Improving the quality of myofascial release research – A critical appraisal of systematic reviews

Ajimsha, M.S.; Shenoy, Preethi J

doi:10.1016/j.jbmt.2019.03.011

Cited by 14 publications

(14 citation statements)

References 24 publications

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“…While considering the experimental studies, to have the high quality evidence, appraise and organise the studies with good quality designs, randomization and double-blinding first (Ajimsha & Shenoy 2019). One should understand that a systematic review is not necessarily superior to a well-conducted RCT, and not all RCTs are necessarily superior to observational studies of good methodological quality(Ajimsha & Shenoy 2019). Authors should use their critical appraisal skills to interpret any research evidence before applying it to clinical practice.…”

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confidence: 99%

Role of fascial connectivity in musculoskeletal dysfunctions: A narrative review

Ajimsha

Shenoy

Gampawar

2020

Journal of Bodywork and Movement Therapies

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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confidence: 99%

Role of fascial connectivity in musculoskeletal dysfunctions: A narrative review

Ajimsha

Shenoy

Gampawar

2020

Journal of Bodywork and Movement Therapies

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“…To have the high quality evidence, we need to appraise and organize the studies with good quality designs. Participants should be randomized, the design should be double blinded (Ajimsha and Shenoy, 2019). Usage of apriori calculated sample sizes; adequate power; limiting the sources of bias; appropriate levels of significance; assessing the threats to statistical validity; appropriate registration and the usage of technologies and radiological outcome measures may revolutionize the future of this field of research.…”

Section: Discussionmentioning

confidence: 99%

“…We need to abstain from reporting within group differences as evidence of effectiveness (Matthews and Altman, 1996;KF Schulz et al, 2010). One should understand that a systematic review or meta-analysis isn't essentially higher than a well-conducted RCT, and not all RCTs are essentially greater than observational trials of sound methodological quality (Ajimsha and Shenoy, 2019). Practitioners should utilize their critical appraisal skills to decipher any research findings before applying it to clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Myofascial Force Transmission in the Humans: A Systematic Scoping Review of In-Vivo Studies

Ajimsha¹,

Surendran²,

Jacob³

et al. 2020

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Background: The fascial system provides an environment that enables all body systems to operate in an integrated manner and is capable of modifying its tensional state in response to the stress applied to it. Recent in vitro, animal and cadaveric studies have shown that “myofascial force transfer” (MFT) has the potential to play a major role in musculoskeletal function and dysfunction.Objective: Human evidence for the existence of invivo MFT is scarce. This scoping review attempts to gather and analyse the available evidence of the in-vivo human MFT studies in order to sustain and facilitate further research and evidence based practice in this field.Methods: A search of most major databases was conducted with relevant keywords that yielded 238 articles as of August 2020. A qualitative analysis of the studies was conducted after rating it with Oxford’s Center for Evidence –based Medicine (CEBM) scale.Result: Nineteen studies ranging from randomized controlled trials to case studies covering 540 patients were included in this review. The analysed studies were highly heterogeneous and of lower methodological quality meddling with the quantitative analysis. Ten studies are confirming a ‘most likely’ existence of MFT, eight studies confirming it as ‘likely’ and one study couldn’t confirm any MFT existence in this review.Conclusion: Findings from in vivo human studies supports the animal and cadaveric studies claiming the existence of MFT which need to be corroborated by the future high quality studies. Forthcoming studies on MFT may give answers and solutions to many of the human musculoskeletal mysteries or dysfunctions.

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“…The effect size of the study by Barnes et al was f = 0.90 and that of the RCT by Wong et al f = 0.57. Due to the large uncertainty regarding the assumed intervention effects of an MFR, the recommendations of Ajimsha et al [22] were followed and a medium effect size (f = 0.25) was assumed. The power analysis resulted in a total sample size of 44, for a power of 95 % and a significance level of α = 0.05.…”

Section: Secondary Objectivesmentioning

confidence: 99%

Practical measurement of changes in leg length discrepancy after a myofascial release on the thoracolumbar fascia in patients with acute low back pain. A pilot study.

Brandl¹

2021

Preprint

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Background: A relationship between leg length discrepancy (LLD), pelvic obliquity and acute low back pain (aLBP) is discussed in recent work. Myofascial release (MFR) techniques are probably one approach to tread aLBP. It is proposed to use anamnestic LLD survey in aLBP patients. The aim of this study is to evaluate a practical measurement of LLD and the feasibility of MFR in the setting of a randomized control trial (RCT).Methodology: In 12 subjects (7 female, 5 male) with aLBP and a LLD greater than 3 mm, a MFR technique was performed on the thoracolumbar fascia. At baseline, post-intervention and follow-up, LLD was measured with a cross-line laser, pain with the visual analogue scale (VAS) and finger floor distance (FFD). Patients completed a survey after follow-up to assess their acceptance of the study procedure. The therapist evaluated the methods in terms of practicability.Results: The cost on time and resources for the LLD measurement and the MFR treatment was low. The participants voted with medium to high acceptance for the study procedure. The LLD decreased by 5.00 mm after treatment and by 4 mm to follow-up. The minimum detectable changes were exceeded in 7 out of 12 cases after intervention and in 2 of 9 cases at follow-up. The VAS showed a reduction in pain of 17.50 mm to follow-up but not after treatment. The FFD revealed no clinically relevant differences.Conclusion: Measurement of LLD is applicable in daily practice in a manual therapy setting, but it cannot be assumed to be a valid method for an RCT. Valid methods such as video raster stereography are therefore recommended. A comprehen-sive RCT with an MFR arm to investigate the impact of this intervention on leg length is feasible.

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Improving the quality of myofascial release research – A critical appraisal of systematic reviews

Cited by 14 publications

References 24 publications

Role of fascial connectivity in musculoskeletal dysfunctions: A narrative review

Role of fascial connectivity in musculoskeletal dysfunctions: A narrative review

Myofascial Force Transmission in the Humans: A Systematic Scoping Review of In-Vivo Studies

Practical measurement of changes in leg length discrepancy after a myofascial release on the thoracolumbar fascia in patients with acute low back pain. A pilot study.

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