Effects of a Myofascial Technique on Biomechanical Properties of the Lumbar Myofascia of Chronic Low Back Pain Adults

Study Overview
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Brief Summary
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Non-specific low back pain is a worldwide health issue that remains poorly understood. Some authors have shown that the thoracolumbar fascia of low back pain adults presents changes in biomechanical properties. As it is richly endowed with pain receptors, the thoracolumbar fascia could therefore be a key contributor to this chronic pain condition. Myofascial techniques (MFTs) are commonly used in manual therapy by practitioners of various backgrounds to address fascia biomechanical properties, but there is a paucity of objective evidence on their effects on tissue state. Musculoskeletal ultrasonography, sonoelastography and myometry are emerging imaging techniques that can quantify the biomechanical properties of fascia and underlying muscle. These innovative techniques could in turn contribute to a better understanding of MFTs effects on fascial properties. The main objective of this study is to evaluate the immediate effect of a standardized MFT on the elastography features of the lumbar paraspinal muscle and fascia (i.e. myofascial unit). The secondary objectives are to evaluate the immediate effects of a MFT on: i) ultrasonography features of the myofascial unit; ii) myometry features of the myofascial unit; ii) pain intensity.

Official Title
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Effects of a Myofascial Technique on Biomechanical Properties of the Lumbar Paraspinal Muscle and Thoracolumbar Fascia in Chronic Low Back Pain Adults Assessed by Elastography, Ultrasonography and Myometry

Conditions
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Chronic Low Back Pain

Intervention / Treatment
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* Other: Myofascial release technique
* Other: Simulated Myofascial Release technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adults over 18 years of age, lumbar pain and/or referred pain above or below the gluteal fold , with intensity > 3/10, persisting for > 6 months and presenting during the day > 50% of the time. Exclusion Criteria: history of serious spinal or lower extremity injury or surgery in the last year identifiable back pain or known pathology known rheumatological condition oral or injectable corticosteroids in the lumbar spine within the last 3 months psychiatric disorder pregnancy manual treatment of the lumbo-sacral region 1 month prior to the experimentation and during the week of the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Myofascial release technique group<br> | Other: Myofascial release technique<br>* Myofascial technique on the thoracolumbar fascia and lumbar paraspinal muscles<br>|
| Sham Comparator: Simulated myofascial release technique group<br> | Other: Simulated Myofascial Release technique<br>* Superficial hands contact on the lumbar area<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in elastography features of the myofascial unit | Evaluated with a shear wave sonoelastography device. | Baseline (before treatment), post-treatment (immediately after treatment) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in ultrasonography features of the myofascial unit | Evaluated with a B-mode ultrasound imaging device | Baseline (before treatment) post-treatment (immediately after treatment) | 
| Changes in myometry features of the myofascial unit | Evaluated with a myotonometer | Baseline (before treatment) post-treatment (immediately after treatment) | 
| Changes in pain intensity | Numeric rating Scale (0 to 10; minimum = 0; maximum = 10; higher score means worst outcome) | Baseline (before treatment) post-treatment (immediately after treatment), at day 2 and at day 7 after the intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Osteopathy, Low back pain, Fascia properties, Thoracolumbar fascia, Myofascial release, Manual therapy, Ultrasound imaging, Sonoelastography