Efficacy of myofascial therapy and kinesitherapy in improving function in shoulder pathology with prolonged immobilization: a randomized, single-blind, controlled trial

Abstract

Background: The best physiotherapeutic approach in shoulder pathology that generates prolonged immobilization is still uncertain. Kinesitherapy remains the most widely used option. Myofascial induction (MI) is a therapeutic approach in which the aim is to release fascial tension and regain mobility that has been presented as a possible option in other musculoskeletal pathologies, although its efficacy in shoulder pathology has not been sufficiently studied. This Prospective, single-blind randomized controlled trial in a university hospital setting aimed to compare the efficacy of myofascial therapy and kinesitherapy in improving function in shoulder pathology with prolonged immobilization. Methods: Patients were randomly assigned to a control group, which received conventional kinesitherapy, or to the intervention group, which received a myofascial therapy protocol. Both groups completed a therapeutic exercise program based on specific mobilization and strengthening exercises. Main Outcome Measures: The QuickDash questionnaire was the primary outcome, Visual Analog Scale and the Passive Range Of Motion of the shoulder were the secondary outcomes. The outcomes were evaluated at baseline (T0), at 4 (T2), 8 (T2), and 12 weeks (T3) Results: 44 participants were included. Comparative analysis revealed no statistically significant differences at 12 weeks between the two therapies in any of the variables explored. Significant improvement was observed in functionality measured with the QuickDash scale and in range of motion measurements in both groups (p<0.05). Only myofascial therapy achieved a clinically and statistically significant reduction (VAS improvement >or= 2) at 12 weeks, [GC: -1.568 (3.626) p=0.055; MG: -2.091 (3.715) p=0.015]. Conclusions: Both, myofascial therapy and kinesitherapy can improve function, mobility, and pain in patients with painful shoulder associated with prolonged immobilization, with no significant differences between therapies, although in the medium term only myofascial therapy achieves a clinically and statistically significant improvement in pain Trial registration: Trial registration: ClinicalTrials.gov NCT04944446. Registered 29 june 2021 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT0494444