles related to the conduct of individual body segments, joints and muscles. The com�bined physical training programmes that include strength and muscle stretching exercises, particu�larly with regard to the postural antigravity muscles, should help in the prevention of health prob�lems that could occur later in life. Future research on the impact of early school-based back pos�ture promotion in relation to the integration of back posture principles according to biomechanical
favourable lifestyle and back pain prevalence later in life is essential.
Keywords: posture, assessment, exercise, scoliosis
... 32 The increase in flexibility after FR can be explained by using the property that the fascia hardens when it is still and softens as it moves. 34,35 In comparison with the control group in this study, the reason for the significant difference in PA that was observed only in the FR group was that the fascia was softened and the tissue increased due to the friction generated during FR, thereby reducing PA. ...
... It can be concluded the fascial release technique may provide a decrease in HA viscosity and facilitates the gliding movements of the fascial layers and thus increases the ROM. It has been reported in the literature that mechanoreceptors in the fascia are stimulated by the manual techniques to regulate the autonomic nervous system and thus leading to an increase in local fluid flow, a decrease in local vasodilatation, and tissue viscosity, in general muscle tone and the tone of muscle cells in the fascia [39]. It is thought that these effects may be created with the fascial release technique. ...
Background
Fascial release technique is used for releasing fascial tissue to decrease pain, to increase range of motion, and to improve functional level.
Objective
To investigate the acute effects of fascial release technique on pain, range of motion, upper extremity functional level, and fear of movement in individuals with arthroscopic rotator cuff repair.
Methods
Thirty volunteers with an arthroscopic rotator cuff repair were included in the study. The individuals were randomly divided into two groups. One group received only conventional physiotherapy including hot pack, interferential current, and exercise program, while the fascial release technique was applied to the other group in addition to the conventional physiotherapy program for 2 weeks with 2 sessions per week. Individuals were assessed for pain intensity, range of motion, functional level, fear of movement before and after treatment, and satisfaction level after treatment.
Results
Demographic and clinical characteristics of the groups were similar (p > 0.05). Both groups showed improvement in pain, range of motion, and upper extremity functions (p < 0.05). Improvements in the treatment group were better than the conventional physiotherapy group (p < 0.05). Fear of movement was significantly decreased in the treatment group (p < 0.05). Both groups were similar in terms of satisfaction level (p > 0.05).
Conclusion
Fascial release technique is acutely effective on the pain, joint range of motion and upper extremity functions in the treatment of individuals with arthroscopic rotator cuff repair and more successful results can be obtained by including it in the early rehabilitation program after arthroscopic rotator cuff surgery.
... As a result, It's a type of manual therapy for articulations of any kind with a limited range of motion. By inducing repetitive muscular movements, this procedure can ease muscle restriction or weakness, as well as lessen local oedema [25].Through deep tissue stimulation and localised vasodilation, MET suppresses sympathetic tone [26]. After that, the patient can perform an isometric contraction and a postisometric relaxation on the contracted muscle. ...
Introduction: Chronic neck pain might lead to a change in muscle tissue fibres. Neck discomfort is a serious and prevalent sickness. It is common in the general population, and it frequently results in severe impairment. These alterations have an impact on the cervical spine's capacity to govern 3-D movement efficiently. A range of manual therapy approaches are available to assist relieve pain and impairment while also cervical spine range of motion enhancement and everyday mobility. More evidence for Muscle Energy Technique (MET) in treating such a condition was found. This case report describes muscular energy technique's effect on a patient who has been suffering from neck pain for a long time. Case Presentation: At the previous three months, a 27-year-old female accountant in a hospital with extended periods of sitting while working on a computer presented to our facility with neck pain. Increase in pain with looking up. Discussion: The therapy was well embraced through this patient to muscle energy technique resulting in a high degree of flexibility in the cervical spine, reduce pain and improves flexibility and strength. Conclusion: Physiotherapy has a significant effect Pain, strength, and range of motion are all factors to consider. The findings of this case study indicate that a specific muscle energy technique It's possible that a routine will help to alleviate the problem of neck pain, improves strength and functional ability. Case Study Jain et al.; JPRI, 33(59A): 124-129, 2021; Article no.JPRI.78427 125
... When mechanical stress is applied to the muscle fascia, intrafascial mechanoreceptors are stimulated. This change changes the proprioceptive input to the central nervous system, which in turn changes the tension in the tissue-related motor units (Schleip 2003). The IASTM method has been reported to be effective in the treatment of MTrPs (Gulick 2018). ...
Purpose
To compare the ischaemic compression (IC) and instrument-assisted soft tissue mobilization (IASTM) in the treatment of MTrPs in addition to standard rehabilitation program in patients with rotator cuff tears.
Methods
Participants with rotator cuff tears were included the study (n = 46). Patients were randomly divided into two groups; which were Group 1 (IC + standard rehabilitation program (n = 23)), and Group 2 (IASTM + standard rehabilitation program (n = 23)) groups. Pain were assessed by visual analog scale (VAS). Range of motion (ROM) was assessed by a universal goniometer. Active MTrPs were assessed according to the Travel and Simons criteria. Pressure pain threshold (PPT) were assessed by a digital algometer. Function were evaluated by the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) and American Shoulder and Elbow Surgeons Standardised Shoulder Assessment (ASES) Form. Anxiety and depression were evaluated by the Hospital Anxiety and Depression (HAD) scale. Satisfaction was assessed by the Global Rating of Change scale after 6 weeks treatment.
Results
After the treatment, pain, ROM and the DASH, ASES, HAD scores improved in both groups (p < 0.05). The active MTrPs of 2 muscles, PPT of 4 muscles and DASH in Group 1 significantly improved compared to Group 2 (p < 0.05).
Conclusion
Although patients with low functionality accumulated in the IC group, the IC is more effective than the IASTM in increasing the PPT and functional improvement according to the results of the DASH score.
