Effects of Isolated Myofascial Release Therapy in Patients with Chronic Low Back Pain-A Systematic Review.

Dysfunctions of the lumbosacral area and related pain syndromes, such as chronic low back pain (CLBP), are among the most common musculoskeletal problems in modern society. The purpose of this study was to evaluate the effectiveness of isolated myofascial release techniques (MFR) in the treatment of CLBP in adults. PubMed, Web of Science, Scopus, and Cochrane Library databases were searched for studies published from 1 January 2013 to 1 March 2023. We included English-language randomized controlled trials evaluating the effect of isolated MFR performed by a specialist on adults with CLBP. Only studies with a comparison group without treatment or with sham MFR were included. A total of 373 studies were detected, of which 6 studies were finally included in this review. There was a total of 397 CLBP patients aged 18-60 in all study groups. The studies evaluated the effects of a series of MFR treatments as well as a single intervention. After applying a series of treatments, a statistically significant reduction in pain intensity, improvement in the range of motion, reduction in the level of functional disability and fear-avoidance beliefs, as well as a decrease in the activity of paraspinal muscles at maximum trunk flexion were demonstrated. A single, 40-min complex intervention involving tissues at various depths significantly reduced the level of pain, improved the range of motion, and reduced the resting activity of paraspinal muscles in the standing position, but did not affect postural stability. The use of a single 5 min MFR technique did not affect pain intensity and sensitivity and functional disability. The findings suggest that the use of a series of isolated MFR improves the condition of patients with CLBP by reducing the intensity of pain, improving functional efficiency, and reducing the activity of the paraspinal muscles in the position of maximum forward bend. The use of a single intervention containing a set of techniques covering superficial and deep tissue also reduces the intensity of pain, improves mobility, and reduces the resting activity of the paraspinal muscles in a standing position. Given the small number of eligible studies with limitations, conclusions should be interpreted with caution and avoid overgeneralizing the benefits of isolated MFR based on limited or mixed evidence.

The Effects of Extracorporeal Magnetic Innervation in the Treatment of Women with Urinary Incontinence: A Systematic Review.

PURPOSE: The aim of this study is to identify and critically evaluate literature regarding the clinical efficacy of extracorporeal magnetic innervation (ExMI) in the treatment of female patients with urinary incontinence (UI). METHODS: An analysis was carried out using the following electronic databases: Medline, PubMed, ScienceDirect, and the Cochrane Library (data published between 2008 and 2023). Searches of the above databases were conducted in April 2023. Only randomized clinical studies (RCTs) in English studies were eligible for the study. Randomized controlled trials were included in the review and evaluated with the Downs and Black checklist. RESULTS: Eleven studies met the inclusion criteria. Among these, two studies examined the use of ExMI and PMFT (pelvic floor muscle training) and three studies compared active ExMI versus sham ExMI. Four studies evaluated solely ExMI, and moreover, there was no control group in two of these studies. One study compared the effects of Kegel exercises with ExMI, while another study compared electrostimulation with ExMI. The reviewed studies exhibited significant differences in interventions, populations, and outcome measures. CONCLUSIONS: Extracorporeal magnetic stimulation has shown promise as an effective treatment for female urinary incontinence. Whether used alone or as a component of combination therapy, ExMI has the potential to enhance patients' quality of life (QoL) without significant safety concerns.

Analysis of Postural Stability Following the Application of Myofascial Release Techniques for Low Back Pain-A Randomized-Controlled Trial.

