Fink M.1
1Hannover Medical School, Rehabilitation Medicine, Hannover, Germany
Background: Restricted painful shoulder movement is a common problem and difficult to treat. The present prospective randomised single-blind controlled trial evaluates the efficacy of the ´fascial distortion model´ according to Typaldos.
Purpose: The therapeutic possibilities for the treatment of restricted painful shoulder movement are manifold but not convincing. Also approaches in the manual medicine lack of compelling results from clinical studies. Therefore it was the aim of this clinical study to verify the efficiancy of a new therapy in the field of manual medicine.
Methods: A total of 60 patients were randomised to receive either the FDM-guided treatment (FDM, n = 30) or a ´conventional´ manual therapy (MT, n = 30). The primary endpoint for the treatment effect was the shoulder mobility, and secondary endpoints were pain (measured on a VAS), raw force and function as expressed by the Constant-Murley and DASH scores.
Results: Before therapy, groups were well comparable in terms of all outcome parameters. All endpoints showed a substantial and significant improvement in both treatment groups. Improvement was significantly more marked in the FDM group as compared to the MT group, and the effect occurred significantly faster. During post-treatment observation, there was no further improvement and the achieved benefit in mobility in the FDM group decreased. However, the abduction ability of 150.2 ± 37.2° continued to be substantially better than in control patients (124.1 ± 38.6°, p 0.01), and the ultimate improvement in abduction was 59.4° (64 % more than baseline) as opposed to 25.9° (27 %) in controls. Secondary outcome parameters (raw force, functional handicap, and pain) showed a significant improvement in both groups but a significantly better result in patients treated according to FDM guidelines. However, patients in this group experienced pain during the treatment more frequently (21/27 vs. 10/27, p 0.01).
Conclusion(s): Treatment of restricted painful shoulder movement according to the FDM is an effective modality with swift onset of action and acceptable side effects that is superior to conventional manual therapy. Long-term effects and modes of action need to be investigated.
Implications: The results emphasize the multiple clinical oberservations. An extension of the classical manual therapy through the concept of the Fascial Distortion Model is obviously evident.
Funding acknowledgements: clinical study without funding
Topic: Pain & pain management
Ethics approval: The study was approved by the Ethic Commitee of the Hannover Medical School.
All authors, affiliations and abstracts have been published as submitted.