... As a result of the mechanical tension placed on the fascia, the ROM of the ankle joint increases. Mechanical pressure activates mechanoreceptors, which alter the information sent to the central nervous system, resulting in a change in tissue tension [26]. ...
Aim: The purpose of this study was to evaluate and compare the effects of Instrument-Assisted Soft-Tissue Mobilisation (IASTM) and Therapeutic Ultrasound in patients with heel pain in terms of Numerical Pain Rating Scale and Foot and Ankle Ability Measure scale. This was undertaken as even though Ultrasound is regularly used, heel pain still remains resistant to treatment in some patients. Hence, the need to compare a relatively newer technique with it. Study Design : Experimental study Place and Duration: Department of Musculoskeletal Physiotherapy Sciences, Ravi Nair Physiotherapy College, Sawangi (Meghe) , Wardha , duration of 12 months. Methods: Seventy people (n=70) with heel discomfort (lasting 6 weeks to 1 year) were chosen at random and placed into two groups, each getting eight therapy sessions. IASTM and Home Exercise Program was given to Group A, whereas Therapeutic Ultrasound and Home Exercise Program was given to Group Calf muscle stretches and Plantar fascia stretches were incorporated in the Home Exercise Programme. Outcome measures were recorded both at the beginning of treatment and after final treatment. The patients were assessed for Numerical Pain Rating Scale with first step in morning and at the beginning of first session and after end of last session and for Foot and Ankle Ability Measure scale at the beginning of first session and after end of last session. A follow up period of 90 days (after last session) was taken, the measurements of Numerical Pain Rating Scale and Foot and Ankle Ability Measure scale were taken again to see the long-term effects. Results: Group A which received IASTM + Home exercises showed great improvements than Ultrasound and Home exercise group, from baseline to week 4 after the pain intensity and foot function were assessed using Numerical Pain Rating Scale and Foot and Ankle Ability Measure scale. Statistically significant differences were found in both the groups. i.e. P=0.0001. But 7 people in Ultrasound group complained of pain and functional ability at follow-up session. Conclusion: In this study, it can be concluded that combining both the IASTM and Home Exercise Program have got beneficial effects in decreasing the pain intensity thus improving the foot and ankle function in patients with heel pain.
... Studies have been demonstrated the positive effects of manual therapy on the fascia, [13][14][15][16] it is believed that MVT could attenuate visceral fascia densification, favoring bladder compliance. Additionally, since the endopelvic fascia connects the visceral system with the pelvic floor muscles (PFM), 17 MVT could increase the functionality of these muscles. ...
Aims
To compare the effects of manual visceral therapy (MVT) associated with pelvic floor muscle training (PFMT) on urinary incontinence (UI) symptoms, vaginal resting pressure, and maximum voluntary contraction of the pelvic floor muscles (PFM).
Methods
A double-blinded randomized controlled trial of 5 weeks duration with two active intervention arms: PFMT + MVT and PFMT + manual sham therapy (MST). Participants were women over 18 years of age with complaint or diagnosis of UI symptoms. The primary outcome was the severity of UI symptoms, assessed by the International Consultation on Incontinence Questionnaire – Short Form. The secondary outcomes measures included the vaginal resting pressure and the maximum voluntary contraction of PFM assessed by digital manometry.
Results
Fifty-two incontinent women participated in the study. There was no significant difference between groups in UI symptoms (F (1.74, 86.9) = 0.406; p = 0.638), vaginal resting pressure (mean difference −1.5 cmH₂0 [95% confidence interval [CI] −4.5 to 1.5; p = 0.33]), and maximum voluntary contraction of PFM (median 0.0 cmH₂0 [25%–75% interquartile range 0.0–5.6; p = 0.12]) after the intervention period.
Conclusions
Combining MVT with PFMT was not more effective than PFMT alone in reducing UI symptoms, in change vaginal resting pressure and maximum voluntary contraction of PFM. Due to the limitations of the study, further investigations are still needed to confirm these findings.
... In contrast, the much lighter touch of the PLC treatment is likely to act only on cutaneous receptors. Fascial mechanoreceptors could trigger changes in muscle tone, fluid hydration, as well as neurological effects, which was likely achieved through the interventions in this study [35,36]. ...
Background:
Spine shape parameters, such as leg length and kyphotic or lordotic angle, are influenced by low back pain. There is also evidence that the thoracolumbar fascia plays a role in such pathologies. This study examined the immediate effects of a myofascial release (MFR) technique on the thoracolumbar fascia and of an osteopathic treatment (OMT) on postural parameters in patients with acute low back pain (aLBP).
Methods:
This study was a single-blind randomized placebo-controlled trial. Seventy-one subjects (43.8 ± 10.5 years) suffering from aLBP were randomly and blindedly assigned to three groups to be treated with MFR, OMT, or a placebo intervention. Spinal shape parameters (functional leg length discrepancy (fLLD), kyphotic angle, and lordotic angle) were measured before and after the intervention using video raster stereography.
Results:
Within the MFR group, fLLD reduced by 5.2 mm, p < 0.001 and kyphotic angle by 8.2 degrees, p < 0.001. Within the OMT group, fLLD reduced by 4.5 mm, p < 0.001, and kyphotic angle by 8.4°, p = 0.007.
Conclusion:
MFR and OMT have an influence on fLLD and the kyphotic angle in aLBP patients. The interventions could have a regulating effect on the impaired neuromotor control of the lumbar muscles.
... La liberación miofascial manual es una intervención que intenta estirar de forma indirecta las fibras musculares diafragmáticas para reducir la tensión generada por los PGM, normalizar la longitud de sus fibras, y promover una mayor efectividad de la contracción muscular, consiguiendo un incremento de la movilidad de la parrilla costal (152,153). El comúnmente usado terminó "relajación o liberación tisular", en relación al resultado del tratamiento de los desequilibrios musculares, es típicamente razonado desde una perspectiva estructural y mecánica (154). El tejido conectivo es conocido por estirarse tras una carga estática debido a sus propiedades viscoelásticas innatas; sin embargo, este efecto es transitorio y dependiente de la duración y el modo de estiramiento (155). ...