INTRODUCTION: Low back pain (LBP) is one of the most frequently observed disorders of the musculoskeletal system in the modern population. It is suggested that myofascial disorders in the highly innervated thoracolumbar fascia (TLF), reported in patients with LBP, may be an underlying cause of the ailment. Research also confirms that patients with LBP demonstrate poorer postural stability compared with individuals without the condition. Myofascial release techniques (MFR) are additional therapeutic options that complement existing therapies and help provide a more holistic treatment for chronic LBP (CLBP). OBJECTIVE: Evaluation of changes in postural stability following one MFR intervention applied to CLBP subjects immediately after manual therapy and after a month. It was hypothesized that postural stability is going to aggravate immediately after the MFR intervention and improve one month after treatment compared with the baseline results before the treatment. METHODS: 113 patients with CLBP participated in a randomized-controlled trial. The experimental group (n = 59) received one MFR intervention, whereas the control group (n = 54) did not receive any therapeutic intervention. Posturography was performed to determine experimental group's immediate response to the therapy and to evaluate the experimental and control groups' responses to the therapy one month after the intervention. RESULTS: Only 2 out of 12 comparisons of stabilometric parameters demonstrated reliable effects that are in line with our research hypotheses. Even though both comparisons were observed for therapy outcomes within the experimental group, no reliable differences between the groups were found. CONCLUSIONS: A single MFR treatment in the TLF did not affect postural stability in CLBP patients in the experimental group. Further studies are needed to extend the findings by performing a series of holistic MFR treatments applied to a larger area of the body surface that would induce more general tissue changes and thus having a greater impact on postural stability.

Quality of Life in Yoga Practitioners-Research Conducted on a Population of Polish Yogis.

Background: The aim of the study is to determine the quality of life of a population of healthy adult yoga practitioners and the correlation between the features of yoga practice and the quality of life. Methods: A total of 300 people aged 35-50 years were examined and divided into two groups. The respondent (SG; n = 150) was a yoga practitioner, and the control (CG; n = 150) did not practice yoga. The original questionnaire and the quality-of-life questionnaire (WHOQOL-BREF) were used. The chi-square test, the Kolmogorov-Smirnov test, the Mann-Whitney U test, the ANOVA Kruskal-Wallis test and the linear regression model were used. The significance level was set at p < 0.05. Results: Yoga practitioners are characterised by a significantly greater overall satisfaction with the quality of life (U = 9794.50; p < 0.05), a higher level of health satisfaction (U = 9194.50; p < 0.01) and higher satisfaction with quality life in terms of the results of somatic domains (U = 7579.00; p < 0.001), psychological (U = 8554.00; p < 0.001) and environmental domains (U = 7919.5; p < 0.001). A relationship was observed between the experience of yoga practice and the assessment of the quality of life in terms of physical functioning. Conclusions: The practice of adult yoga positively influences the assessment of their quality of life in the physical, mental and environmental spheres.

Analysis of Muscle Activity Following the Application of Myofascial Release Techniques for Low-Back Pain-A Randomized-Controlled Trial.

INTRODUCTION: Lumbosacral dysfunctions and the resulting pain syndromes, such as low-back pain (LBP), are one of the most common musculoskeletal problems being faced by society around the world. So far, a contributory role of thoracolumbar fascia (TLF) dysfunction in some cases of LBP has been suggested. Research also confirms that muscle resting activity level in the TLF area is increased in people with LBP. Myofascial release (MFR) is a therapeutic option offered to patients with chronic low-back pain (CLBP). The therapy aims to improve flexibility and sliding between layers of soft tissue, and thus decrease muscle activity, reduce pain intensity, and improve functional performance. OBJECTIVE: This study aims to assess changes in resting activity of selected muscles within the TLF in a group of patients with CLBP immediately after a single MFR treatment and one month after the intervention. METHODS: A total of 113 patients with CLBP completed the study. Simple randomization was applied to assign subjects to study groups. The experimental group (n = 59) underwent a single session of MFR therapy. No therapeutic intervention was applied to the control group (n = 54). Surface electromyography was used to evaluate positive treatment effects in patients immediately after receiving the therapy (experimental group) and after one month (experimental and control group). RESULTS: A statistically reliable decrease in the activity of erector spinae (ES) and multifidus muscles (MF) was observed after a single session of MFR therapy. Effects of the treatment were present immediately after receiving the therapy and one month after the intervention. CONCLUSIONS: A single MFR treatment in patients with CLBP immediately reduces the resting activity levels of ES and MF. Results of measurements carried out one month after the treatment confirm that the therapeutic effects were maintained.

Randomized-Controlled Trial Examining the Effect of Pelvic Floor Muscle Training in the Treatment of Stress Urinary Incontinence in Men after a Laparoscopic Radical Prostatectomy Pilot Study.

