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Effects of myofascial release in non-specific chronic low back pain: a randomized clinical trial [with consumer summary]
Arguisuelas MD, Lison JF, Sanchez-Zuriaga D, Martinez-Hurtado I, Domenech-Fernandez J
Spine 2017 May;42(9):627-634
clinical trial
9/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

STUDY DESIGN: Double-blind, randomized parallel sham-controlled trial with concealed allocation and intention-to treat analysis. OBJECTIVE: To investigate the effects of an isolate Myofascial Release protocol (MFR) on pain, disability and fear- avoidance beliefs in patients with chronic low back pain (CLBP). SUMMARY OF BACKGROUND DATA: MFR is a form of manual medicine widely used by physiotherapists in the management of different musculoskeletal pathologies. Up to this moment, no previous studies have reported the effects of an isolated MFR treatment in patients with CLBP. METHODS: Fifty four participants, with nonspecific CLBP, were randomized to MFR group (n = 27) receiving four sessions of myofascial treatment, each lasting 40 minutes, and to control group (n = 27) receiving a sham MFR. Variables studied were pain measured by means Short Form McGill Pain questionnaire (SF-MPQ) and visual analogue scale (VAS), disability measured with Roland Morris questionnaire and Fear-Avoidance Beliefs measured with FAB questionnaire (FABQ). RESULTS: Subjects receiving MFR displayed significant improvements in pain (SF-MPQ) (mean difference -7.8; 95% CI -14.5 to -1.1, p = 0.023) and sensory SF-MPQ subscale (mean difference -6.1; 95% CI -10.8 to -1.5, p = 0.011) compared to the sham group, but no differences were found in VAS between groups. Disability and the FABQ score also displayed a significant decrease in the MFR group (p < 0.05) as compared to sham MFR. CONCLUSION: Myofascial Release Therapy produced a significant improvement in both pain and disability. However, as the minimal clinically important differences in pain and disability are included in the 95% IC, we can not know if this improvement is clinically relevant. LEVEL OF EVIDENCE: 2.
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