Effects of diaphragm muscle treatment in shoulder pain and mobility in subjects with rotator cuff injuries.
Introduction: The rotator cuff inflammatory or degenerative pathology is the main cause of shoulder pain. The shoulder and diaphragm muscle have a clear relation through innervation and the connection through myofascial tissue. In the case of nervous system, according to several studies the phrenic nerve has communicating branches to the brachial plexus with connections to shoulder key nerves including the suprascapular, lateral pectoral, musculocutaneous, and axillary nerves, besides, the vagal innervation that receives the diaphragm and their connections with the sympathetic system could make this muscle treatment a remarkable way of pain modulation in patients with rotator cuff pathology. To these should be added a possible common embryological origin in some type of vertebrates. Considering the connection through myofascial system, the improving of chest wall mobility via diaphragm manual therapy could achieve a better function of shoulder girdle muscles with insertion or origin at ribs and those that are influenced by the fascia such as the pectoralis major muscle, latissimus dorsi and subscapularis.
Objectives:
• Main objective:
To compare the immediate effect of diaphragm physical therapy in the symptoms of patients with rotator cuff pathology regarding a manual treatment over shoulder muscles.
• Specific objectives:
1. To evaluate the immediate effectiveness of each of the three groups in shoulder pain using a numerical pain rating scale (NPRS) and compare between them.
27
2. To evaluate the immediate effectiveness of each of the three groups in shoulder range of motion (ROM) using an inclinometer and compare between them. 3. To evaluate the immediate effectiveness of each of the three groups in pressure pain threshold (PPT) using an algometer and compare between them.
Material and method: A prospective, randomized, controlled, single-blind (assessor) trial with a previous pilot study in which a final sample size of 45 subjects was determined to people diagnosed with rotator cuff injuries and with clinical diagnosis of myofascial pain syndrome at shoulder. The sample were divided into 3 groups of treatment (15 subjects per group):
1. A direct treatment over the shoulder by ischemic compression of myofascial trigger points (MTP) (control / rotator cuff group).
2. Diaphragm manual therapy techniques (diaphragm group).
3. Active diaphragm mobilization by hipopressive gymnastic (hipopressive group).
The pain and range of shoulder motion were assessed before and after treatment in all the participants by inclinometry, NPRS of pain in shoulder movements and algometry. The data obtained were analyzed by an independent (blinded) statistician, who compared the effects of each one of the treatments using the Student’s t-test for paired samples or the Wilcoxon signed rank test, and calculated the post -intervention percentage of change in every variable. An analysis of variance (ANOVA) followed by the post-hoc test or a non-parametric Kruskal-Wallis test for non-parametric multiple-groups comparisons were performed to compare pre- to post-intervention outcomes between groups. Effect-size estimates of each intervention and between groups were calculated to allow interpretation of results in a more functional and meaningful way.
Results:
Both the control group and diaphragm group showed a statistically (p< 0.005) and clinically significant improvement, as well as a significant effect size (moderate to strong), on the NPRS in shoulder flexion and abduction movements. Regarding NPRS in shoulder external rotation, only the control group obtained a significant effect size. There was a significant increase in shoulder abduction and external rotation ROM (p<
Efectos del tratamiento del músculo diafragma en el dolor y la movilidad del hombro en sujetos con patología del manguito rotador.
28
0.001) with a significant effect size in the control group. The PPT at the xiphoid process of the sternum showed a statistically (p< 0.001) and clinically significant improvement in the diaphragm group. The hipopressive gymnastic treatment was found to be no clinically effective in the shoulder pain and mobility, and showed a less efficacy than the other two groups.
Conclusion:
Both the shoulder non-direct treatment by a protocol of diaphragm manual therapy techniques and the rotator cuff MTP intervention showed been clinically effective in reducing pain (NPRS) immediately in shoulder flexion and abduction movements. The ROM assessment improvements obtained post- intervention by the diaphragm group have not been enough to consider them as clinically significant. The control group has obtained a significant effect size in shoulder abduction and external rotation ROM improvement. Both the control group and the diaphragm group treatments have been more effective in improving shoulder pain and mobility than the hipopressive group. The control group intervention has been the most effective in improving shoulder external rotation pain and mobility. The diaphragm group intervention was more effective in improving PPT at the xiphoid process than the other groups. Neither the effect size nor clinical significance proves the short-term benefit of the hipopressive gymnastic treatment in shoulder pain and mobility. Future studies are necessary to show the effectiveness of the diaphragm manual therapy applied in several sessions to determine its long-term effects in shoulder pain and mobility.
... The fascia and connective tissue systems communicates much faster than the CNS using chemo-mechano-transduction to initiate a biochemical response. It is estimated that mechanical vibrations travelling the myofascial network move three times faster than the signals sent by the CNS [39]. ...
Foundational Stability, Support, Strength, Symmetry and Balance of the Foot and Lower Extremity is the Predictable Primary Starting Platform for All Closed Chain Stance and Movement
... In contrast, the much lighter touch of the PLC treatment is likely to act only on cutaneous receptors. Fascial mechanoreceptors could trigger changes in muscle tone, fluid hydration, as well as neurological effects, which was likely achieved through the interventions in this study [35,36]. ...