AIM: The aim of this study was to assess the impact of pelvic floor muscle training (PMFT) in the treatment of stress urinary incontinence (SUI) in men after they received radical prostatectomy (RP). METHODS: From November 2018 to September 2019, patients who underwent radical prostatectomy were assessed for eligibility. A total of 37 men were then randomly assigned to the experimental group (EG) and the control group (CG). The EG group received supervised exercise twice a week for 12 weeks, and the CG did not receive any intervention. To objectify the results obtained in both groups before and after the intervention, the authors assessed myostatin concentration. Moreover, the Expanded Prostate Cancer Index Composite (EPIC-26) was applied to assess the quality of life, and Beck's Depression Inventory (BDI-II) was used to measure depression severity. RESULTS: Study results demonstrated a statistically significant reduction of myostatin concentration in the EG following the treatment and no statistically significant differences in this parameter in the CG. In addition, a comparison of the EPIC-26 scores in the EG at the initial and final assessments revealed a statistically significant improvement in the quality of life in each domain. A comparison of the EPIC-26 scores in the CG at the initial and final assessments showed there is a statistically significant decline in quality of life in the "overall urinary problem" and "sexual" domain. A comparison of the BDI-II scores at the initial and final assessments showed a statistically significant decline in depressive symptoms in the EG and no statistically significant differences in the CG. CONCLUSIONS: PFMT is an effective treatment for urinary incontinence (UI) in men who received radical prostatectomy.

Assessment of the Effectiveness of Pelvic Floor Muscle Training (PFMT) and Extracorporeal Magnetic Innervation (ExMI) in Treatment of Stress Urinary Incontinence in Women: A Randomized Controlled Trial.

OBJECTIVE: The purpose of this study is to assess the effectiveness of pelvic floor muscle training and extracorporeal magnetic innervation in treatment of urinary incontinence in women with stress urinary incontinence. METHODS: The randomized controlled trial enrolled 128 women with stress urinary incontinence who were randomly allocated to either one out of two experimental groups (EG1 or EG2) or the control group (CG). Subjects in the experimental group 1 (EG1) received 12 sessions of pelvic floor muscle training, whereas subjects in the experimental group 2 (EG2) received 12 sessions of extracorporeal magnetic innervation. Subjects in the control group (CG) did not receive any therapeutic intervention. The following instruments were used to measure results in all study groups at the initial and final assessments: Revised Urinary Incontinence Scale (RUIS), Beck Depression Inventory (BDI-II), General Self-Efficacy Scale (GSES), and King's Health Questionnaire (KHQ). RESULTS: In both experimental groups, a statistically significant decline in depressive symptoms (BDI-II) and an improvement in urinary incontinence severity (RUIS) and quality of life (KHQ) were found in the following domains: "social limitations," "emotions," "severity measures," and "symptom severity scale." Moreover, self-efficacy beliefs (GSES) improved in the experimental group that received ExMI (EG2). No statistically significant differences were found between all measured variables in the control group. Comparative analysis of the three study groups showed statistically significant differences at the final assessment in the quality of life in the following domains: "physical limitations," "social limitations," "personal relationships," and "emotions." Conclusion. Pelvic floor muscle training and extracorporeal magnetic innervation proved to be effective treatment methods for stress urinary incontinence in women. The authors observed an improvement in both the physical and psychosocial aspects.

The Impact Of Pelvic Floor Muscle Training On Urinary Incontinence In Men After Radical Prostatectomy (RP) - A Systematic Review.

PURPOSE: The purpose of this study was to determine the efficacy of pelvic floor muscle training (PFMT) in the treatment of urinary incontinence (UI) in men after radical prostatectomy (RP). METHODS: PubMed, ScienceDirect, and Cochrane Library databases were searched for studies published in years 2000-2019. We included randomized controlled trials in English which compare clinic-based vs home-based PFMT, preoperative and postoperative PFMT, supervised vs unsupervised PFMT, and PFMT alone vs no treatment at all. RESULTS: Eight articles were included in the final review. There was a total of 1078 patients aged 45-75 in all study groups. The study participants received radical retropubic prostatectomy or radical prostatectomy. Included studies assessed the following interventions: preoperative and postoperative PFMT, supervised vs home-based PFMT, unsupervised PFMT vs no treatment at all, and PFMT combined with resistance and flexibility exercises vs PFMT alone. CONCLUSION: PFMT is an effective treatment for urinary incontinence in men after radical prostatectomy. PFMT improves not only physical parameters but also the quality of life of men after RP.

