Investigating the Effects of Percussion Therapy on Ultrasonography-Diagnosed Thoracolumbar Fascia on Trigger Points and Hyperlordosis in Low Back Pain: A Placebo-Controlled Trial.

Background: Thoracolumbar fascia (TLF) is crucial for stabilization and load distribution. Individuals with non-specific low back pain (NSLBP) and hyperlordosis present with trigger points (TrPs) and tight TLF. Instrument-assisted percussion therapy (IAPT) is a form of vibration therapy used for the release of fascia. However, the effect of IAPT has not been well understood on TrPs in TLF and its effect on posture. Primary Study Objective: To determine the effect of IAPT on hyperlordotic posture, pelvic inclination, TrPs, and disability in NSLBP. Another aim was to evaluate the tangible effect of IAPT on TrPs. Methods/Design: Double-blinded placebo-controlled trial conducted on NSLBP patients with lumbar hyperlordosis. Participants: Thirty-two participants with NSLBP were randomly allocated into IAPT and placebo groups. Intervention: The Interventional group (n = 16) underwent IAPT and the placebo group (n = 16) underwent sham IAPT along with interferential therapy (IFT) and cryotherapy for alternate days over two weeks. Primary Outcome Measures: Pre- and post-intervention (2 weeks) both the groups were evaluated for TrPs using a pressure algometer, diagnostic USG to assess dimensions of TrPs on TLF, Index of lumbar lordosis (ILL), Lumbar lordosis curve (LLC) using flexicurve, pelvic tilt (PT) angle using bubble inclinometer, and Modified Oswestry Disability Index (MODI). Results: Upon between-group comparison, for PT (P = .0009), ILL (P = .0001), LLC (P = .0033), length (P = .0007), and breadth of TrPs (P = .0004), the improvements were significantly better in IAPT group than the control group except for PPT (P = .2834) and MODI (P = .0135) where both the groups were equally effective. Conclusion: IAPT is an effective method of releasing TrPs and correcting hyperlordotic lumbar and pelvic posture in individuals with NSLBP. Further, the study created confirmatory evidence that IAPT is effective for treating TrPs and is not merely a placebo effect.

Combined effect of myofascial release and passive stretching on plantar pressure in individual with hamstring tightness- an experimental study.

INTRODUCTION: The lower kinetic chain is known to be affected by hamstring tightness which causes biomechanical alterations. As per the literature, short hamstring might cause prolonged forefoot loading, which can cause higher repeated stress on the plantar fascia. There is evidence supporting the use of various stretching and myofascial release techniques for hamstring tightness, further research is needed to investigate their impact on plantar pressure. Hence the study aims to determine combined effect of myofascial release and passive stretching on plantar pressure in individual with hamstring tightness. METHODS: This was an experimental pre-post study design with 67 randomised screenings from asymptomatic health care science students aged 18 to 25. From this scientific survey, a sample size of 47 students having HMS tightness based on the popliteal angle were recruited using a universal goniometer. An intervention was proposed that included MFR and passive stretching in 3 sessions on alternate days. Plantar pressure of these individuals was noted by using the "Harris and Beath foot printing mat" before and after the intervention. RESULT: Significant pressure changes were observed after intervention: great toe of right side (p = 0.001), toes 2 to 5 of right side (p = 0.010) and left side (p = 0.008), first metatarsal of left side (p = 0.010), lateral forefoot of right side (p = 0.019) and left (p = 0.018), medial heel (p = 0.044), and lateral heel of right side (p = 0.025). These values substantiate the enhancement in plantar pressure. CONCLUSION: The combined effect of Myofascial release and passive stretching in an individual with hamstring tightness resulted in a significant increase in popliteal angle and plantar pressure.

Effect of Seven Sessions of Posterior-to-Anterior Spinal Mobilisation versus Prone Press-ups in Non-Specific Low Back Pain - Randomized Clinical Trial.

INTRODUCTION: Low back pain is non-specific in 85% of population. Posterior-to-anterior (PA) mobilization and press-up exercises are common physical therapy interventions used to treat low back pain. AIM: The purpose of this study was to investigate the effect of posterior-to-anterior spinal mobilization and prone press-ups in non-specific low back pain. MATERIALS AND METHODS: The study design was double blind randomized clinical trial. Forty participants reporting to Physiotherapy Out-patient department in hospital who were 18-45 years of age and had diagnosis of non-specific low back pain were included. Primary outcome measures were lumbar extension range, pain and physical function. RESULTS: Both interventions resulted in significant reduction in the average pain scores for both groups. Similarly, gain in total lumbar extension was significant in both the PA mobilization group and the press-up group. Functional scores significantly improved for both the groups. Both the groups significantly differed in terms of pain, lumbar extension and functional scores. PA mobilization proved to be a superior intervention. CONCLUSION: PA mobilization and press-ups can be used as an effective intervention in non-specific low back pain.