Background: Spine shape parameters, such as leg length, kyphotic or lordotic angle, are influenced by low back pain. There is also evidence that the thoracolumbar fascia plays a role in such pa-thologies. This study examined the immediate effects of a myofascial release technique (MFR) on the thoracolumbar fascia and of an osteopathic treatment (OMT) on postural parameters in pa-tients with acute low back pain (aLBP). Methods: This study was a single-blind randomized pla-cebo-controlled trial. Seventy-one subjects (43.8 ± 10.5 years) suffering from aLBP were randomly and blinded assigned to three groups to be treated with MFR, OMT or a placebo intervention. Spinal shape parameters (functional leg length discrepancy (fLLD), kyphotic angle, lordotic an-gle) were measured before and after the intervention using video raster stereography. Results: Within the MFR group, fLLD reduced by 5.2 mm, p < 0.001 and kyphotic angle by 8.2 degrees, p < 0.001. Within the OMT group, fLLD reduced by 4.5 mm, p < 0.001 and kyphotic angle by 8.4 °, p = 0.007. Conclusion: MFR and OMT have an influence on fLLD and the kyphotic angle in aLBP patients. The interventions could have a regulating effect on the impaired neuromotor control of the lumbar muscles.
... MTs may induce local effects, through the activation of mechanobiological pathways that can change the cells' behavior (106), and lead to systemic responses involving the circulatory, immune, endocrine, and nervous systems, and the mental state (6,7,9,(107)(108)(109)(110). These systemic responses could influence the brain processes and, thus, interact with the VR and AR experience. ...
Virtual reality (VR) and augmented reality (AR) have been combined with physical rehabilitation and psychological treatments to improve patients' emotional reactions, body image, and physical function. Nonetheless, no detailed investigation assessed the relationship between VR or AR manual therapies (MTs), which are touch-based approaches that involve the manipulation of tissues for relieving pain and improving balance, postural stability and well-being in several pathological conditions. The present review attempts to explore whether and how VR and AR might be integrated with MTs to improve patient care, with particular attention to balance and to fields like chronic pain that need an approach that engages both mind and body. MTs rely essentially on touch to induce tactile, proprioceptive, and interoceptive stimulations, whereas VR and AR rely mainly on visual, auditory, and proprioceptive stimulations. MTs might increase patients' overall immersion in the virtual experience by inducing parasympathetic tone and relaxing the mind, thus enhancing VR and AR effects. VR and AR could help manual therapists overcome patients' negative beliefs about pain, address pain-related emotional issues, and educate them about functional posture and movements. VR and AR could also engage and change the sensorimotor neural maps that the brain uses to cope with environmental stressors. Hence, combining MTs with VR and AR could define a whole mind-body intervention that uses psychological, interoceptive, and exteroceptive stimulations for rebalancing sensorimotor integration, distorted perceptions, including visual, and body images. Regarding the technology needed to integrate VR and AR with MTs, head-mounted displays could be the most suitable devices due to being low-cost, also allowing patients to follow VR therapy at home. There is enough evidence to argue that integrating MTs with VR and AR could help manual therapists offer patients better and comprehensive treatments. However, therapists need valid tools to identify which patients would benefit from VR and AR to avoid potential adverse effects, and both therapists and patients have to be involved in the development of VR and AR applications to define truly patient-centered therapies. Furthermore, future studies should assess whether the integration between MTs and VR or AR is practically feasible, safe, and clinically useful.
Connective tissue makes up of about 16% of the body’s weight and stores about 25% of body’s total water content. Connective tissues are derived embryologically from the mesenchyme and form the biological blocks of the skin, fascia, muscles, nerve sheaths, periosteum, aponeuroses, bones, ligaments, tendons, joint capsules, adipose tissues, blood vessels, and cartilage.KeywordsVertebral arteryFacet jointSacroiliac jointWhiplash injuryThoracic outlet syndrome
OBJECTIVES: Muscle energy technique (MET) is a voluntary contraction of a patient’s muscle in a predetermined direction, at varying levels of intensity. Its commonly used as a treatment option in musculoskeletal rehabilitation. This study aims to investigate the effectiveness of MET in the treatment of people with musculoskeletal injuries with particular emphasis on flexibility, range of motion (ROM), and function. METHODS: Scopus (via Science Direct), CINAHL via (EBSCO), Embase (via OvidSP), PubMed, and PEDro were searched using specified keywords to select randomized controlled trials that assessed the effect of MET on flexibility, ROM, or function in patients with musculoskeletal disorders. Two authors extracted all related information from the included trials and presented them in an excel spreadsheet. Two other authors independently conducted the quality assessment. Meta-analysis was performed where homogeneity (similirty regarding population and outcomes) was sufficient and required data were available. RESULTS: A total of 42 studies were included. Yet, twelve joined the meta-analysis where six comparisons were conducted. Of them, four comparisons were composed of two trials, one comparison consisted of six, and another one was composed of four. No statistically significant differences were observed between MET and other comparators regarding function and ROM, especially in patients with low back or neck pain. MET was statistically significantly better than control or sham interventions on the flexibility of patients with sacroiliac joint (SIJ) problems. CONCLUSIONS: MET can produce better flexibility than placebo and control interventions in patients with SIJ problems. MET is not better than other interventions regarding function and ROM. Although the existence of multiple trials testing the effectiveness of MET, there is obvious heterogeneity. There is no sufficient evidence to reliably determine the clinical effect of MET in practice.
Background:
Many fascial therapies have been demonstrated to positively affect the range of motion, pain sensitivity, balance, daily functioning, and participation in social activities. Among these therapies, myofascial release has been extensively studied and widely used in clinical trials. The fascial distortion model was recently introduced, and it has received much attention due to its rapid onset of action and ease of application.
Objective:
This study aims to compare the effects of myofascial release and the fascial distortion model on range of motion, pain sensitivity, and balance, with the goal of helping therapists select the most appropriate treatment.
Methods:
Sixteen healthy adults were included in a prospective, randomized, single-blind study. The subjects were randomly assigned to either the myofascial release or fascial distortion model groups. The outcome measures were functional reach test, pain pressure threshold, straight leg-raising test angle, and finger floor distance.
Results:
The myofascial release and fascial distortion model groups showed significantly increased straight leg-raising angle and finger floor distance, but no between-group differences were observed (p > .05). The fascial distortion model group demonstrated significantly better pain control (p < .05), which was also better than in the myofascial release group (p < .05). The myofascial release group showed significantly improved balance control (p < .05); however, there was no difference between the two groups (p > .05).
