Myofascial Techniques Research Articles

Assessing Kinesiophobia and Catastrophizing Patient-Reported Outcomes in a Randomized Controlled Trial: Efficacy of Capacitive-Resistive Monopolar Radiofrequency Combined with Myofascial Techniques vs. Sham Radiofrequency in Chronic Pelvic Pain Syndrome-A Secondary Analysis.

Chronic Pelvic Pain Syndrome causes psychological distress, worsened by kinesiophobia and pain catastrophizing. This study assesses whether combining capacitive-resistive monopolar radiofrequency with myofascial techniques is more effective than myofascial techniques alone for improving psychological outcomes such as kinesiophobia and catastrophizing. This double-blind, randomized controlled trial enrolled 81 chronic pelvic pain syndrome patients (67.9% female, mean age 43.6 years) from March 2019 to April 2021. Participants were assigned to either an activated (intervention) or deactivated (control) capacitive-resistive monopolar radiofrequency group, with both groups receiving physiotherapy and pain education over 10 weeks. Outcomes on kinesiophobia and catastrophizing were assessed at weeks 5 and 10, using the Spanish versions of the Tampa Scale (TSK-11) and Pain Catastrophizing Scale (PCS). At treatment's end, the intervention group showed greater improvement in kinesiophobia (3 points) compared to controls, though nonsignificant (p = .099). The intervention also significantly reduced catastrophizing scores by 8 points versus control (p = .042). No major adverse effects occurred, and adherence was high (86.4%), with no differences between groups. This study shows that combining capacitive-resistive monopolar radiofrequency with myofascial techniques can improve kinesiophobia and catastrophizing in chronic pelvic pain syndrome patients, such as fear movement and catastrophic thinking related to pain. This marks a potential breakthrough in chronic pain management. Future research should focus on larger, multicenter RCTs with extended follow-up periods to better assess long-term effects. Clinical trial registration (NCT03797911).

UTILIZAÇÃO DAS TÉCNICAS MIOFASCIAIS NAS CERVICOBRAQUIALGIAS: UMA REVISÃO LITERÁRIA

Objective: Analysis of different articles in order to investigate the effectiveness of myofascial techniques as therapeutic methods for combating cervicobrachialgia in comparison to other techniques such as neural mobilization and craniosacral techniques. Methodology: A search was conducted on the Google Scholar, PEDro and Lilacs platforms using the following keywords: Myofascial techniques; cervicobrachialgia; physiotherapy. Results: Nine articles were found studying the effectiveness of different techniques, including myofascial techniques. Discussion: The articles were analyzed and demonstrated effectiveness in different aspects such as pain and range of motion. Conclusion: After analyzing the nine articles, the myofascial technique demonstrated satisfactory results, as did the other techniques demonstrated and analyzed, such as neural mobilization and craniosacral techniques, even in situations where the technique was used in conjunction with others.

Myofascial pain syndrome in patients with cancer: a narrative review.

Myofascial pain syndrome (MPS) is a chronic musculoskeletal pain syndrome. The purpose of this review is to describe the epidemiological and treatment evidence and to address the future research agenda in patients with cancer. A narrative review of previous reports investigating the prevalence and treatment of MPS in the oncology field is presented. The target population is patients with cancer and cancer survivors. There have been three prospective and two retrospective studies investigating the prevalence of MPS. MPS is as high as 38%-45% in patients with advanced or incurable cancer and 11.9%-44.8% in cancer survivors. A total of nine reports investigated the efficacy of the following interventions: trigger point injection (TPI), myofascial techniques and ischaemic compression. TPI has been reported to be effective in four observational studies. One randomised study reported the efficacy of myofascial techniques, but two randomised studies reported no added beneficial effects of it in breast cancer survivors. Two randomised studies investigated the efficacy of ischaemic compression, but the obtained results were contradictory. MPS is highly prevalent. We should know that non-cancer pain is also common in both patients with cancer and survivors. In treating such pain, careful physical examination is essential. Then, non-pharmacological treatment should be considered as well as pharmacotherapy. As evidence regarding MPS in the oncology field is scarce, further research is warranted.

