The effect of myofascial release of the physiological chains on the pain and health status in patients with fibromyalgia, compared to passive muscle stretching and a control group: a randomized controlled clinical trial

Nina Bretas Bittar Schulze; Thaynara do Nascimento Paes Barreto; Geisa Guimarães de Alencar; Thaís Amara da Silva; Angela Luzia Branco Pinto Duarte; Aline Ranzolin; Gisela Rocha de Siqueira

doi:10.1080/09638288.2023.2255130

The effect of myofascial release of the physiological chains on the pain and health status in patients with fibromyalgia, compared to passive muscle stretching and a control group: a randomized controlled clinical trial

Disabil Rehabil. 2023 Sep 12:1-14. doi: 10.1080/09638288.2023.2255130. Online ahead of print.

Authors

Nina Bretas Bittar Schulze¹, Thaynara do Nascimento Paes Barreto¹, Geisa Guimarães de Alencar¹, Thaís Amara da Silva¹, Angela Luzia Branco Pinto Duarte², Aline Ranzolin², Gisela Rocha de Siqueira¹

Affiliations

¹ Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife - PE, Brazil.
² Hospital das Clínicas da Universidade Federal de Pernambuco (UFPE), Recife - PE, Brazil.

PMID: 37698013
DOI: 10.1080/09638288.2023.2255130

Abstract

Objective: To explore the potential effectiveness of myofascial release compared to passive muscle stretching and to a control group in modulating pain intensity and health status in adults diagnosed with fibromyalgia (FM).

Materials and methods: A preliminary randomized controlled clinical trial was conducted, consisting of eight weekly sessions. The participants were divided into three groups: myofascial release group (RG = 13), a muscle stretching group (SG = 13), and a control group (CG = 12), which received advice from a rheumatologist. The outcomes measured were the visual analogue pain scale (VAS), the fibromyalgia impact questionnaire (FIQ) (representing health status), and the number of painful areas. Univariate analyzes of covariance (ANCOVA) were performed at baseline, after 4 weeks (during treatment), after 8 weeks (post-treatment), and after 12 weeks (follow-up). The International Physical Activity Questionnaire (IPAQ), the Beck Depression Inventory (BDI) and the Pain Catastrophizing Scale (PCS) were included as covariates. Clinical trial registration number: NCT: 03408496.

Results: After eight weeks, the RG showed lower VAS scores compared to the CG (mean difference 95% CI: -5.10 to -1.26) and the SG (mean difference 95% CI: -4.9 to -0.23) with no difference between the SG and the CG. The total FIQ score for the RG was lower than the CG after 4 weeks (95% CI: -49.92 to -5.61), and 8 weeks (mean difference 95% CI: -52.72 to -15.73), although there was no difference between the RG and SG, as well as between the SG and CG, at both time points. The number of painful body areas was similar in all groups at the four time points.

Conclusion: Preliminary results suggest that the RG possibly showed greater improvements in pain intensity and health status compared to the CG, and possibly greater improvements in pain intensity compared to the SG.

Keywords: Fibromyalgia; disability; manual therapy; myofascial; pain; stretching.

Plain language summary

Myofascial release in fibromyalgia may potentially have greater improvements on pain modulation and health status when compared to medical counseling.Myofascial release, when compared to stretching, may potentially offer greater improvement in pain modulation in fibromyalgia.Myofascial release was not effective in decreasing the number of painful body areas of patients with fibromyalgia.