Author: Martina Frank
Supervisor: Robert Schleip
Introduction: Low Back Pain is one of the most commonly occurring symptoms among individuals seeking medical treatment. Research indicates that the fasciae may be involved in triggering such pain.
Questions: The aim of this master thesis is to determine whether Randomized Controlled Trials with at least medium methodological quality exist on the effectiveness of fascial or manual treatment for Low Back Pain. If so, what is the methodological quality and effectiveness which is achieved in these studies? It should also be investigated whether these studies derive a statement about the mechanism of action and if an explanation of the mechanism of action of fascial treatment for Low Back Pain can be found.
Methods: RCTs concerning osteopathic or manual therapy of the fasciae as a treatment for Low Back Pain were identified based on of a systematic search of ten leading medical-literature databases and the bibliographies of journal articles and books, as well as through participation in the Fascia Research Summer School 2012. The studies were methodically evaluated using the Physiotherapy Evidence Database Scale (PEDro scale). Literature studies, meta-analyses, studies with invasive fascia treatment techniques, and studies in which fascia treatment was not a primary concern were all excluded, provided the PEDro scale assessment also yielded < 5 points.
Results: The 11 included studies reported the mean PEDro value of 6/10 points and differed a lot concerning the evaluated variables and methods. 9 of the studies showed a short-term pain improvement, 4 of 6 studies were able to detect an improvement in the dysfunction or impairment, 3 of 4 found an improvement in the mobility of different regions, 2 of 3 reported a subjective physical and mental health on, 2 of 3 studies found a reduction of medication consumption. A statement about long-term effects cannot be made. 6 of the 11 trials reported as hyothesis for the mode of action positive tissue chages of the fasciae.
Conclusion: The short-term effectiveness of fascia and manual techniques for Low Back Pain could be demonstrated. For the long-term effects and the mechanisms of the work no conclusive result could be found.