Comparative effectiveness of Maitland Spinal Mobilization versus myofascial techniques on pain and symptom severity in women with Fibromyalgia syndrome: A quasi-randomized clinical trial with 3-month follow up

ObjectiveThe aim of this experimental study was to determine which manual therapy approach is more effective in addressing health status by improving symptoms (sensory, cognitive, emotional, and social) in patients with fibromyalgia. Material and methodsA quasi-randomized clinical trial with 3-month follow-up was conducted in 52 female patients (age 52.5 ± 8.1 years) affected by rheumatologist-diagnosed Fibromyalgia and evaluated at the Asociación de Fibromialgia y Síndrome de Fatiga Crónica (AFINSYFACRO) in Móstoles and AFIBROM, Madrid, Spain. Two manual therapy approaches were applied: the myofascial technique approach (MTA) and Maitland Mobilization Approach (MMA). The study examined the following outcomes: Widespread Pain, Symptom Severity, Impact on Quality of Life, Perceived Pain, Sensitization-Associated Pain, Sleep Quality, Physical Activity, and Psychological, Cognitive, and Emotional Factors. Patient Satisfaction was also assessed. ResultsNo significant differences were found between groups over time for most variables. However, the MTA group showed significant improvements in pain intensity, central sensitization, general health, sleep quality, and anxiety compared with the MMA group. ConclusionsDespite the lack of between-group differences in all variables over time, MTA may be useful in the treatment of fibromyalgia, reducing pain, central sensitization, and negative emotional symptoms, as well as improving general health and sleep quality. Due to problems during the study, randomization was abandoned. This problem becomes a virtue by taking advantage of the situation to apply statistical compensation methods, which will serve as a guide for future research that suffers from this problem. We suggest the inclusion of longer follow-up periods in future studies.

The Erector Spinae Muscle, a Determining Factor in the Pathological Biomechanics of the Spine

Pathological biomechanics of adolescent idiopathic scoliosis is dominated by unilateral erector spinae stiffness. This leads to morpho pathological vertebral changes that aggravate the condition. Manual therapies can be used to correct the asymmetry of the stretch reflexes, and massage techniques can be used to improve the range of motion. Pain is an aggravating factor for biomechanical disorders and can be combated by myofascial techniques. To prevent scoliosis in adults, it is possible to tone the erector spinae muscles (deadlifts and their variations, exercises with free weights, arm and leg ergometer exercises, some aquatic exercises, Pilates isometric exercises performed on a stable surface). Keywords: spinal erector muscles, scoliosis prophylaxis

The effect of myofascial techniques on the electrical activity of the neck muscles