Conclusions:
Either myofascial release or fascial distortion model can be chosen to improve the range of motion. However, if pain sensitivity is the goal, it is expected that the fascial distortion model will be more effective.
Context:
Anatomy trains theory states that performing techniques in any part of the superficial myofascial backline can remotely treat other parts of this pathway. Due to the connections of different parts of the superficial backline, it is possible to influence the hamstring by performing the technique in the lumbar area. As chronic nonspecific low back pain (LBP) may lead to or be caused by hamstring tightness, remote myofascial release (MFR) techniques using the superficial backline can help improve hamstring tightness.
Objective:
This study aimed to evaluate the effect of remote MFR on hamstring tightness for those with chronic nonspecific LBP.
Design:
Single-blind, parallel design.
Setting:
The present study was performed at the clinical setting of Tarbiat Modares University in Iran.
Methods:
This study included 40 participants (20 males and 20 females) who were 40.5 (5.3) years old with chronic nonspecific LBP and hamstring tightness.
Interventions:
Participants were randomly divided into the lumbar MFR (remote area) and hamstring MFR groups. Participants underwent 4 sessions of MFR for 2 weeks.
Main outcome measures:
A passive knee-extension (PKE) test was used for muscle tightness evaluation 3 times.
Results:
Repeated-measure analysis of variance test showed that after the lumbar and hamstring MFR, the PKE was significantly reduced in both legs: lumbar MFR (right knee: from 61.04° [2.17°] to 51.01° [4.11°], P ≤ .003 and left knee: from 63.02° [3.12°] to 52.09° [2.48°], P ≤ .004) and hamstring MFR (right knee: from 62.01° [4.32°] to 50.50° [7.18°], P ≤ .001 and left knee: from 63.11° [2.56°] to 51.32° [5.31°], P ≤ .002). Least Significant Difference (LSD) post hoc test results showed that the 2 groups were not significantly different after the MFR (P ≥ .05). Also, the intraclass correlation coefficient index showed that the PKE test has excellent reliability (intraclass correlation coefficient, .910 for the right limb and .915 for the left limb). The minimal detectable change at the 95% confidence interval indicated that a change greater than or equal to 6° is required to exceed the threshold of the error PKE test, respectively.
Conclusion:
The present study showed that the remote MFR technique to the lumbar region demonstrated the same significant results in decreasing hamstring tightness as was noted in hamstring MFR to both limbs in patients with chronic nonspecific LBP.
Das Fasziendistorsionsmodell beschreibt sechs spezifische Deformierungen der menschlichen Faszien, Fasziendistorsionen genannt, die einzeln oder in Kombination Beeinträchtigungen des Bewegungsapparats und verschiedener anderer Organsysteme verursachen. Das Modell stellt die Konsequenz von Formveränderungen der Faszien auf die Funktionstüchtigkeit des menschlichen Körpers in den Mittelpunkt und erweitert das schulmedizinische Konzept von Schmerz und Funktionseinschränkung.
Традиционните медицински практики от различни части на света и в частност акупунктурата имат своето място в медицинската практика и са включени в закона за здравето като алтернативни методи за подобряване на здравето. Тяхното използване никога не е прекъсвало, а в съвремието са в подем. Китайската традиционна медицина има няколко основни направления едно от което е акупунктурата. Акупунктурата на езика като вид манипулация представлява интерес за нашето проучване с морфологичните й аспекти. Морфологичните изменения, които настъпват в тъканите след иглоубождането, може да бъдат установени и документирани с помощта на обективни, съвременни хистологични методи. Количественото измерване е улеснено от компютърни програми за хистоморфометрични методи.
Езикът е плътен мускулест орган разположен в устната кухина свързан със съществени функции в живия организъм. От тази гледна точка той винаги е представлявал интересен обект за изучаване, както от морфологията, така и от клиниката. Близкото му разположение до централната нервна система (ЦНС) и богатата му инервация го прави област за рефлексологични манипулации. Манипулациите върху него са бързи, лесни и същевременно ефективни. Напредъкът в хранително-вкусовата и фармацевтични индустрии също насочва интереса към езика като място за прилагане на нови вещества, като стимуланти за вкусовия анализатор или сублингвални системи за пренос на лекарства. Един от първите органи в досег с антигените на околната среда е езика, което засилва неговата роля за имунната реакция на организма и може да се проучва във връзка със съответните клинични проявления като имунна реакция и автоимунни заболявания. Нашият интерес към него в това проучване е фокусиран върху морфологичните промени, които настъпват в езикът в резултат на акупунктура, както и към нормалната му морфология.
Inflammatory processes in the thoracolumbar fascia lead to thickening, compaction, and fibrosis and are thought to contribute to the development of nonspecific low back pain (nLBP). The blood circulation of fascial tissue may play a critical role in this process, as it may promote hypoxia-induced inflammation. This study examined the influence of thoracolumbar fascia morphology (TLFM), sports activity (SA), body mass index (BMI), pain, and a set of myofascial release (MFR) techniques on blood flow data (BFD) of lumbar myofascial tissue. This study was a single-blind, randomized, placebo-controlled trial. Thirty pain-free subjects (40.5 ± 14.1 years) were randomly assigned to two groups treated with MFR or a placebo intervention. Correlations between pain, SA, BMI, and TLFM were calculated at baseline. The effects of TFLM and MFR on BFD were determined. There were strong correlations between pain (r = -0.648), SA (d = 0.681), BMI (r = -0.798), and TLFM. Blood flow was significantly different between disorganized and organized TLFM (p < 0.0001). The MFR group had a significant increase in blood flow after treatment (31.6%) and at follow-up (48.7%) compared with the placebo group. Circulatory restrictions caused by disorganized TFLM could lead to hypoxia-induced inflammation, which likely results in pain and impaired proprioceptive function and contributes to the development of nLBP. The deformation and altered morphology associated with dysfunction of blood vessels and free nerve endings could be positively affected by the intervention in this study.
