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Life
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Clinical Implications of the Fascial System
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Clinical Implications of the Fascial System

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 5705

Special Issue Editors

Dr. Antonio Stecco

E-Mail Website
Guest Editor
Rusk Rehabilitation, New York University School of Medicine, New York, NY 10016, USA
Interests: fascia; myofascial pain; MPS; connective tissue; MSK dysfunctions; spasticity; biomechanics
Special Issues, Collections and Topics in MDPI journals
Dr. Carmelo Pirri

E-Mail Website
Guest Editor
Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy
Interests: ultrasonography; echogenicity; fascial imaging

Special Issue Information

Dear Colleagues,

The fascial system has become an object of increasing interest. However, surprisingly little attention has been paid to fascia throughout the past several centuries. Singer wrote in 1935: ‘‘the dissection methods pay attention to all organs of the body and anatomical atlases bring pictures of them, but the envelops of these organs, the fasciae, are mostly left to the imagination of the students. A correct knowledge of the fascia, however, is as important as a proper knowledge of the organs’’. In addition, a large gap exists between anatomists and clinicians. The latters have traditionally thought the fascia to be a passive structure that envelops muscles, or simple fills the empty space between organs. However, it is now evident that fascia is a dynamic tissue with complex vasculature, great innervation and clear mechanic function, constituting a fundamental element for body motion, proprioception and, if in dysfunction, a pain generator.

Given the importance of fascia in the clinical field, Life journal is launching a Special Issue on this vital topic of research.

We encourage you and your colleagues to submit articles reporting on this topic. Reviews or original articles dealing with clinical aspects associated with fascia disfunctions are particularly welcome.

Dr. Antonio Stecco
Dr. Carmelo Pirri
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • connective tissue
  • deep fascia
  • superficial fascia
  • retinacula
  • muscle stiffness
  • hyaluronan
  • densification
  • biomechanics
  • myofascial pain syndrome
  • pain

Published Papers (4 papers)

