Overall Function and Symptom Impact of Self-Applied Myofascial Release in Adult Patients with Fibromyalgia: A Seven-Week Pilot Study

Authors: Domenica Tambasco, Riina Bray

Abstract:

Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, and reduced function. Management of symptoms include medications, physical treatments and mindfulness therapies. Myofascial Release is a modality that has been successfully applied in various musculoskeletal conditions. However, to the author’s best knowledge, it is not yet recognized as a self-management therapy option in Fibromyalgia. In this study, we investigated whether Self-applied Myofascial Release (SMR) is associated with overall improved function and symptoms in Fibromyalgia. Eligible adult patients with a confirmed diagnosis of Fibromyalgia at Women’s College Hospital were recruited to SMR. Sessions ran for 1 hour once a week for 7 weeks, led by the same two physiotherapists knowledgeable in this physical treatment modality. The main outcome measure was an overall impact score for function and symptoms based on the validated assessment tool for fibromyalgia, the Revised Fibromyalgia Impact Questionnaire (FIQR), measured pre- and post-intervention. Both descriptive and analytical methods were applied and reported. We analyzed results using a paired t-test to determine if there was a statistically significant difference in mean FIQR scores between initial (pre-intervention) and final (post-intervention) scores. A clinically significant difference in FIQR was defined as a reduction in score by 10 or more points. Our pilot study showed that SMR appeared to be a safe and effective intervention for our fibromyalgia participants and the overall impact on function and symptoms occurred in only 7 weeks. Further studies with larger sample sizes comparing SMR to other physical treatment modalities (such as stretching) in an randomized control trial (RCT) are recommended.

Keywords: Fibromyalgia, myofascial release, fibromyalgia impact questionnaire, fibromyalgia assessment status.

References:

[1] https://www.rheumatology. org
[2] Wolfe F et al. The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care & Research Vol. 62, No. 5, May 2010, pp 600–610 DOI 10.1002/acr.20140 © 2010, American College of Rheumatology.
[3] Alonso-Blanco et al. Multiple active myofascial trigger points reproduce the overall spontaneous pain pattern in women with Fibromyalgia and are related to widespread mechanical hypersensitivity. The Clinical journal of pain. 27(5):405-13. February 2011.
[4] Andrew Still Taylor. The Philosophy and Mechanical Principles of Osteopathy. (1899)
[5] Fascia: The Tensional Network of the Human Body. The science and clinical applications in manual and movement therapy. 2012, Pages 319-326.
[6] Michael J. Shea, Holly Pinto. Myofascial Release Therapy: A Visual Guide to Clinical Applications Paperback – Nov 18, 2014.
[7] Tozzi P. Does fascia hold memories? J Bodyw Mov Ther. 2014;18(2):259–265. doi: 10.1016/j.jbmt.2013.11.010
[8] Liptan G et al. A pilot study of myofascial release therapy compared to Swedish massage in fibromyalgia. J Bodyw Mov Ther. 2013;17(3):365–370. doi: 10.1016/j.jbmt.2012.11.010.
[9] Adelaida María Castro-Sánchez et al. Benefits of Massage-Myofascial Release Therapy on Pain, Anxiety, Quality of Sleep, Depression, and Quality of Life in Patients with Fibromyalgia. Evid Based Complement Alternat Med. 2011; 2011: 561753.
[10] Ceca D et al. Benefits of a self-myofascial release program on health-related quality of life in people with fibromyalgia: a randomized controlled trial. J Sports Med Phys Fitness. 2017;57(7-8):993–1002. doi:10.23736/S0022-4707.17.07025-6.
[11] https://www.fibromyalgia-symptoms.org/new-criteria-for-diagnosing-fibromyalgia.html
[12] Wolfe F et al. Rheumatism. Volume 46, December 2016, Pages 319-329.
[13] Gary W. Jay. Fibromyalgia: What Clinicians Need to Know: The most successful medical treatment of fibromyalgia is an interdisciplinary approach.
[14] Bennett RM et al. The Revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties (published correction appears in Arthritis Res Ther. 2009;11(5):415). Arthritis Res Ther. 2009;11(4): R120. doi:10.1186/ar2783
[15] Wolfe F et al. Seminars in Arthritis and Rheumatism. Volume 46, Issue 3, December 2016, Pages 319-329.
[16] Lorena SB et al. Effects of muscle stretching exercises in the treatment of fibromyalgia: a systematic review. Rev Bras Reumatol. 2015;55(2):167–173. doi: 10.1016/j.rbr.2014.08.015.
[17] Sosa-Reina et al. Effectiveness of Therapeutic Exercise in Fibromyalgia Syndrome: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Biomed Res Int. 2017; 2017:2356346. doi:10.1155/2017/2356346.
[18] Kim SY et al. Flexibility exercise training for adults with fibromyalgia. Cochrane Database of Systematic Reviews 2019, Issue 9. Art. No.: CD013419. DOI: 10.1002/14651858.CD013419.
[19] Assumpção, Ana & Matsutani et al. Muscle stretching exercises and resistance training in fibromyalgia: which is better? A three-arm randomized controlled trial. European journal of physical and rehabilitation medicine. (2017) 54. 10.23736/S1973-9087.17.04876-6.
[20] Scott David Mist et al. Complementary and alternative exercise for Fibromyalgia: A Meta-Analysis. J Pain Res. 2013; 6: 247-260.
[21] Osteopathic Manipulative Medicine. Stevan Walkowski DO, Robert Baker DO, in Pain Procedures in Clinical Practice (Third Edition), 2011
[22] Ge HY et al. Myofascial trigger points: spontaneous electrical activity and its consequences for pain induction and propagation. Chin Med. 2011; 6:13. Published 2011 Mar 25. doi:10.1186/1749-8546-6-13.