This is a five-part article that shares the compassionate artistry and science behind self-regulation and co-regulation. Each section explores the concept of self-regulation and how Somatic Movement Dance Therapy supports health through self-regulatory and co-regulatory processes. Part 1 offers general reflections on self-regulation and how the field differs from bodywork modalities and mechanistic health regimes. Part 2 shares polyvagal theory and how practice supports a deep parasympathetic state (immobilization without fear). Part 3 enacts a research process where polyvagal theory is evident and applied in practice. Part 4 shares processes of co-regulation and the transpersonal heart-field. Part 5 details somatic touch combined with sense perception of the heart-field. I share photographic images of my students throughout where they are applying theory to practice and, additionally, empirically investigating how theory might support or illuminate their practice. The article shares how parasympathetic ease-and-release is an essential physiological state that underlies self-regulatory health. I also apply research by Doc Childre and Stephen Porges, attending to polyvagal theory and HeartMath; I share how this science shapes my practice and my training course in Somatic Movement Dance Therapy. The article is redacted from my new book, Somatic Movement Dance Therapy : The Healing Art of Self-Regulation and Co-Regulation . Across the pages I share sensory-perceptual pathways into a physiological state of consciousness (a transpersonal field of breath and heart) that supports ease and healing.
Introduction
Self-massage using a foam roller (foam rolling) has been used to improve joint range of motion (ROM). However, the effect of foam rolling on the morphology of a targeted muscle, tendon, and muscle-tendon unit (MTU) has not been fully clarified. This study aimed to investigate extensibility changes in the gastrocnemius muscle (GM), MTU, and the Achilles tendon (AT) in terms of maximum ankle dorsiflexion (max-DF) following a foam rolling intervention. This was an interventional study with no controls.
Methods
Study participants comprised 10 male and female students (mean [standard deviation]: 22.7 [2.5] years; height, 164.2 [6.7] cm; weight, 57.9 [7.9] kg). The foam rolling intervention was performed on the right leg plantar flexor muscles for 3 min. The outcomes were max-DF with specified resistance values (ROM-SR) and non-specified resistance values (ROM-NSR) and GM, MTU, and AT extensibility. An ultrasound device was used to determine the rate of change by subtracting the value in a neutral ankle joint position (0°) from the ankle max-DF to identify GM, MTU, and AT extensibility. All outcomes were measured pre- and post-intervention.
Results
The range of ankle joint dorsiflexion increased significantly following the foam rolling intervention (Δ: ROM-SR, +4.35 [5.79]; ROM-NSR, +4.18 [4.43]), whereas GM extensibility increased 4.0 mm, although no significant difference was observed pre- and post-intervention.
Conclusion
Foam rolling was effective in increasing ankle joint dorsiflexion ROM. Moreover, it was suggested that the GM morphology might be affected by the intervention.
This article is a report of the somatic practice, Bones for Life®, as both a therapeutic tool for self-healing and as a simple and readily accessible tool to increase students’ somatic awareness in the voice studio. The author’s experience with a congenital defect of the left temporomandibular joint (TMJ), and the access to relief that this somatic modality has afforded her, is articulated. Four of the ninety processes are explored—specifically focused on improved alignment and ease of movement in the upper shoulder area—as presented in Workshop format at the 2021 Virtually PAVA Symposium. Finally, some thoughts on why these processes work to create changes in vocalization are offered.
Prior studies have shown that self- and manual massage (SMM) increases flexibility in non-adjacent body areas. It is unclear whether this also influences performance in terms of force generation. Therefore, this study investigated the effect of SMM on the plantar surface on performance in the dorsal kinetic chain. Seventeen young participants took part in this within-subject non-randomized controlled study. SMM was applied on the plantar surface of the dominant leg, but not on the non-dominant leg. A functional performance test of the dorsal kinetic chain, the Bunkie Test, was conducted before and after the intervention. We measured the performance in seconds for the so-called posterior power line (PPL) and the posterior stabilizing line (PSL). The performance of the dominant leg in the Bunkie Test decreased significantly by 17.2% from (mean ± SD) 33.1 ± 9.9 s to 27.4 ± 11.1 s for the PPL and by 16.3% from 27.6 ± 9.8 s to 23.1 ± 11.7 s for the PSL. This is in contrast to the non-dominant leg where performance increased significantly by 5.1% from 29.7 ± 9.6 s to 31.1 ± 8.9 s for the PPL and by 3.1% from 25.7 ± 1.5 s to 26.5 ± 1.7 s for the PSL. SMM interventions on the plantar surface might influence the performance in the dorsal kinetic chain.
Objectives: myofascial pain syndrome (MPS) is associated with reductions in range of movement (ROM), decrease in physical function and performance and increase in pain in different populations. Elucidating the best prevention and treatment strategies for MPS has been one of the main goals in the last decade. The objective of the present study was to compare the acute effects of self-myofascial foam rolling (SFR) and dry-needling (DN) techniques on ankle dorsiflexion ROM, soreness post-needling and performance through countermovement jump (CMJ) height.
Methods: a prospective crossover design composed by 12 active adults, aged 23.41 ± 1.68 years (weight: 78.33 ± 9.02 Kg; height: 1.79 ± 0.088 m) with active ankle dorsiflexion restriction was performed. Participants were randomized into the SFR and DN techniques to analyze its effects on ankle dorsiflexion ROM, muscle soreness and jump height at pre, post and 24 h post-intervention.
Results: significant improvements were found by DN on ankle dorsiflexion at 24 hours post intervention and muscle soreness by SFR at the same time point. No significant differences were found between conditions.
Conclusions: Both SFR and DN are effective in improving ankle dorsiflexion and performance in young adults without producing an acute effect in muscle soreness.
