Effects of Diacutaneous Fibrolysis on Flexibility and Active Neuromuscular Response

Study Overview
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Brief Summary
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Diacutaneous fibrolysis is a physiotherapeutic instrumental technique, used to treat musculoskeletal conditions causing pain and/or movement restriction. It is applied by means of metallic hooks, ending in a spatula with beveled edges, that seems to allow a better pressure distribution on the skin and a deeper and more precise application, compared to the manual approach. Recent studies indicate positive responses regrading pain intensity decrease in sports people suffering anterior knee pain, improving range of motion in subacromial impingement syndrome, improving sensory conductivity in symptomatic patients with carpal tunnel syndrome, decreased pain in patients with chronic epicondialgia or improveing function athletes with anterior knee pain. However, the specific action mechanism, have not been investigated in depth yet. There are no studies evaluating its effects on posterior muscular chain of lower extremity in athletes, where FD effects on neuromuscular response could be more evident due to the overload involved on this area. The aim of this study is to evaluate the immediate, and after 30 minutes, effects of a single diacutaneous fibrolysis session on flexibility, strength and neuromuscular activity on hamstring in athletes. A randomized controlled trial with blind evaluator. Randomization will be done between lower extremities of each subject (Random.org). Regardless of its own dominance, diacutaneous fibrolysis will be applied to de following muscles and intermuscular septums: gluteus maixmus, biceps femoris and semitendinosus to de lower experimental limb. The other extremity will not be treat (control limb). Sample recruitment. Athletes from UIC university community, who compete officially or institutionally, whether they are federated or recorded in a sport official register where the predominant activity focuses on the lower train (athletics, cycling, football, rugby...). Procedure. The anthropometric data will be collected at the beginning of the study. Each outcome assessment will be performed by a blinded evaluator at the baseline, immediately after the technique application and 30 minutes after.

Official Title
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Effects of Diacutaneous Fibrolysis on Flexibility and Active Neuromuscular Response on Posterior Muscular Chain of Lower Limb in Athletes

Conditions
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Hamstring Contractures

Intervention / Treatment
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* Other: Diacutaneous fibrolysis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Athletes <160º in the Passive Knee Extension test Participants must sign and have informed consent. Exclusion Criteria: Poor skin Trophic condition Taking anticoagulants Inflammatory process Recent musculoskeletal lower limb injury (< 6 month)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

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
Interventional Model Description: A randomized control trial
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Diacutaneous fibrolysis group<br>Diacutaneous fibrolysis is a physiotherapeutic instrumental technique, used to treat musculoskeletal conditions causing pain and/or movement restriction. It is applied by means of metallic hooks, ending in a spatula with beveled edges. Regardless of its own dominance, diacutaneous fibrolysis will be applied to de following muscles and intermuscular septums: gluteus maximus, biceps femoris and semitendinosus to de lower experimental limb. A single session of 10 minutes will be applied. | Other: Diacutaneous fibrolysis<br>* Diacutaneous fibrolysis is a physiotherapeutic instrumental technique, used to treat musculoskeletal conditions causing pain and/or movement restriction. It is applied by means of metallic hooks, ending in a spatula with beveled edges. Regardless of its own dominance, diacutaneous fibrolysis will be applied to de following muscles and intermuscular septums: gluteus maximus, biceps femoris and semitendinosus to de lower experimental limb. A single session of 10 minutes will be applied.<br>|
| No Intervention: Control group<br>Participants will be used as their own controls, with one lower extremity randomly receiving intervention. The control extremity will not receive any intervention | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hamstring neuromuscular activity | Hamstring neuromuscular activity (% of muscular fiber recruitment) will be assessed by surface electromyogram (mDurance). The electrodes will be placed on hamstring muscle while performing a functional movement. | Change between baseline (immediately before intervention) and post intervention (immediately after intervention); Change between baseline (immediately before intervention) and 30 minutes after intervention] | 
| Gluteus maximus neuromuscular activity | Gluteus maximus neuromuscular activity (% of muscular fiber recruitment) will be assessed by surface electromyogram (mDurance). The electrodes will be placed on gluteus maximus muscle while performing a functional movement. | Change between baseline (immediately before intervention) and post intervention (immediately after intervention); Change between baseline (immediately before intervention) and 30 minutes after intervention] | 
| Hamstring isometric strength | Isometric muscle strength (Kg) will be evaluated by means of a digital dynamometer (Microfeet 2). This measures will be taken across a knee flexion. | Change between baseline (immediately before intervention) and post intervention (immediately after intervention); Change between baseline (immediately before intervention) and 30 minutes after intervention] | 
| Guteus maximus isometric strength | Isometric muscle strength (Kg) will be evaluated by means of a digital dynamometer (Microfeet 2). This measures will be measured by means of hip extension. | Change between baseline (immediately before intervention) and post intervention (immediately after intervention); Change between baseline (immediately before intervention) and 30 minutes after intervention] | 
| Height on counter movement jump | Height (centimeters) on counter movement jump will be assessed using a mobile application called My jump. Its data has been used as an indirect indicator of explosive muscular strength of lower limb | Change between baseline (immediately before intervention) and post intervention (immediately after intervention); Change between baseline (immediately before intervention) and 30 minutes after intervention] | 
| Time flight on counter movement jump | Time flight (milliseconds) on counter movement jump will be assessed using a mobile application called My jump. | Change between baseline (immediately before intervention) and post intervention (immediately after intervention); Change between baseline (immediately before intervention) and 30 minutes after intervention] | 
| Force on counter movement jump | Force (newtons) on counter movement jump will be assessed using a mobile application called My jump. | Change between baseline (immediately before intervention) and post intervention (immediately after intervention); Change between baseline (immediately before intervention) and 30 minutes after intervention] | 
| Back chain flexibility Changes | Back chain flexibility is going to be assessed by means of modified Back Saver Sit and reach test (centimeters). | Change between baseline (immediately before intervention) and post intervention (immediately after intervention); Change between baseline (immediately before intervention) and 30 minutes after intervention] | 
| Hamstring flexibility changes | Hamstring muscles flexibility will be assessed using the passive knee extension test (degrees) by means of goniometer. | Change between baseline (immediately before intervention) and post intervention (immediately after intervention); Change between baseline (immediately before intervention) and 30 minutes after intervention] | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Diacutaneous fibrolysis, Physiotherapy, Neuromuscular response