Introduction. Research by foreign scientists often present the results of studies of the effects of specific osteopathic techniques on the body. Myofascial techniques are dynamic low-amplitude techniques in which the myofascial complex of tissues is rhythmically stretched in areas where their mobility is limited. In one study of paravertebral muscles using surface electromyography (sEMG) before and after myofascial techniques, a statistically significant (p<0,05) decrease in their electrical activity was obtained. No publications devoted to the study of the effect of myofascial techniques on the electrical activity of the neck muscles were found.The aim is to study the effect of myofascial techniques on the electrical activity of the neck muscles in individuals with increased tone of these muscles.Materials and methods. A prospective study was conducted in the Department of Osteopathy of Mechnikov North-West State Medical University in which 30 apparently healthy volunteers who did not present active complaints, aged from 23 to 35 years, took part, with a median of 25 years. Inclusion criteria were palpation-determined increased tone of the sternocleidomastoid and upper trapezius muscles. Non-inclusion criteria were the presence of diseases and/or conditions that are an absolute contraindication to osteopathic correction, a history of neck injuries; taking medications that affect muscle tone at the time of the study; neuromuscular diseases. At the beginning of the study, all volunteers underwent palpation of the upper trapezius and sternocleidomastoid muscles on both sides. The degree of increase in muscle tone was assessed in points: 1 — weak; 2 — medium; 3 — strong; 0 — normal tone. Next, they underwent myofascial mobilization techniques: longitudinal and unilateral lateral mobilization of the soft tissues of the neck, separate mobilization of the sternocleidomastoid muscles. Before, immediately after, and three days after the session, muscle tone was recorded using surface electromyography (sEMG), which was performed on a wireless monitoring complex for electrophysiological signals «Kolibri» (OOO NMF «Neurotech», Russia). At rest, the average and maximum amplitude of electrical activity of the sternocleidomastoid and upper trapezius muscles was measured. The recording was made synchronously from the right and left sides of the body.Results. The sEMG indices of muscles with different tone based on the results of subjective assessment were statistically highly significant (p=0,0001). Moreover, according to the A(avg) indicator, the range diagrams either did not intersect or intersected only slightly. The electrical activity of the sternocleidomastoid muscles after myofascial mobilization techniques decreased statistically significantly and remained at the same level for 3 days (p=0,01). Such dynamics were observed in both the average and maximum amplitude of electrical activity. The amplitude of electrical activity of the right sternocleidomastoid muscle was slightly greater than that of the left (all subjects were right-handed), but these differences did not reach statistical significance (p>0,05). After treatment, there was a trend towards a decrease in the asymmetry of electrical activity between the left and right sternocleidomastoid muscles, both middle and maximum, but these changes were not statistically significant (p>0,05). The electrical activity of the upper part of the right trapezius muscle decreased statistically significantly after treatment and remained at this level for 3 days (p=0,01). The left trapezius muscle was excluded from the study due to technical reasons.Conclusion. The study showed that osteopaths (who are completing residency training in osteopathy) palpably distinguish between normal muscle tone and its increase in weak and moderate degrees. One session of myofascial mobilization techniques leads to a decrease in the tone of the sternocleidomastoid muscles and the upper part of the right trapezius muscle according to sEMG. Such changes occur immediately after the session and then persist for at least three days in young people with increased tone of these muscles. Surface electromyography can be used to objectively record and measure the results of specific osteopathic techniques. This is important for increasing the evidence of clinical research in osteopathy.

Imaging tools for assessment and evolution of connective adhesions treatment: pilot study

Background: Chronic genital pain by connective disorder requires visual assessment, both at the beginning and during the treatment itself. Image enhancement devices can help this process. Aims: To test smartphone microscopy lenses and a thermography to visualize vulvar connective adherences. Method: Pilot study. Two sets of smartphone microscopy lenses and a thermographic camera were used to observe connective adherences in the vestibulovulvar region of one volunteer. Images were recorded before and after treatment with myofascial techniques. Results: The 12.5x magnification lens was useful in defining of the islands of adherence; the 100x lens was useful for a more precise observation of the white lines that form the internal structure of the adherence, and the thermography allowed the record of the adherence before and after treatment, plus the vasomotor changes caused by the maneuvers. Conclusion: Smartphone microscopy lenses and thermographic cameras can be useful for better visualization of areas of connective adherence, both for initial assessment and for the record of results for evolution of myofascial techniques for genital pain of connective origin.

Effects of a Myofascial Technique on the Stiffness and Thickness of the Thoracolumbar Fascia and Lumbar Erector Spinae Muscles in Adults with Chronic Low Back Pain: A Randomized before-and-after Experimental Study.

The thoracolumbar fascia (TLF) may be a pain generator, given its rich innervation. Structural and biomechanical changes have also been documented in adults with chronic non-specific low back pain (LBP). Myofascial techniques (MFTs) are commonly used in manual therapy and are hypothesized to reduce tissue stiffness and pain. However, evidence for these effects is limited. The objective of this study was to evaluate the immediate effects of a standardized MFT compared to a simulated MFT on: (1) the stiffness of the TLF and erector spinae muscles (shear-wave sonoelastography), (2) the thickness of the TLF (B-mode ultrasound), and (3) pain intensity (numerical rating scale). Forty-nine participants with chronic non-specific LBP were included in a randomized before-and-after experimental study. Outcome measures were collected before (T0) and immediately after the intervention (T1). Pain intensity was also assessed on day two (T2) and seven (T7). The MFT group showed a significant decrease in left erector spinae muscle stiffness and left TLF thickness compared to the simulated group. In addition, there was a significant reduction in pain intensity in the MFT group compared to the simulated group at T1 and T2. The results of this study suggest that MFT results in immediate tissue changes and transient pain reduction in patients with LBP.

