Fascial manipulation vs. standard physical therapy practice for low back pain diagnoses: A pragmatic study

Abstract

Background: Connective tissue mobility alters motor unit recruitment, but the restoration of fascial mobility allows for optimal motor function. The Fascial Manipulation^® (FM^®) method is a multiplanar approach that assesses and treats the mobility of deep fascia in specific anatomical locations where motor units converge.

Objectives: To assess the effects of FM^® vs. standard physical therapy treatment (SPT) in patients with low back pain (LBP).

Design: Six-months controlled clinical trial.

Method: 102 participants with LBP received SPT or FM^®. Numeric Pain Rating Scale (NPRS), 15- point Global Rating of Change (GROC), and Oswestry Disability Index (ODI) were used to monitor progress.

Results: The FM^® group had a significantly lower ODI (p < 0.009) and NPS scores (p < 0.0001) and significantly higher GROC scores (p < 0.003) once their means were adjusted for initial scores. When comparing the SPT to FM^®, the final ODI decreased by at least 1 category in 48.9% of the SPT cases, while in 36.2% of the cases was no change. ODI minimal clinical importance difference (MCID) change of 10% decrease in scores occurred in 70.2% of the SPT group compared to 96% of the FM^® group (p = 0.003). ODI MCID change of 50% decrease in scores occurred in 40% of the SPT group compared to 64.6% of the FM^® group (p = 0.02) 44.7% of the participants in the SPT group had final GROC values above +5 at discharge, compared to 92% of the participants from the FM^® group (p = 0.0001). The FM^® subjects had almost three times the change in NPRS compared to SPT counterparts (-4.3 ± 2.2 to -1.5 ± 2.4, p=0.0001).

Conclusions: FM^® appears to improve NPRS, GROC, and ODI more than SPT. FM^® may provide an effective treatment technique for LBP.

Keywords: Fascia; Fascial manipulation; Low back pain; Motor unit.