Restoration of Full Shoulder Range of Motion After Application of the Fascial Distortion Model
Joshua D. Boucher, DO; Jose Figueroa, DO
Through the fascial distortion model, physicians can apply a manual technique to rapidly and effectively increase ROM and decrease pain.
Decreased active and passive range of motion (ROM) accompanied by pain in the shoulder is a common presentation for patients with frozen shoulder, and it can be difficult to restore normal function. Through the fascial distortion model, physicians can apply a manual technique to rapidly and effectively increase ROM and decrease pain. A 28-year-old man presented 18 months after sustaining a shoulder hyperextension injury. On active and passive ROM examination, he had approximately 90° of shoulder abduction and moderately reduced internal rotation associated with 8/10 pain. After 2 applications of the fascial distortion model, his shoulder restored to full abduction and internal rotation with no pain.
Efficacy of a manual treatment method according to the fascial distortion model in the management of contracted ("frozen") shoulder
Frozen shoulder is a common problem and difficult to treat. The present prospective randomised single-blind controlled trial evaluates the efficacy of the 'fascial distortion model' according to Typaldos as a remedy for the 'frozen shoulder'.
MATERIALS AND METHODS:
A total of 60 patients were randomised to receive either the FDM-guided treatment (FDM, n = 30) or a 'conventional' manual therapy (MT, n = 30). The primary endpoint for the treatment effect was the shoulder mobility, and secondary endpoints were pain (measured on a VAS), raw force and function as expressed by the Constant-Murley and DASH scores.
Before therapy, groups were well comparable in terms of all outcome parameters. All endpoints showed a substantial and significant improvement in both treatment groups. Improvement was significantly more marked in the FDM group as compared to the MT group, and the effect occurred significantly faster. During post-treatment observation, there was no further improvement and the achieved benefit in mobility in the FDM group decreased. However, the abduction ability of 150.2 ± 37.2° continued to be substantially better than in control patients (124.1 ± 38.6°, p < 0.01), and the ultimate improvement in abduction was 59.4° (64 % more than baseline) as opposed to 25.9° (27 %) in controls. Secondary outcome parameters (raw force, functional handicap, and pain) showed a significant improvement in both groups but a significantly better result in patients treated according to FDM guidelines. However, patients in this group experienced pain during the treatment more frequently (21/27 vs. 10/27, p < 0.01).
Frozen shoulder treatment according to the FDM is an effective modality with swift onset of action and acceptable side effects that is superior to conventional manual therapy. Long-term effects and modes of action need to be investigated.
Link to article: https://www.ncbi.nlm.nih.gov/pubmed/22918828