Moraes Santos G1, dos Santos Amorim M1, Sinhorim L1, Wagner J1, Lemos FDP1, Sonza A1
1Santa Catarina State University, Physical Therapy, Florianópolis, Brazil
Background: The trapezius muscle (TM) frequently contains trigger points and is culprit for a myriad of head, shoulder and neck pain syndromes. Oriented from incorrect executions during daily life activities these pain syndromes compromises the TM. This muscle has a viscoelastic coating called fascia, which, in turn, is a soft tissue component, belonging to the connective tissue, that permeates the entire human body. During some activities that generate muscle overload, the fascia may undergo energy demands in which the local blood supply may be decreased, causing tissue hypoxia to result in pain. Decreased tissue blood supply could limit or prevent slippage of myofascial tissues. However, myofascial release can influence mechanoreceptors within the fascia, contributing to changes in local fluid dynamics. This reduces excessive muscle tension, capillary constriction, and increases local temperature and blood flow.
Purpose: To investigate whether myofascial release improves peripheral muscle oxygenation of individuals with trapezius muscle pain.
Methods: The study included 12 adult volunteer from both sexes, between 20 and 26 years with TM pain. The volunteers were equally divided into 3 groups: myofascial release group (MG), sham and control (no intervention) (CG). Participants were randomly assigned by random-computer generated number. The TM was evaluated by a blinded and trained physical therapist. A myofascial release protocol, using the surface slip technique was performed on group were applied for 10 minutes each session, once a week, for 6 weeks. The primary outcome, i.e., changes in muscle oxygenation (oxygenated haemoglobin-OHb; deoxygenated haemoglobin-HHb; total haemoblogin-tHb; tissue saturation index-TSI%) were measured by Near Infrared Spectroscopy (NIRS) before and after myofascial reorganization intervention. NIRS was positioned in the medium fibers of the trapezius muscle (below T3). Two way repeated measures ANOVA was performed with post hoc analysis with Bonferroni correction, in order to check difference in the average of muscle oxygenation variables among groups and pre-post test procedures.
Results: MG did not show significant differences in muscle oxygenation variables for OHb (1.9 ±2.3 vs. 2.3±4.3 and 5.7±8.6), HHb (0.8 ±1.6 vs. 1.8 ±2.6 and 2.7±5.1), tHb (2.6 ±3.5 vs. 3.9 ±6.5 and 8.4±13.3) - values in mMol/dl and TSI% (89.6±6.7 vs. 88.4 ±3.3 and 81.5±4.0) compared to the sham or CG, respectively. However, comparing before and after myofascial release, TSI in the TM had a higher percentage increase (19%) in MG than sham group (16%) and CG (9%). The visual analogue pain scale showed a median of 2.5 in the trapezius muscle before intervention and 1.0 after.
Conclusion(s): This study demonstrated that 10 min application of myofascial release, once a week, for 6 weeks did not improve peripheral muscle oxygenation of TM compared to sham and no treatment. However, TSI values can be seen as a measure of dynamic balance between oxygen delivery in use. Therefore, myofascial release technique could have a possible role in the management of individuals with TM pain.
Implications: Myofascial release technique contributes to changes in local fluid dynamics and gives key insights that will lead to the improvement of therapies related to TM dysfunction .
Keywords: Musculoskeletal manipulations, Physiotherapy modalities, Oxygen level
Funding acknowledgements: Santa Catarina Research Foundation - FAPESC (2017TR764)
Purpose: To investigate whether myofascial release improves peripheral muscle oxygenation of individuals with trapezius muscle pain.
Methods: The study included 12 adult volunteer from both sexes, between 20 and 26 years with TM pain. The volunteers were equally divided into 3 groups: myofascial release group (MG), sham and control (no intervention) (CG). Participants were randomly assigned by random-computer generated number. The TM was evaluated by a blinded and trained physical therapist. A myofascial release protocol, using the surface slip technique was performed on group were applied for 10 minutes each session, once a week, for 6 weeks. The primary outcome, i.e., changes in muscle oxygenation (oxygenated haemoglobin-OHb; deoxygenated haemoglobin-HHb; total haemoblogin-tHb; tissue saturation index-TSI%) were measured by Near Infrared Spectroscopy (NIRS) before and after myofascial reorganization intervention. NIRS was positioned in the medium fibers of the trapezius muscle (below T3). Two way repeated measures ANOVA was performed with post hoc analysis with Bonferroni correction, in order to check difference in the average of muscle oxygenation variables among groups and pre-post test procedures.
Results: MG did not show significant differences in muscle oxygenation variables for OHb (1.9 ±2.3 vs. 2.3±4.3 and 5.7±8.6), HHb (0.8 ±1.6 vs. 1.8 ±2.6 and 2.7±5.1), tHb (2.6 ±3.5 vs. 3.9 ±6.5 and 8.4±13.3) - values in mMol/dl and TSI% (89.6±6.7 vs. 88.4 ±3.3 and 81.5±4.0) compared to the sham or CG, respectively. However, comparing before and after myofascial release, TSI in the TM had a higher percentage increase (19%) in MG than sham group (16%) and CG (9%). The visual analogue pain scale showed a median of 2.5 in the trapezius muscle before intervention and 1.0 after.
Conclusion(s): This study demonstrated that 10 min application of myofascial release, once a week, for 6 weeks did not improve peripheral muscle oxygenation of TM compared to sham and no treatment. However, TSI values can be seen as a measure of dynamic balance between oxygen delivery in use. Therefore, myofascial release technique could have a possible role in the management of individuals with TM pain.
Implications: Myofascial release technique contributes to changes in local fluid dynamics and gives key insights that will lead to the improvement of therapies related to TM dysfunction .
Keywords: Musculoskeletal manipulations, Physiotherapy modalities, Oxygen level
Funding acknowledgements: Santa Catarina Research Foundation - FAPESC (2017TR764)
Topic: Musculoskeletal; Orthopaedics; Pain & pain management
Ethics approval required: Yes
Institution: Santa Catarina State University
Ethics committee: Human Research Ethics Committee from Santa Catarina State University
Ethics number: 2630855
All authors, affiliations and abstracts have been published as submitted.
