• Manual therapy · Feb 2016

    The effectiveness of soft-tissue therapy for the management of musculoskeletal disorders and injuries of the upper and lower extremities: A systematic review by the Ontario Protocol for Traffic Injury management (OPTIMa) collaboration.

    • Steven Piper, Heather M Shearer, Pierre Côté, Jessica J Wong, Hainan Yu, Sharanya Varatharajan, Danielle Southerst, Kristi A Randhawa, Deborah A Sutton, Maja Stupar, Margareta C Nordin, Silvano A Mior, Gabrielle M van der Velde, and Taylor-VaiseyAnne LALUOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1..
    • Department of Graduate Studies, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1.
    • Man Ther. 2016 Feb 1; 21: 18-34.

    BackgroundSoft-tissue therapy is commonly used to manage musculoskeletal injuries.ObjectiveTo determine the effectiveness of soft-tissue therapy for the management of musculoskeletal disorders and injuries of the upper and lower extremities.DesignSystematic Review.MethodsWe searched six databases from 1990 to 2015 and critically appraised eligible articles using Scottish Intercollegiate Guidelines Network (SIGN) criteria. Evidence from studies with low risk of bias was synthesized using best-evidence synthesis methodology.ResultsWe screened 9869 articles and critically appraised seven; six had low risk of bias. Localized relaxation massage provides added benefits to multimodal care immediately post-intervention for carpal tunnel syndrome. Movement re-education (contraction/passive stretching) provides better long-term benefit than one corticosteroid injection for lateral epicondylitis. Myofascial release improves outcomes compared to sham ultrasound for lateral epicondylitis. Diacutaneous fibrolysis (DF) or sham DF leads to similar outcomes in pain intensity for subacromial impingement syndrome. Trigger point therapy may provide limited or no additional benefit when combined with self-stretching for plantar fasciitis; however, myofascial release to the gastrocnemius, soleus and plantar fascia is effective.ConclusionOur review clarifies the role of soft-tissue therapy for the management of upper and lower extremity musculoskeletal disorders and injuries. Myofascial release therapy was effective for treating lateral epicondylitis and plantar fasciitis. Movement re-education was also effective for managing lateral epicondylitis. Localized relaxation massage combined with multimodal care may provide short-term benefit for treating carpal tunnel syndrome. More high quality research is needed to study the appropriateness and comparative effectiveness of this widely utilized form of treatment.Copyright © 2015 Elsevier Ltd. All rights reserved.

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