A Randomized-Controlled Trial Pilot Study Examining the Effect of Pelvic Floor Muscle Training on the Irisin Concentration in Overweight or Obese Elderly Women with Stress Urinary Incontinence.

OBJECTIVE: This study aimed to examine the effect of pelvic floor muscle training on the irisin (Ir) concentration in overweight or obese elderly women with stress urinary incontinence. METHODS: The number of participants included in analysis was 49: 28 women in the experimental group and 21 women in the control group. The experimental group (EG) underwent pelvic floor muscle training, whereas no therapeutic intervention was applied to the control group (CG). Irisin concentration, severity of urinary incontinence (RUIS), and body mass index (BMI) were measured in all women at the initial and final assessments. RESULTS: By comparing the initial and final assessment results we have been able to demonstrate statistically significant differences in the measured variables in the experimental group. No statistically significant differences in the measured variables were reported for the control group at the initial and final assessments. Moderate negative correlation was observed between the BMI results with the irisin concentration results in the EG at the initial assessment and no correlation at the final assessment. Weak positive correlation was observed between the BMI results with the irisin concentration in the CG at the initial and final assessment. CONCLUSION: Further studies are necessary to observe the regulation of irisin concentration and explain mechanisms underlying these effects.

Rehabilitation of infants after transtibial amputation due to thrombosis in the perinatal period. Case report.

Congenital thrombosis and amputation in infancy is not common. Therefore, the existing literature lacks sufficient evidence regarding this subject. Available research primarily focuses on treatment and causes of thrombosis in children. The paper describes a case of preterm infant after transtibial amputation due to common iliac artery thrombosis during the perinatal period. The girl began neurodevelopmental therapy based on normal development patterns of infants, which was provided three times a week for 45 minutes. The rehabilitation process also included prosthesis and surgical interventions. The assessment of motor development of the child was carried out at the age of 6, 9, 12, 18 and 20 months, using the motor scale of the Albert Infants Motor Scale (AIMS). Case analysis allows to state that infant rehabilitation after transtibial amputation should be individualized, and focus on supporting normal motor development, based on the correct movement sequences of infants. Additionally, the AIMS scale can be used to assess the gross motor development in infants after amputation and is useful in formulating early therapeutic intervention. A prosthetist should perform prosthesis revisions as often as needed, i.e., in infants that is usually every 4 months. What is more, successful outcomes can be achieved by implementing proper surgical procedures regarding the appositional overgrowth of the residual limb in growing children.

[Assessment of irisin concentration in women with stress urinary incontinence after using exracorporeal magnetic innervation (EXMI) - pilot study].

OBJECTIVE: Introduction: In Poland, urinary incontinence (UI) is the ninth in frequency of reported health problem, which occurs in 15.4% of women over 60 years of age (data of the Central Statistical Office of 2016). The search for optimal treatment methods for this disease and objective methods for assessing the effectiveness of therapy is a challenge for an interdisciplinary team of specialists. The aim: To examine the effect of Extracorporeal Magnetic Innervation (ExMI) on the Irisin concentration in women with stress urinary incontinence. PATIENTS AND METHODS: Materials and methods: A total of 52 women were included in the analysis: 28 participants were allocated to the experimental group (EG) and 24 to the control group (CG). EG patients completed ExMI therapy, whereas no therapeutic intervention was applied to the CG. Irisin concentration, severity of urinary incontinence (RUIS) were measured in all women at the initial and final assessments. RESULTS: Results: By comparing the initial and final assessment results we have been able to demonstrate a statistically significant differences in the measured variables in the EG. No statistically significant differences in the measured variables were reported for the CG at the initial and final assessments. No correlation was observed between the Irisin concentration results and severity of urinary incontinence in the EG at the final assessment. CONCLUSION: Conclusions: There is a need for further studies of biochemical parameters in the assessment of pelvic floor muscle dysfunction.

