title: Fascial Manipulation® for chronic aspecific low back pain: a single blinded randomized controlled trial.
abstract: BACKGROUND
  The therapeutic approach to chronic aspecific low back pain (CALBP) has to consider the multifactorial aetiology of the disorder. International guidelines do not agree on unequivocal treatment indications. Recommendations for fascial therapy are few and of low level evidence but several studies indicate strong correlations between fascial thickness and low back pain. This study aims at comparing the effectiveness of Fascial Manipulation® associated with a physiotherapy program following guidelines for CALBP compared to a physiotherapy program alone.
  
  
  METHODS
  24 subjects were randomized into two groups, both received eight treatments over 4 weeks. Outcomes were measured at baseline, at the end of therapy and at a 1 month and a 3 months follow-up. Pain was measured with the visual analogue scale (VAS) and the brief pain inventory (BPI), function with the Rolland-Morris disability questionnaire (RMDQ), state of well-being with the short-form 36 health-survey (SF-36). The mean clinical important difference (MCID) was also measured.
  
  
  RESULTS
  Patients receiving Fascial Manipulation® showed statistically and clinically significant improvements at the end of care for all outcomes, in the short (RMDQ, VAS, BPI) and medium term for VAS and BPI compared to manual therapy. The MCID show significant improvements in the means and percentage of subjects in groups in all outcomes post-treatment, in the short and medium term.
  
  
  CONCLUSIONS
  Fascial tissues were implicated in the aetiology of CALBP and treatment led to decreased symptomatic, improved functional and perceived well-being outcomes that were of greater amplitude compared to manual therapy alone.
authors.affiliation: Physiotherapy Academic Program, University of Bologna, Bologna, 40138, Italy.
authors.forename: Mirco
authors.initials: M
authors.lastname: Branchini
authors.affiliation: Private Practice, Bologna, 40138, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Lopopolo
authors.affiliation: Department of Continuity Assistance and Disability, University of Bologna, Bologna, 40138, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Andreoli
authors.affiliation: Department of Emergency, University of Bologna, Bologna, 40138, Italy.
authors.forename: Ivano
authors.initials: I
authors.lastname: Loreti
authors.affiliation: Private Practice, Padova, 35120, Italy.
authors.forename: Aurélie M
authors.initials: AM
authors.lastname: Marchand
authors.affiliation: Sports Medicine Unit, University of Padua, Padova, 35120, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Stecco
keywords: low back pain; myofascial pain; nonspecific pain; thoracolumbar fascia