The effectiveness of diacutaneous fibrolysis on pain, range of motion and functionality in musculoskeletal disorders: A systematic review and meta-analysis

Abstract

Objective: To assess the effectiveness of diacutaneous fibrolysis in reducing musculoskeletal disorders symptoms such as pain, range of motion and functionality. Data sources: A systematic review of MEDLINE, Cochrane, PEDro and Science Direct was conducted until September 2020. Review methods: Computerized search strategy was performed to identify randomized controlled trials applying diacutaneous fibrolysis, on subjects with musculoskeletal disorders. Eligible articles and data extraction were conducted independently by two reviewers. Methodology quality and risk of bias were assessed by Risk of Bias 2 tool from the Cochrane Collaboration and Physiotherapy Evidence Database. Outcomes assessed were pain intensity, range of motion and functionality. Results: Search strategy identified 98 potential randomized control trials and six studies involving 386 participants, were finally included. Diacutaneous fibrolysis intervention added to usual physiotherapy treatment was compared to control group. Pain intensity immediately after treatment showed a pooled Standard Mean Difference (SMD) of –0.58 with 95% confidence interval (CI) from –1.12 to –0.04, and in the longest follow-up SMD was –0.63 with 95% CI (–1.21 to –0.05). Functionality showed a pooled SMD of –1.02 with 95% CI (–1.67 to –0.36) immediately after intervention and a SMD of –0.84 with 95% CI (–1.54 to –0.14). Range of motion could not be included in the quantitative synthesis. Conclusion: Diacutaneous fibrolysis is an effective treatment, when combined with conventional physiotheraphy, reducing pain immediately after treatment and long term follow-up and improving function in both, short and long term in musculoskeletal disorders.

Effect of diacutaneous fibrolysis on the muscular properties of gastrocnemius muscle

“…DF is an instrument-assisted soft tissue mobilization developed from the Cyriax deep friction massage principles. It consists of a set of metallic hooks applied to the skin which seems to allow deeper penetration and a more precise application than manual techniques, providing advantages on treatment [6]. Instrument-assisted soft tissue mobilization also seems to minimize the therapist force, but increase the force applied on the tissue [7].…”

“…The DF technique has also been shown to produce an increase of the range of motion in dorsiflexion of the ankle [1][2][3], a reduction in passive resistance of dorsiflexion of the ankle [8][9][10], and a decrease in the myotendinous reflex of the triceps surae [9,10] when used in healthy subjects. A recent review and metaanalisis concluded that DF is an effective technique in combination with conventional treatment to reduce pain both in a short and long-term and to increase function in patients with musculoskeletal disfunctions [6]. However, the underlying mechanisms of these effects are unknown.…”

Effects of diacutaneous fibrolysis in patients with tension-type headache: A randomized controlled trial

“…A set of metallic hooks is used to achieve a more in-depth and more precise application than manually. A recent systematic review and meta-analysis published by Cadellans et al [ 17 ] has shown that diacutaneous fibrolysis is an effective technique for improving symptoms and function in other musculoskeletal disorders such as shoulder pain [ 18 , 19 ], chronic lateral epicondylalgia [ 20 ], patellofemoral pain [ 21 ] and carpal tunnel syndrome [ 22 , 23 ].…”

Effects of diacutaneous fibrolysis in patients with tension-type headache: A randomized controlled trial

“…A set of metallic hooks is used to achieve a more in-depth and more precise application than manually. A recent systematic review and meta-analysis published by Cadellans et al [14] has shown that diacutaneous fibrolysis is an effective technique for improving symptoms and function in other musculoskeletal disorders such as shoulder pain [15,16], chronic lateral epicondylalgia [17], patellofemoral pain [18] and carpal tunnel syndrome [19,20].…”