Effects of a myofascial technique on tissue state and pain intensity of adults presenting chronic nonspecific low back pain

Effects of a myofascial technique on tissue state and pain intensity of adults presenting chronic nonspecific low back pain

New myofascial release techniques for genital and pelvic pain show zero pain in 10 sessions

Background: Chronic pelvic pain afflicts a quarter of the world's population, and for which there is no efficient treatment. Aims: To test a new assessment protocol and two new myofascial release protocols for genital pain and chronic pelvic pain. Method: Patients with any complaint of genital pelvic pain were recruited in 9 pelvic physiotherapy offices during two months, classified into muscle pain (type 1) or connective pain (type 2). They were subject to respective myofascial techniques. Initial and final VAS and absence of pain in LDAs, including sexual pain, were used as a measure of the effectiveness of the protocols. The number of sessions required for discharge was used as an efficiency measure. Results: 107 women from 8 Brazilian cities attempted to the study, mean age 33 ± 7 years. 25,6% had type 1 pain, 25,6% had type 2 and pain and 48,7% both types. All had zero pain at the end. The average number of sessions needed to zero pain was 4,5±2. Conclusion: The New Functional Classification of Pain is effective in the functional diagnosis of genital pain, and the new myofascial techniques proposed completely eradicate pelvic pain in women in a maximum of 10 sessions.

Aspects Regarding the Recovery of the Ankle Sprain by Myofascial Techniques

"Introduction: A sprained ankle is an injury that occurs when you roll, twist or turn your ankle in an awkward way. This can stretch or tear the tough bands of tissue (ligaments) that help hold your ankle bones together. The incidence of training injuries is almost constant for players between the ages of 13 and 19, with the majority of injuries ranging from 1 to 5 injuries per 1,000 hours of training, while younger players have lower incidences. The incidence of injuries during the match tends to increase with age, in all age groups, with an average incidence of about 15 to 20 injuries per 1,000 hours of play in players over 15 years of age. Objective: The aim of this study is to verify the efectiveness of an individualized kinetic program in association with myofascial techniques. Methods: The myofascial techniques used are IASTM (Ergon therapy), dry needling, cupping and kinesiotaping. In this study a 18 years old football player was included. The evaluation was performed by the Biodex (for the muscle strength) and lunge test (for the range of motion). Results: After a month o treatment, our patient improved his strength and range of motion. Conclusion: Studies have shown that these techniques of myofascial release provide a huge effectiveness on the flexibility of the muscles, having even much more efficacy than stretching. Using myofascial techniques, has a much quicker result on the recuperation of the ankle sprain offering a great efficacy on the total recuperation of the pacient. Key words: manual therapy, rehabilitation, ankle sprain "

Comparative effects of Myofascial Technique Alone and In Combination with Isometrics on Myofascial pain Syndrome Due to Excessive Smartfone Usage

