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

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.

IMPLICATIONS FOR REHABILITATION

• 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.

Keywords:

• Fibromyalgia
• manual therapy
• myofascial
• stretching
• pain
• disability

Acknowledgements

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.

The authors acknowledge the collaboration of patients who were willing to participate in the research and all associations involved in this study. This study is part of a master’s dissertation on the postgraduate program of the Universidade Federal de Pernambuco.

Disclosure statement

The authors report there are no competing interests to declare.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.