College
Rowan-Virtua School of Osteopathic Medicine
Keywords
Myofascial Release, Osteopathic Medicine, Muscle Physiology, Myoton
IRB or IACUC Protocol Number
PRO-2024-86
Date of Presentation
5-1-2025 12:00 AM
Poster Abstract
Context: Osteopathic manipulative treatment (OMT) is often indicated for back pain due to its high tolerability and post-treatment improvement in patients’ self-reported pain and functionality. Specifically, myofascial release (MFR) has been found to yield a significant improvement in both symptoms and quality of life. Until recently, there has not been much data published about the quantifiable effect of MFR and other OMT modalities on muscle physiology, especially taking treatment dose and force into consideration. Therefore, quantifying the changes in muscle characteristics through myotonometry would greatly benefit the field of osteopathic medicine in order to create more personalized treatment plans for patients and to determine the ideal treatment conditions for maximal impact.
Objectives: Primary: To determine if there is a significant difference in the paraspinal musculature following MFR at different treatment doses and forces, and whether the effect is modulated by time or force. Secondary: To establish the physiological effect of osteopathic MFR treatment through objectively measurable outcomes, including muscle tone, stiffness and elasticity.
Methods: For preliminary results, 15 participants were randomly placed into one of six treatment groups receiving MFR for either 30 or 90 seconds at normal, 0.5x, or 1.5x force. Force was determined using a spring scale attached to a frictionless platform on which the provider stood to exert the required horizontal force on the patient. Measurements of muscle tone, stiffness, and elasticity were taken at the level of T1, 2-3 inches lateral to the spinous process to assess the perpendicular fibers of the trapezius muscle, before and after each treatment using the MyotonPro device. Inclusion criteria: The study population included first through fourth-year medical students at Rowan-Virtua School of Osteopathic Medicine that are 18 years or older and of all genders and ethnic backgrounds. Exclusion criteria: Subjects with a history of any musculoskeletal or neurologic conditions taking medications that may alter muscle tone or those with a body mass index (BMI) > 30 kg/m2 were excluded to avoid potential skewing of data.
Results: The study included 15 participants with an average age of 25.4 years, height of 66.23 in, weight of 155.53 lbs, and BMI of 24.86 kg/m². Paired samples t-tests showed no statistically significant changes in muscle tone (t(29) = 1.117, p = 0.273), stiffness (t(29) = 0.709, p = 0.484), or elasticity (t(29) = 0.340, p = 0.737) following MFR treatment. Effect sizes were small across all measures, with Cohen's d values of 0.204 for tone, 0.129 for stiffness, and 0.062 for elasticity. Correlation analysis showed that there was minimal influence of applied force on tissue changes, with Pearson's r values of 0.015 for tone, 0.124 for stiffness, and 0.097 for elasticity.
Conclusion: Trends from these preliminary results suggest a small decrease in muscle tone and stiffness following MFR with correlation analysis suggesting that the amount of total force applied has a small influence on the tissue changes seen. Limitations: These results are preliminary and were based on a limited sample size of only 15 participants, which may affect the statistical power and generalizability of our findings. Future directions: We intend to continue recruitment of subjects to achieve the target sample size of 66 participants, thereby enhancing the validity of these findings.
Disciplines
Alternative and Complementary Medicine | Medicine and Health Sciences | Musculoskeletal System | Osteopathic Medicine and Osteopathy
Included in
Alternative and Complementary Medicine Commons, Musculoskeletal System Commons, Osteopathic Medicine and Osteopathy Commons
Establishing the Dose-Response Effect of Myofascial Release on Muscle Physiology
Context: Osteopathic manipulative treatment (OMT) is often indicated for back pain due to its high tolerability and post-treatment improvement in patients’ self-reported pain and functionality. Specifically, myofascial release (MFR) has been found to yield a significant improvement in both symptoms and quality of life. Until recently, there has not been much data published about the quantifiable effect of MFR and other OMT modalities on muscle physiology, especially taking treatment dose and force into consideration. Therefore, quantifying the changes in muscle characteristics through myotonometry would greatly benefit the field of osteopathic medicine in order to create more personalized treatment plans for patients and to determine the ideal treatment conditions for maximal impact.
Objectives: Primary: To determine if there is a significant difference in the paraspinal musculature following MFR at different treatment doses and forces, and whether the effect is modulated by time or force. Secondary: To establish the physiological effect of osteopathic MFR treatment through objectively measurable outcomes, including muscle tone, stiffness and elasticity.
Methods: For preliminary results, 15 participants were randomly placed into one of six treatment groups receiving MFR for either 30 or 90 seconds at normal, 0.5x, or 1.5x force. Force was determined using a spring scale attached to a frictionless platform on which the provider stood to exert the required horizontal force on the patient. Measurements of muscle tone, stiffness, and elasticity were taken at the level of T1, 2-3 inches lateral to the spinous process to assess the perpendicular fibers of the trapezius muscle, before and after each treatment using the MyotonPro device. Inclusion criteria: The study population included first through fourth-year medical students at Rowan-Virtua School of Osteopathic Medicine that are 18 years or older and of all genders and ethnic backgrounds. Exclusion criteria: Subjects with a history of any musculoskeletal or neurologic conditions taking medications that may alter muscle tone or those with a body mass index (BMI) > 30 kg/m2 were excluded to avoid potential skewing of data.
Results: The study included 15 participants with an average age of 25.4 years, height of 66.23 in, weight of 155.53 lbs, and BMI of 24.86 kg/m². Paired samples t-tests showed no statistically significant changes in muscle tone (t(29) = 1.117, p = 0.273), stiffness (t(29) = 0.709, p = 0.484), or elasticity (t(29) = 0.340, p = 0.737) following MFR treatment. Effect sizes were small across all measures, with Cohen's d values of 0.204 for tone, 0.129 for stiffness, and 0.062 for elasticity. Correlation analysis showed that there was minimal influence of applied force on tissue changes, with Pearson's r values of 0.015 for tone, 0.124 for stiffness, and 0.097 for elasticity.
Conclusion: Trends from these preliminary results suggest a small decrease in muscle tone and stiffness following MFR with correlation analysis suggesting that the amount of total force applied has a small influence on the tissue changes seen. Limitations: These results are preliminary and were based on a limited sample size of only 15 participants, which may affect the statistical power and generalizability of our findings. Future directions: We intend to continue recruitment of subjects to achieve the target sample size of 66 participants, thereby enhancing the validity of these findings.