Myofascial Pain Syndrome (MPS) is a regional musculoskeletal pain disorder which is caused by the formation of myofascial trigger points. Myofascial trigger point pain is typical and frequently so debilitating that it is vital to receive quick and efficient treatment. This pain is commonly seen in people that are in their teenage or in adults effecting both men and women. Many interventions have been used to treat this condition by physiotherapists and respective health care providers such as trigger point release, massage therapies, acupuncture techniques, and other heat and cold therapies, among others. Objective: This study compares the efficiency of myofascial release techniques along with isometrics exercises and isolated myofascial release for the upper trapezius muscles' myofascial trigger points. Methods: It was a Randomized clinical trial carried out in the city of Faisalabad. Two groups of the patients were made and randomly assigned by lottery method. Both the groups received myofascial release techniques baseline treatment. Group A received the isometrics with myofascial release technique and group B received the isolated myofascial release technique. The Trapezius muscle's trigger points were assessed using Simon's trigger point criteria. Outcome measures were VAS and Neck pain assessment form. Results: Upon completion of the trial, NDI and VAS scores were assessed prior to and after the treatment; before treatment group A of NDI demonstrated average score of 10.7333 and group B showed 14.5333, while after treatment the score was transformed to group A; 3.4000 and group B; 4.8667. For VAS, group A and B before treatment scored 5.7333 and 5.8667, respectively, whereas, after treatment they scored 2.4667 and 2.5333, respectively. Conclusion: MFR along with isometrics was slightly more effective as compared to isolated MFR in pain alleviation and improvements of ROM but statistically both of interventions given were effective.

Comparing the Effects of a Series of Ischaemic Compression Therapy and Muscle Energy Techniques on Pain Threshold and Muscle Tension in People with Upper Crossed Syndrome

Introduction: Myofascial pain syndromes and upper crossed syndrome (UCS) are common phenomena observed in society. The main reasons for their formation are postural defects and chronic muscle overload. Trigger points (TP) develop within the affected muscles, generating pain and other symptoms that worsen quality of life. A popular method of therapy is ischaemic compression (IC) of trigger points and muscle energy techniques (MET). However, in literature on the subject, there is a lack information on the effects of a series of therapies with these techniques on the reduction of pain and muscle tension. Aim: The aim of the study was to determine the optimal myofascial technique in the treatment of patients with UCS presenting with pain and excessive tension in the trapezius muscle. Material and methods: In the study, 45 people with UCS with TP in the trapezius back muscle were qualified for the trial. The subjects were randomly divided into 3 equal groups. Group A underwent a series of 5 IC trigger point treatments, while group B received a series of 5 MET treatments. Group C was a control group not subjected to any therapeutic intervention. Changes in pain threshold and muscle resting electrophysiological values after the completion of the 5-week therapy intervention were assessed. The Statistica 13 program was used for statistical analysis of the data. Results: A significant increase in pain threshold on both sides of the body was demonstrated in groups A and B, but not in group C. Comparison of pain changes between the right and left sides showed no significant differences between groups. There was a significant decrease regarding tension in group C on both sides of the body and its increase in group A on the right side, however, in each case, these values were within the physiological norms. Conclusions: A series of 5 ischaemic compression treatments and muscle energy techniques are effective in reducing pain caused by latent trigger points in people with UCS but are not associated with changes in resting tension beyond physiological norms.

Combined impact of myofascial techniques and gymnastics for the rehabilitation of children with neuropathy of the facial nerve

Facial neuropathy (Bell’s palsy) is a disease characterized by damage to the nerve fibers of the VII cranial nerve with the occurrence of unilateral facial muscle weakness or paralysis. Damage to the facial nerve is the most common type of cranial neuropathy. Delayed treatment onset and/or inadequate therapy of the disease leads to the residual neurological deficit, which may significantly reduce the patient’s quality of life. The best result in the rehabilitation of children with facial nerve neuropathy is provided with an integrated approach using myofascial manual therapy techniques and exercises. This is achieved during the therapy sessions with a myofascial manual techniques complex. After preparing the muscles, fascia and skin, the therapist conducts a set of passive and active exercises with a patient to restore the work of his/her facial muscles. The method was created, tested, and implemented in the Federal State Autonomous Institution “National Medical Research Center of Children’s Health” of the Ministry of Health of the Russian Federation. The essence of the method consists of the process of therapy sessions, providing a gradual recovery of functional relationships between the myofascial structures of the face, and improvement of lymphatic drainage, arterial blood supply, and venous outflow restoration. The alternation of myofascial manual techniques with exercises contributes to the maximum effective restoration of the symmetrical work of the facial muscles. Evaluation of the effectiveness of myofascial manual techniques and corrective exercises was carried out by clinical presentation changes and follow-up data. Comprehensive rehabilitation using myofascial manual techniques and exercises makes it possible to achieve improvement in restoring the function of facial muscles, eliminating asymmetry, and preventing complications. Conclusion. The obtained results demonstrated the effectiveness of myofascial manual techniques and exercises in the rehabilitation of children with facial neuropathy. Based on the results of the study, a positive effect of this method was shown to improve the functions of mimic muscles and facial symmetry in children with Bell’s palsy.