A randomised-controlled trial pilot study examining the effect of pelvic floor muscle training on steroid hormone concentrations in elderly women with stress urinary incontinence.

INTRODUCTION: In this study, we attempted to examine the effect of pelvic floor muscle training on testosterone and cortisol concentrations in elderly women with stress urinary incontinence. MATERIAL AND METHODS: The number of participants included in the analysis was 59: 30 women in the experimental group (EG) and 29 women in the control group (CG). The EG underwent pelvic floor muscle training, whereas the CG did not receive any therapeutic intervention. In the present study the authors measured testosterone and cortisol concentrations as well as body mass index (BMI) in all study participants at the initial and final assessments. RESULTS: The initial and final assessment results were compared and showed a statistically significant decrease in cortisol concentration and an increase in testosterone concentration in the EG. However, no statistically significant differences in the measured variables were observed in the CG at the initial and final assessments. The authors did not report any statistically significant correlations between testosterone and cortisol concentrations and the BMI score in the EG and CG. Also, statistically significant correlations between testosterone and cortisol concentrations in the EG were not apparent. CONCLUSIONS: Determination of the concentration of testosterone and cortisol is a method that may help to objectify pelvic floor muscle training outcomes in elderly women with stress urinary incontinence.

A randomized-controlled trial pilot study examining the effect of extracorporeal magnetic innervation in the treatment of stress urinary incontinence in women.

INTRODUCTION: Peri- and postmenopausal women frequently suffer from urinary incontinence (UI). Generally, UI becomes more severe with age. It impacts physical, mental, and social functioning as well as the quality of life, often leading to depression. Extracorporeal magnetic innervation (ExMI) is a relatively new conservative treatment method for UI. OBJECTIVE: The aim of the study was to assess the effectiveness of ExMI in the treatment of stress UI in women. METHODS: A total of 52 women were included in the analysis: 28 participants were allocated to the experimental group (EG) and 24 to the control group (CG). The average age was 65.41 years (±SD 4.08). EG patients completed ExMI therapy. The treatment sessions lasted for 15 minutes, and occurred three times a week, for 4 weeks. No therapeutic intervention was applied to the CG. To objectify the treatment outcomes in both groups before and after the treatment, we measured myostatin concentration and performed the UI severity assessment (The Revised Urinary Incontinence Scale), perceived self-efficacy assessment (General Self-Efficacy Scale), and depression severity assessment (Beck Depression Inventory). RESULTS: The authors compared the EG results at the initial and final assessments and found a statistically significant improvement in severity of UI (P=0.001) and depression severity (P=0.006), and a decrease in myostatin concentration (P≤0.001). The authors did not find any statistically significant differences between all measured variables for the CG at the initial and final assessments. Furthermore, there were no statistically significant differences between all measured variables for the EG and the CG at the final assessment. CONCLUSION: Further trials are needed to determine optimal treatment protocols for various UI types and to evaluate long-term outcomes of the ExMI treatment.

The impact of pelvic floor muscle training on the myostatin concentration and severity of urinary incontinence in elderly women with stress urinary incontinence - a pilot study.

OBJECTIVE: The aim of the study was to assess the myostatin concentration and an improvement in the severity of urinary incontinence (UI) after pelvic floor muscle training (PFMT) in a group of elderly women with stress UI. METHODS: A total of 74 participants were included in the analysis: 40 participants in the experimental group (EG) and 34 participants in the control group (CG). The EG underwent PFMT, whereas no therapeutic intervention was applied to the CG. Myostatin concentration and UI severity (Revised Urinary Incontinence Scale [RUIS]) were assessed in all women before and after the treatment. RESULTS: By comparing the results before and after the treatment, we have been able to demonstrate a statistically significant decrease in myostatin concentration (P<0.0001) and an improvement in the severity of UI (RUIS) (P<0.0001) in the EG. No statistically significant differences in all measured variables were reported before and after the treatment in the CG. A lower myostatin concentration (P=0.0084) and an improvement in the severity of UI (RUIS) (P=0.0008) were observed after the treatment in the EG compared to that in the CG. CONCLUSION: Effective PFMT causes downregulation of myostatin concentration and an improvement in the severity of UI in elderly women with stress UI. Further trials on a larger EG and an assessment of long-term treatment outcomes are required.

