Il 5° Congresso Internazionale sulla Riabilitazione in Acqua, basata sull'evidenza scientifica chiamato ICEBAT 2018 si è tenuto dal 14 al 16 Aprile 2018 a Las Vegas (USA).
Riccardo Pasqualini ha presentato in una relazione orale il metodo Aquatic Manual Therapy,
ABSTRACT DELLA PRESENTAZIONE:
TITLE: Aquatic Manual Therapy: Evaluation of therapeutic aquatic soft tissue manipulation and specific stabilizing exercises in the treatment of Chronic Low Back Pain with radiologic diagnosis of spondylolisthesis.
AUTHORS:Riccardo Pasqualini1 Yazmin Castillo Sanchez2Riccardo Marchi1 Josè Sergio Puig Espinosa3 Maura de la Caridad Salabarrìa Roig3 Miguel Ángel Karam Calderon 2
1European Academy of Health Research, Italy
2Universidad Autonoma del Estado de Mexico (UAEM), Mexico
3Centro de Estudios para la Calidad Educativa y la Investigaciòn Cientìfica, Mèxico
KEYWORDS:chronic low back pain; spondylolisthesis; aquatic manual therapy ;
Fascial tissue contains contractile elements enabling a modulating role in force generation and mechano-sensory fine-tuning. This hypothesis is supported by in vitro studies demonstrating an autonomous contraction of human lumbar fascia and a pharmacological induction of temporary contraction in rat fascial tissue. Spontaneous regulation of fascial stiffness over a time period ranging from minutes to hours contributes actively to musculoskeletal dynamic movement control. Imbalance of this regulatory mechanism results in modifications of myofascial tonus, or diminished proprioception and neuromuscular coordination, which are key contributors to the patho-mechanisms of several musculoskeletal pathologies and pain syndromes. Manual treatment of the fascial tissue is effective in land-based therapy, so patients search it even if they know it is often painful. Aquatic exercise training is commonly recommended in different pathological conditions, and aquatic therapy is been shown to be effective in musculoskeletal pain reduction. Fascial tissues can be felt much better in water than on land, and that once deprived of gravity, in the absence of muscle contractions, those same tissues bring the body into a neutral tension position.
Subjects with Chronic Low Back Pain with radiologic diagnosis of spondylolisthesis were randomly assigned to 1 of 2 groups: Aquatic Manual Therapy Group (n=31), Control Group (n=32). Each subject received 30 treatments within 10 weeks. Outcome measures obtained at baseline, after treatment, 6 and 12 months follow-up consisted of McGill Pain Questionnaire (self-report questionnaire to measure quality and intensity of pain), Oswestry Disability Questionnaire (self-report questionnaire to quantify disability for low back pain) and Faces Pain Scale (self-registration measure intensity measurement of pain caused by treatment).
This study is approved by Ethical Research Committee of Universidad Autónoma del Estado de México (Faculty of Medicine). Office N°007/2017.
Results and Discussion.
60 subjects completed the study (95%) with 30 in each group. Statistically significant differences were noted after treatment and at 6-12 months follow-up.
The AMT group had less intense pain (90%), decreased the quantity of disability (96%)and increased tolerability of treatment (60%) compared with the Control Group. Clinical significance was evident for the AMT group, At 12-month follow-up 83,4% of subjects in the AMT group reported of pain reduction as compared with 20% of subject in the Control Group that reported of pain reduction.
At the end of 12 months in the experimental group there was a significant reduction in pain levels measured by the McGill questionnaire, between the control group and the experimental group analyzed before and after treatment. 10% of patients in the experimental group continued to manifest pain from high to intolerable while 73,4% of patients in the control group continued to refer the pain from high to intolerabl
Aquatic therapeutic manipulation of soft tissues appears to be a well tolerable technique and improves functional and perceived well-being outcomes.