Deep pelvic myofascial release (Broad Ligament Maneuver) associated or not with LPF

Background: Among genitopelvic pain is the pain deep into the vagina and deeper than the uterine cervix, different from pain related to penetration or superficial connective pain. Aims: To test the view of abdominal and pelvic fascia, muscles and viscera by ultrasound (USG), as well as the view of two myofascial techniques, one intravaginal and the other external, and diaphragmatic aspiration of LPF, comparing the effectiveness of each technique alone or in combination, regarding the mobilization of visceral and parietal fasciae. Method: Exploratory experimental study guided by USG. Results: Muscles, fasciae and organs were well seeing by USG, as well as the fascial movements caused by each technique. LPF mobilized visceral fascia better, but manual techniques mobilized parietal fascia better. The Broad Ligament Maneuver mobilized both fasciae. The combination of manual techniques with LPF was superior in releasing parietal and visceral fasciae. Conclusion: Fascial mobilization can be effectively visualized by USG. The combination of manual myofascial release techniques with LPF is more effective in mobilizing all fasciae and should be the first choice.

Functional and Aesthetic Outcome Following Simultaneous Temporomandibular Joint Ankylosis Release and Correction of Chin Discrepancy by Lower Border Osteotomy-A Case Report

This is a case report of a 19 year old adult female with facial asymmetry secondary to right Temporomandibular Joint (TMJ) ankylosis with a history of previous surgery at the age of 10 years with gap arthroplasty for tmj ankylosis which was unsuccessful and lead to relapse .Because of decreased mouth opening and facial disfigurement patient was not able to have a quality life. She reported to our department where she got operated simultaneously for tmj ankylosis with interpositional arthroplasty using temporalis myofascial flap and novel osteotomy technique for correction of chin asymmetry. After surgery there is a significant improvement in patient both functionally and aesthetically.

Fascial therapy, strength exercises and taping in soccer players with recurrent ankle sprains: A randomized controlled trial

IntroductionRecurrent ankle sprains are common in soccer players, characterized by restricted range of motion, pain, and decreased proprioception, strength, and postural control. The objective was to evaluate the effectiveness of a fascial therapy and strength training program, combined with kinesiotaping, in improving ankle range of motion, pain, strength and stability in footballers with recurrent sprains. MethodA simple blind randomized clinical trial was conducted on soccer players. Thirty-six federated footballers were recruited and randomized to the two study groups. The experimental group received an intervention using myofascial techniques applied to the subastragaline joint, eccentric training with an isoinertial device and neuromuscular taping. The control group was administered an intervention using myofascial techniques on the subastragaline joint and eccentric training with an isoinertial device. The results were recorded for all players at baseline, after 4 weeks of intervention, and at the end of the 4-week follow-up period. ResultsSubsequent to intervention and follow-up, we found statistically significant improvements in the experimental group in ankle mobility, strength and stability. The control group exhibited improvements in all study variables. No differences in the improvement of variables were found based on the allocation of athletes to one group or another. ConclusionThe combination of fascial therapy and eccentric strength training with an isoinertial device improves ankle mobility, strength and stability in footballers with recurrent ankle sprains. The use of taping techniques failed to provide a greater improvement of the study variables when combined with manual therapy and strength techniques.