The impact of pelvic floor muscle training on the quality of life of women with urinary incontinence: a systematic literature review.

PURPOSE: The purpose of this review was to assess the effectiveness of pelvic floor muscle training (PFMT) in the treatment of urinary incontinence (UI) in women, with a particular focus on the impact of this form of therapy on the patients' quality of life (QoL). METHODS: The following electronic databases were searched: PubMed, Embase, and Cochrane Library (articles only in English, 1990-2017). Search terms were as follows: urinary incontinence, pelvic floor muscle training, pelvic floor exercises, quality of life. Systematic review methods were based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. RESULTS: The assessment of the impact of PFMT on the QoL of women with UI was conducted among 2,394 women in 24 selected studies. After the end of treatment, the majority of patients in the experimental groups noted a statistically significant improvement in QoL. CONCLUSION: The results of this literature review demonstrate that PFMT is an effective treatment for UI in women. PFMT significantly improves the QoL of women with UI, which is an important determinant of their physical, mental, and social functioning.

The influence of active exercise in low positions on the functional condition of the lumbar-sacral segment in patients with discopathy.

BACKGROUND: Pain in the lower segments of the spine is among the most frequent symptoms in industrialized countries. Injuries to intervertebral discs are the cause of this kind of discomfort in 90% of cases. The factors promoting the disease are: physical activity limitation, prolonged sitting position, overweight and bad movement stereotypes. New methods of treating sacral pain ignore the aspect of weakening the muscle force and do not introduce active exercise to the program of rehabilitation. OBJECTIVES: The aim of the work was to describe the influence of active exercise in low positions on the functional condition of patients with L-S segment discopathy. MATERIAL AND METHODS: The examination group consisted of 20 patients, including 17 women and 3 men. The examination was conducted twice, before and after a two-week long series of rehabilitation. The examined patients practiced a 20-minute exercise program for 10 days. The subjective part of the examination referred to pain discomfort felt by the patients and existing difficulties in performing everyday activities. The objective part included the measurement of movement range of the lumbar segment with the use of Schober's test, finger-to-floor test and spine rotation in the sitting position. RESULTS: It was shown that intervertebral disc disease may lead to spine flexibility limitation and to pain occurrence. CONCLUSIONS: Practicing active exercise in low positions significantly improves the movement range and body posture and it reduces pain in the lower segments of the spine. Moreover, the patient's functional abilities are improved while performing everyday activities.

Discopathy of the lumbar-sacral segment and its influence on sexual dysfunction.

BACKGROUND: Intervertebral disc disease is a widespread medical and social problem. Degeneration of intervertebral discs can lead to disc disease, commonly known as discopathy. One of the consequences of discopathy is pressure on the spinal cord or nerve roots that supply the genitals and sexual centers located in the core. In addition, the accompanying pain and limitation of mobility can lead to the occurrence of sexual dysfunction. OBJECTIVES: The goal of the study was to ascertain the influence of discopathy in the lumbosacral (L-S) segment on the occurrence of sexual dysfunction. MATERIAL AND METHODS: The study involved 50 hospitalized patients with discopathy in the L-S segment were asked to complete a specially prepared questionnaire (11 questions). The goal of the survey was to compare the patients' satisfaction with their sex life before and after the disease. The questions were constructed in a way that excluded other indicators that could affect their sexual activity, i.e.: bad moods, bad family relations, or a lack of sexual activity due to age or the lack of a partner. RESULTS: Discopathy in the lumbar-sacral segment has an influence on sexual activity. A decrease in the assessment of satisfaction with one's sex life can be observed among patients with discopathy. CONCLUSIONS: The pain and neurological symptoms associated with intervertebral disc disease reduce the patients' satisfaction with their sex lives. Patients in the group surveyed noted a change in sexual performance, often resulting in passivity, discouragement, weakness or a complete lack of interest in sex. The disorders also affect the emotional state. The patients also noted a significant decrease in physical activity.