Effectiveness of Manual and Instrumental Myofascial Release in Chronic Low Back Pain and the Posture of Practitioners CrossFit®

Official title

Effectiveness of Manual and Instrumental Myofascial Release in Chronic Low Back Pain and the Posture of Practitioners CrossFit®: Protocol of a Randomized Controlled Clinical

Overview

Background: Chronic low back pain (LBP) can lead to major functional disabilities and force people to take time off work, sports or leisure activities. Regular physical exercise is an important ally in reducing the risk factors for most diseases, and CrossFit® is one of the modalities that has been gaining momentum when choosing an exercise. However, the intensity recommended in training can collaborate with the development of musculoskeletal problems such as pain and postural changes, interfering with the development of the practice, with low back pain being one of the most common disorders in these practitioners, especially caused by mechanical stress. Considering that CrossFit® practitioners have already incorporated physical exercise into their routine, passive techniques such as myofascial release (ML) have been discussed as a form of treatment for LBP. For this reason, this study was designed to verify the efficacy of ML in the LBP of CrossFit® practitioners, comprising two techniques, one manual and one instrumental, and to see if the outcome of the LBP alters the posture of the spine. This is a randomised controlled clinical that will be conducted in a CrossFit® box in the city of Goiânia-GO, Brazil. At least 51 people will take part who have been doing CrossFit® for at least 3 months, who have LBP, are aged between 18-59 and are not undergoing any other treatment for low back pain. There will be two experimental groups, one that will receive manual MR and the other, cupping therapy, as well as a control group that will not receive any technique. The sessions will take place twice a week for 8 weeks. The primary outcome will be low back pain intensity, assessed at baseline, weekly and after 8 weeks, and the secondary outcomes, which will be postural deviations, spinal mobility and history of musculoskeletal pain, assessed at baseline and at the end of 8 weeks. There will be no blinding between therapist and participants. Discussion: This study will investigate whether MR is effective in relation to LBP, given that some results have already shown positive responses in acute conditions, while also verifying the repercussions on the postural aspect. The results could provide additional knowledge about the best technique to use and, having applicability to our outcomes, will favour and simplify treatment, helping professionals to make clinical decisions.

Interventions

• Other Myofascial release
  The sequence of myofascial release is as follows: 30 seconds of contact between the therapist's hands and the entire region of the participant's spine, sliding with medium pressure in a caudocranial direction; palpation of the erector spinae, quadratus lumborum, gluteus and piriformis muscles bilaterally, to identify trigger points, marking each point of tension with a dermographic pencil for subsequent manipulation; 3 cycles of bilateral paravertebral release, by sustained pressure with crossed
• Other Cupping therapy
  The acrylic cups (DongBang®) will be placed on the meridional points, as Traditional Chinese Medicine calls them, 1 cup in the central region of each popliteal fossa, the so-called B40 or Wei Zhong point, 6 cups in the region of the quadratus lumborum muscles, more specifically on the BL23 or Shenshu points (approximately 5 centimetres lateral to the edge of the L2 spinous process), BL24 or Qihaishu (approximately 5 centimetres lateral to the edge of the spinous process of L3) and BL25 or Dachan

Primary outcome measures

• Pain intensity [Time frame: Baseline, once a week throughout the intervention period (at the beginning of each week) and post intervention (8 weeks)]

Secondary outcome measures (3)

• Spinal postural deviations [Time frame: Baseline and post intervention (8 weeks)]
• Spine mobility [Time frame: Baseline and post intervention (8 weeks)]
• History of musculoskeletal pain [Time frame: Baseline and post intervention (8 weeks)]

Eligibility criteria

Inclusion criteria

• men and women aged between 18 and 59 years;
• presence of low back pain for at least 12 weeks;
• have started regular CrossFit® activity at least 3 months ago.

Exclusion criteria

• perform other physical activity than CrossFit®;
• continuous use of painkillers;
• previous pathologies or spinal surgery;
• amputations;
• haematological disorders;
• fibromyalgia;
• hypersensitivity or skin lesions.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Treatment

Study locations

Brazil · 1 center

• Federal University of Goias — Goiânia

Identifiers

NCT: NCT06715761 · Federal University of Goiás

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