Multidisciplinary team in temporomandibular disorders

Introduction The temporomandibular disorders (TMD) are one of the main concerns regarding orofacial pathologies and there are an ascending number of cases. They are characterised as a group of pathological conditions that may affect the temporomandibular joint (TMJ), the masticatory musculature and/or other adjacent anatomical structures, leading to pain and dysfunction [1]. The multifactorial aetiology of TMD affects a relatively large number of the world population and requires a multidisciplinary evaluation and diagnosis by the clinical team [2]. Among the various elements that constitute the multidisciplinary team we highlight the dentist and the physiotherapist. The dentist as a first-line professional, most of the time is responsible for the identification of patients potentially at risk and for the follow-up of those who already present the disease [3]. On the other hand, the physiotherapist aims to reduce musculoskeletal pain, promote muscle relaxation, reduce muscle hyperactivity, improve function by restoring the quality and quantity of mandibular movements and maximise joint mobility [4]. Description of the clinical case A 24-year-old female patient with a history of temporomandibular disorder and bruxism she presented an non-assisted mouth opening (UMO) of 28 mm and an assisted mouth opening with pain in the masseter and TMJ bilaterally of 29 mm, after the clinical assessment with the DC/TMD protocol we arrived at a diagnosis of disc displacement without reduction (DDwR) with limited opening, degenerative joint disease in the left TMJ, arthralgia (II), myofascial pain (III) in the masseter with pain referred to other anatomical regions. All the assumptions of the Helsinki Declaration have been fulfilled and an informed consent for clinical case of Clinica Dentária Egas Moniz approved by the ethic commission of Instituto Universitário Egas Moniz. The treatment plan consisted of cognitive behavioural therapy (CBT), prescription of muscle relaxants, occlusal splint especially for reduction of overload due to bruxism, infiltration with 1 ml of hyaluronic acid of high molecular weight in the TMJ bilaterally followed by articular mobilisation techniques and neuromuscular and myofascial techniques. The patient was instructed to continue with the physiotherapy. Results The follow up was made 2 months after with 8 sessions of physiotherapy and 1 more hyaluronic acid infiltration bilaterally as protocoled session, we could observe an absence of temporomandibular joint pain, UMO of 42 mm, decreased crepitation, decreased intensity of myofascial pain (I) and (DDwR) without limited opening. Discussion and conclusion The multidisciplinary dentist-physiotherapist team combines inputs from different professions with the aim of promoting the best patient care and represents an added value for the management of the signs/symptoms of patients with temporomandibular dysfunction.

Carpal Tunnel Syndrome: A National Survey to Monitor Knowledge and Operating Methods.

The aim of this article was to investigate the knowledge, management, and clinical practice of Italian physiotherapists concerning patients with carpal tunnel syndrome (CTS). A national cross-sectional survey consisted of 24 questions was administered from December 2019 until February 2020. A Chi-squared independence test was run to study any difference between subgroups of the sample and responses to the questionnaire. Five hundred and eight respondents completed the survey. Most respondents (n = 225/508; 44.3%) are under 29 years old, female (n = 256/508; 50.4%) and have been working as physiotherapists for less than 5 years (n = 213/508; 41.9%). Most of respondents correctly knows about the cause (n = 455/508, 89.6%), main signs and symptoms of CTS (n = 415/508, 81.70%) and administer education, manual therapy, myofascial techniques and therapeutic exercises (n = 457/508, 89.88%). Three hundred and sixty-four (71.68%) respondents were aware of the influence of psychosocial factors on the patient’s outcomes. The survey showed greater adherence to evidences by physiotherapists holding a master’s degree. The results are mostly comparable with other surveys structured all over the world on the same topic. Italian physiotherapists management of the CTS was not always in line with current evidence. Interventions such as education, manual therapy, therapeutic exercise, nerve and tendon glide techniques are widely used, while the orthotic is only offered by half of the sample.

Effects of Scalp Myofascial Technique and Manual Therapy on Pain and Quality of Life in Tension Type Headache Patients : Six Month Follow-up Results

Effects of Scalp Myofascial Technique and Manual Therapy on Pain and Quality of Life in Tension Type Headache Patients : Six Month Follow-up Results