The integumentary surfaces are derived from ectoderm and consist of a variety of general and specialized regions of stratified epithelium with a superficial keratinized layer of varying thickness. The sensory function of the skin and its appendages (e.g., hairs and claws, which serve as mechanical levers) is achieved by means of a wide diversity of sense organs specialized for several distinct sensory modalities. Mechanical sensibility appears to be dominant, and sensations of touch, pressure, vibration, tickle, itch, with perhaps a contribution from position and movement (kinesthetic) sense, can be correlated with the properties of a variety of sensitive mechanoreceptors. Thermal sensations are conveyed by distinct populations sensitive to either warming or cooling. In many regions, the most numerous innervation consists of the thinnest fibers subserving sensory reports of pain or related noxious and aversive qualities.
In a sample of 24 subjects with healthy veins, the collagen fibrils in the superficial layer of the crural fascia were arranged strictly in bundles running in various directions in space. Our EM pictures confirmed the concept, derived from light microscopy, of the texture of the collagen fibres of the fascia recalling the struts of a concertina barrier. This arrangement makes it possible for the fascia to adapt without tension to every state of contraction of the underlying muscles. In patients with chronic venous insufficiency, on the other hand, this normal arrangement of the collagen within the fascia is completely lost. In place of the scissor-like configuration of the texture, there is a tight disorderly network of fibrils, which are themselves sometimes abnormal in appearance. We describe this situation as 'fascial insufficiency'. The ultrastructural basis of fascial insufficiency accounts for the clinical picture of the chronic compartment syndrome, with its complication of treatment-resistant crural ulcers.
The structure and function of breathing. Patterns of breathing dysfunction in hyperventilation syndrome. Biochemical influences on breathing. Biomechanical influences on breathing. Interaction of psychological and emotional effects with breathing dysfunction. Osteopathic assessment and treatment of thoracic and respiratory dysfunction. Physiotherapy breathing rehabilitation strategies. Self-regulation of breathing. Other breathing issues. Self-help approaches: reducing shoulder movement during breathing.
The muscles of the human body may be divided into two groups, postural and phasic. The postural muscles are those involved primarily in maintenance of upright posture while the phasic muscles are those primarily involved in movement. These two groups of muscles react in distinct ways to musculoskeletal injury and even to the ordinary stresses of daily life. The postural muscles tend to become short and tight while the phasic muscles tend to become weak and inhibited. Tightness of postural muscles is extremely common and can initiate a cascade of changes in locomotor system function which often lead to pain. In our desire to provide thorough and effective care to our patients, we may wish to include examination and treatment for loss of normal muscle length in our treatment protocol. A standardized, step-by-step procedure for length assessment of key postural muscles is presented, as developed by Professor Vladimir Janda, of the Department of Rehabilitation Medicine, Charles University Hospital in Prague.
The sections in this article are:
The purpose of this study is to provide better understanding of the mechanical response of the lumbodorsal fascia to dynamic and static traction loadings. Since the fascia shows a viscoelastic behaviour, tests in which time is a variable were used, namely hysteresis and stress relaxation. Load-strain and load-time curves obtained from the hysteresis and stress-relaxation tests point out three different phenomena. First, an increase in stiffness is noticed when ligaments are successively stretched, i.e. strains produced by successive and identical loads decrease. Second, if a sufficient resting period is allowed between loadings, stiffening is reversed and strains tend to recover initial values. The third phenomenon, observed in stress-relaxation tests as time progresses, is ligament contraction in stretched and isometrically held samples. This third phenomenon may be explained by the possibility that muscle fibres capable of contracting spontaneously could be present in lumbodorsal fascia ligaments.
A randomized, double-blind, controlled, multicenter trial was conducted.
To assess the efficacy of neuroreflexotherapy in the management of low back pain.
Neuroreflexotherapy consists of temporary implantation of epidermal devices in trigger points in the back and referred tender points in the ear.
The rheumatology and rehabilitation departments of three teaching hospitals in Madrid recruited 78 patients with chronic low back pain. These patients were randomly assigned to the control group (37 patients) or to the treatment group (41 patients). Patients in the treatment group underwent one neuroreflexotherapeutic intervention. The control group received sham treatment consisting of placement of the same number of epidermal devices within a 5-cm radius of the target zones. Patients from both groups were allowed to continue drug treatment as previously prescribed. The use of medications during the trial was recorded.
Patients underwent clinical evaluations on three occasions: within 5 minutes before intervention, within 5 minutes after intervention, and 45 days later. The preintervention assessment was carried out by the physician from each hospital department who included the patient in the study. Each of the two follow-up assessments were carried out independently by two of three physicians who had no connection with the research team. Patients in the treatment group showed immediate lessening of pain compared with the results in patients in the control group. The pain relief was clinically relevant and statistically significant, and it persisted up to the end of the trial.
Neuroreflexotherapy intervention seems to be a simple and effective treatment for rapid amelioration of pain episodes in patients with chronic low back pain. At this time, the duration of pain relief beyond 45 days has not been evaluated.
Electrical microstimulation was used to study primary motor and premotor cortex in monkeys. Each stimulation train was 500 ms in duration, approximating the time scale of normal reaching and grasping movements and the time scale of the neuronal activity that normally accompanies movement. This stimulation on a behaviorally relevant time scale evoked coordinated, complex postures that involved many joints. For example, stimulation of one site caused the mouth to open and also caused the hand to shape into a grip posture and move to the mouth. Stimulation of this site always drove the joints toward this final posture, regardless of the direction of movement required to reach the posture. Stimulation of other cortical sites evoked different postures. Postures that involved the arm were arranged across cortex to form a map of hand positions around the body. This stimulation-evoked map encompassed both primary motor and the adjacent premotor cortex. We suggest that these regions fit together into a single map of the workspace around the body.