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Research

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18 pages, 1875 KiB  
Article
Fascia Tissue Manipulations in Chronic Low Back Pain: A Pragmatic Comparative Randomized Clinical Trial of the 4xT Method® and Exercise Therapy
by Robbert van Amstel, Karl Noten, Shaun Malone and Peter Vaes
Life 2024, 14(1), 7; https://doi.org/10.3390/life14010007 - 20 Dec 2023
Viewed by 1502
Abstract
Background: The 4xT method is a protocolized practice in treating musculoskeletal disorders. The 4xT method consists of four components: Test (functional diagnostic test), Trigger (fascia tissue manipulations), Tape (elastic taping), and Train (exercise). There is a lack of clinical studies evaluating the treatment [...] Read more.
Background: The 4xT method is a protocolized practice in treating musculoskeletal disorders. The 4xT method consists of four components: Test (functional diagnostic test), Trigger (fascia tissue manipulations), Tape (elastic taping), and Train (exercise). There is a lack of clinical studies evaluating the treatment effects of the use of the 4xT method. Methods: A randomized controlled trial was conducted to compare the effectiveness of the 4xT method and exercise therapy-only in patients with chronic nonspecific low back pain. Based on a priori sample size calculation, fifty-one individuals with chronic nonspecific low back pain were randomly assigned to either the 4xT or exercise group. Both groups underwent a six-week rehabilitation program with two treatments per week. The primary outcomes were trunk flexion and extension mobility, trunk flexion, and extension mobility-dependent pain, and quality of life evaluated during a 6-week therapy period and after a 6-week therapy-off period. Results: Interaction effects were noted in all outcomes. The 4xT group showed significant improvements over time for trunk flexion and extension mobility, trunk flexion and extension mobility-dependent pain, and quality of life (p < 0.05), with no significant relapse post-therapy (except for extension mobility). The exercise group exhibited significant within-time changes in the quality of life, as measured with the VAS (p < 0.05), but not for EQ-5D-3L. Conclusions: The results of this study demonstrate that the 4xT method stands out as a promising and impactful treatment option for chronic nonspecific low back pain individuals, as it demonstrated significant reductions in mobility-dependent pain, increased trunk mobility, and improved quality of life compared to exercise-only treatments. Full article
(This article belongs to the Special Issue Clinical Implications of the Fascial System)
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14 pages, 1561 KiB  
Article
Effectiveness of Deep Cervical Fascial Manipulation® and Sequential Yoga Poses on Pain and Function in Individuals with Mechanical Neck Pain: A Randomised Controlled Trial
by Prabu Raja G, Shyamasunder Bhat, Ranganath Gangavelli, Anupama Prabhu, Antonio Stecco, Carmelo Pirri, Vennila Jaganathan and César Fernández-de-Las-Peñas
Life 2023, 13(11), 2173; https://doi.org/10.3390/life13112173 - 06 Nov 2023
Cited by 2 | Viewed by 1162
Abstract
Background: This study aimed to investigate the effect of fascial manipulation (FM) of the deep cervical fascia (DCF) and sequential yoga poses (SYP) on pain and function in individuals with mechanical neck pain (MNP). Method: Following the predefined criteria, ninety-nine individuals with MNP [...] Read more.
Background: This study aimed to investigate the effect of fascial manipulation (FM) of the deep cervical fascia (DCF) and sequential yoga poses (SYP) on pain and function in individuals with mechanical neck pain (MNP). Method: Following the predefined criteria, ninety-nine individuals with MNP were recruited, randomised, and assigned to either the intervention group (IG) (n = 51) or the control group (CG) (n = 48). Individuals in the IG received FM (4 sessions in 4 weeks) and the home-based SYP (4 weeks). The CG participants received their usual care (cervical mobilisation and thoracic manipulation (4 sessions in 4 weeks) along with unsupervised therapeutic exercises (4 weeks). The participants underwent baseline and weekly follow-up measurements of pain using a numerical pain rating scale (NPRS) and elbow extension range of motion (EEROM) during the upper limb neurodynamic test 1 (ULNT1). The baseline and the fourth session follow-up measurements of the patient-specific functional scale (PSFS) and fear-avoidance behavior Questionnaire (FABQ) were also taken. Results: A repeated-measures ANOVA was performed. There were statistically significant differences between the IG and CG on the NPRS third and fourth sessions, with mean differences (MD) of −1.009 (p < 0.05) and −1.701 (p < 0.001), respectively. Regarding EEROM, there was a 20.120° difference (p < 0.001) in the fourth session between the groups. The MD in FABQ was −5.036 (p < 0.001), but there were no significant differences in PSFS between the groups during the follow-up. Conclusion: FM and SYP can aid in reducing pain and fear-avoidance behaviour and improve the function and extensibility of the upper quarter region. Full article
(This article belongs to the Special Issue Clinical Implications of the Fascial System)
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16 pages, 5239 KiB  
Article
Effectiveness of the Fascial Manipulation Approach Associated with a Physiotherapy Program in Recurrent Shoulder Disease
by Silvia Bellotti, Massimo Busato, Carla Cattaneo and Mirco Branchini
Life 2023, 13(6), 1396; https://doi.org/10.3390/life13061396 - 15 Jun 2023
Cited by 1 | Viewed by 1465
Abstract
Shoulder pain is a serious clinical disease frequently related to absence from work. It is characterized by pain and stiffness, probably connected to the presence of an inflammatory substrate involving gleno-humeral capsule and collagen tissues. A physiotherapy program has shown to be effective [...] Read more.
Shoulder pain is a serious clinical disease frequently related to absence from work. It is characterized by pain and stiffness, probably connected to the presence of an inflammatory substrate involving gleno-humeral capsule and collagen tissues. A physiotherapy program has shown to be effective for the conservative treatment of this disorder. Our aim is to assess if a manual treatment directed to fascial tissues could obtain better improvement regarding pain, strength, mobility, and function. A total of 94 healthcare workers with recurrent shoulder pain were recruited and then randomized in two groups: the control group (CG) underwent a five-session physiotherapy program; the study group (SG) underwent three sessions of physiotherapy and two sessions of fascial manipulation (FM) technique. At the end of the treatment phase, both groups improved every outcome. Despite few statistical differences between groups, at the follow-up visit, a greater percentage of subjects in SG overcame the minimal clinical important difference (MCID) in every outcome. We conclude that FM is effective for treatment of shoulder pain and further studies should better assess how to manage this treatment to obtain better results. Full article
(This article belongs to the Special Issue Clinical Implications of the Fascial System)
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18 pages, 5001 KiB  
Commentary
Clinical Implications of the Fascial System: A Commentary on One Surgeon’s Journey
by Robert D. Rehnke
Life 2024, 14(1), 89; https://doi.org/10.3390/life14010089 - 05 Jan 2024
Cited by 1 | Viewed by 1130
Abstract
A review of the most important concepts of the last 100 years on the topic of fascia and its fundamental importance to tissue and organ structure and function is provided as a basis for the author’s commentary on the self-organizing nature of fascia. [...] Read more.
A review of the most important concepts of the last 100 years on the topic of fascia and its fundamental importance to tissue and organ structure and function is provided as a basis for the author’s commentary on the self-organizing nature of fascia. Implications for clinical applications in medicine, in both pathophysiology and the treatment of disease, follow from these anatomic insights. Organizing principles of nature put forth by D’Arcy Thompson, Buckminster Fuller, Benoit Mandelbrot, and Adrian Bejan set the stage for understanding tissue and fascial form. The author presents videos from the operating room of living anatomy illustrating the concept of a basic fascia segment, which differentiates according to need in the various locations of the body. Full article
(This article belongs to the Special Issue Clinical Implications of the Fascial System)
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