Multidisciplinary Approaches to Breathing Pattern Disorders Osteopathic Manipulative Techniques for the Body
- Bradley D Gilbert
- Churchill Livingstone
- Edinburgh Crow
L, Bradley D, Gilbert C 2002 Multidisciplinary Approaches to Breathing Pattern Disorders. Churchill Livingstone, Edinburgh Crow WT et al. 2001 Ligamentous Articular Strain: Osteopathic Manipulative Techniques for the Body. Eastland Press, Seattle, WA Folkow B 1962 Cardiovascular reactions during abdominal surgery. Annals of Surgery 156: 905–913
von Bertalanffy L 1952 Problems of Life Germany Yahia L et al. 1993 Viscoelastic properties of the human lumbodorsal fascia
- Tunnell
- Pw
Tunnell PW 1998 Muscle length assessment of tightness-prone muscles. Journal of Bodywork and Movement Therapies 2: 21–26 von Bertalanffy L 1952 Problems of Life. Harper & Row, New York van den Berg F, Cabri J 1999 Angewandte Physiologie – Das Bindegewebe des Bewegungsapparates verstehen und beeinflussen. Georg Thieme Verlag, Stuttgart, Germany Yahia L et al. 1993 Viscoelastic properties of the human lumbodorsal fascia. Journal of Biomedical Engineering 15: 425–429
Myofascial Release: The Search of Excellence
- Barnes Mf Paoli
- J-P Mercier
Barnes MF 1997 The basic science of myofascial release. Journal of Bodywork and Movement Therapies 1: 231–238 Barnes JF 1990 Myofascial Release: The Search of Excellence. Rehabilitation Services Inc., Paoli, PA Barral J-P, Mercier P 1988 Visceral Manipulation. Eastland Press, Seattle, WA Barral J-P, Croibier A 2000 Trauma: An Osteopathic Approach. Eastland Press, Seattle, WA Bauer J, Heine H 1998 Akupunkturpunkte und Fibromyalgie – Mo¨ chirurgischer Intervention. Biologische Medizin 6: 257–261
Somatic Integration: Physiological Basis and Psychological and Clinical Implications Complex movements evoked by microstimulation of precentral cortex
- Gellhorn
- Graziano
Gellhorn E 1967 Principles of Autonomic– Somatic Integration: Physiological Basis and Psychological and Clinical Implications. University of Minnesota Press, Minneapolis, MN Graziano MS et al. 2002 Complex movements evoked by microstimulation of precentral cortex. Neuron 34: 841–851 Heine H 1995 Functional anatomy of traditional Chinese acupuncture points. Acta Anatomica 152: 293
La structure fine de l'apone´ jambiè re
- Staubesand
Staubesand J et al. 1997 La structure fine de l'apone´ jambiè re. Phle´ 50: 105–113
Myofascial Release: The Search of Excellence
- J F Barnes
Barnes JF 1990 Myofascial Release: The
Search of Excellence. Rehabilitation
Services Inc., Paoli, PA
Visceral Manipulation
- J-P Barral
- P Mercier
Barral J-P, Mercier P 1988 Visceral
Manipulation. Eastland Press, Seattle,
WA
Akupunkturpunkte und Fibromyalgie - Möglichkeiten chirurgischer Intervention
- J Bauer
- H Heine
Bauer J, Heine H 1998 Akupunkturpunkte
und Fibromyalgie -Mo¨glichkeiten
chirurgischer Intervention. Biologische
Medizin 6: 257-261
Ligamentous Articular Strain: Osteopathic Manipulative Techniques for the Body
- W T Crow
Crow WT et al. 2001 Ligamentous Articular
Strain: Osteopathic Manipulative
Techniques for the Body. Eastland Press,
Seattle, WA
Functional anatomy of traditional Chinese acupuncture points
- H Heine
Heine H 1995 Functional anatomy of
traditional Chinese acupuncture points.
Acta Anatomica 152: 293
New Zealand Pischinger A 1991 Matrix and Matrix Regulation: Basis for a Holistic Theory in Medicine. Haug International, Brussels Reed ES 1996 Encountering the World: Toward an Ecological Psychology
- S Petersen
Petersen S 2000 Mana Integrative Therapies.
Mana Publications, Manaia, New
Zealand
Pischinger A 1991 Matrix and Matrix
Regulation: Basis for a Holistic Theory in
Medicine. Haug International, Brussels
Reed ES 1996 Encountering the World:
Toward an Ecological Psychology.
Oxford University Press, Oxford
Rolfing: The Integration of Human Structures
- Rolf Ip
Rolf IP 1977 Rolfing: The Integration of
Human Structures. Dennis Landman,
Santa Monica
Senge PM 1990 The Fifth Discipline: The Art
and Practice of the Learning
Organization. Doubleday, New York
Staubesand J, Li Y 1996 Zum Feinbau der
Fascia cruris mit besonderer
Beru¨cksichtigung epi-und intrafaszialer
Nerven. Manuelle Medizin 34: 196-200
La structure fine de l'apone´vrose jambie`re
- J Staubesand
Staubesand J et al. 1997 La structure fine de
l'apone´vrose jambie`re. Phle´bologie 50:
105-113
Harper & Row, New York van den Berg F, Cabri J 1999 Angewandte Physiologie -Das Bindegewebe des Bewegungsapparates verstehen und beeinflussen
- L Von Bertalanffy
von Bertalanffy L 1952 Problems of Life.
Harper & Row, New York
van den Berg F, Cabri J 1999 Angewandte
Physiologie -Das Bindegewebe des
Bewegungsapparates verstehen und
beeinflussen. Georg Thieme Verlag,
Stuttgart, Germany
Angewandte Physiologie - Das Bindegewebe des Bewegungsapparates verstehen und beeinflussen
- F Van Den Berg
- J Cabri
Matrix and Matrix Regulation: Basis for a Holistic Theory in Medicine
- A Pischinger
Zum Feinbau der Fascia cruris mit besonderer Berücksichtigung epi- und intrafaszialer Nerven
- J Staubesand
- Y Li