Analysis of the effect of fascia manipulation on chronic ankle instability_West China Medical Journal

Authors：

LI Wenmao ¹ , QU Fuling ¹ , YI Jiang ¹ , ZHANG Hong ² , XU Lin ¹ ,  LIU Zhongliang ¹

1. Department of Rehabilitation Medicine, Second Hospital of Jilin University, Changchun, Jilin 130041, P. R. China;
2. Department of Rehabilitation Medicine, First Hospital of Jilin University, Changchun, Jilin 130021, P. R. China;

Corresponding author：

LIU Zhongliang, Email: lzltim@163.com

Keywords：

Chronic ankle instability; Fascial manipulation; Propensity score matching

DOI：

10.7507/1002-0179.202103201

Video：

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Objective To explore the clinical efficacy of fascial manipulation (FM) treatment in patients with chronic ankle instability (CAI).Methods The clinical data of CAI patients who received rehabilitation treatment in the Department of Rehabilitation Medicine of the Second Hospital of Jilin University from October 2018 to December 2020 were retrospectively collected. According to different treatment methods, patients were divided into balance training (BT) group and FM group. The BT group received BT for 4 weeks, while the FM group received BT for 4 weeks after FM treatment. Propensity score matching (PSM) was used for 1∶1 matching to compare the effects of different treatment options on the dysfunction of CAI patients. Foot and Ankle Ability Measure (FAAM) [including FAAM-activity of daily living (FAAM-ADL), activity of daily living (ADL) self-scoring, FAAM-sports (FAAM-S), and sports self-scoring], center of pressure (COP), foot lift test (FLT) were used to evaluate the changes in balance function and symptoms pre-treatment and post-treatment.Results A total of 52 patients were included, including 24 cases in FM group and 28 cases in BT group. Finally, after PSM method, 34 patients were included, 17 cases in each group. Before intervention, there was no significant difference in FAAM, COP and FLT between the two groups (P>0.05). After the intervention, FAAM-ADL, ADL self score, COP and FLT in the FM group were better than those in the BT group (P<0.05); there was no significant difference between FAAM-S and exercise self score (P>0.05). Before and after the intervention, FAAM, COP and FLT were improved in both groups (P<0.05). The improvement of FAAM ADL, ADL self-score and the decrease of COP in FM group were higher than that of the BT group (P<0.05). Comparison of FAAM-S, exercise self score and FLT before and after intervention, there was no significant difference between the two groups (P>0.05).Conclusion BT can improve the function of patients with CAI, and the combination of FM is more effective in improving the ability of daily living and static balance.

Citation： LI Wenmao, QU Fuling, YI Jiang, ZHANG Hong, XU Lin, LIU Zhongliang. Analysis of the effect of fascia manipulation on chronic ankle instability. West China Medical Journal, 2021, 36(5): 632-637. doi: 10.7507/1002-0179.202103201 Copy

1.	Kosik KB, McCann RS, Terada M, et al. Therapeutic interventions for improving self-reported function in patients with chronic ankle instability: a systematic review. Br J Sports Med, 2017, 51(2): 105-112.
2.	Waterman BR, Owens BD, Davey S, et al. The epidemiology of ankle sprains in the United States. J Bone Joint Surg Am, 2010, 92(13): 2279-2284.
3.	Terada M, Bowker S, Thomas AC, et al. Alterations in stride-to-stride variability during walking in individuals with chronic ankle instability. Hum Mov Sci, 2015, 40: 154-162.
4.	施晓剑, 韩甲, 刘宇, 等. 慢性踝关节不稳的病理机制和评估诊断研究进展. 中国运动医学杂志, 2019, 38(9): 816-824.
5.	Stecco A, Gilliar W, Hill R, et al. The anatomical and functional relation between gluteus maximus and fascia lata. J Bodyw Mov Ther, 2013, 17(4): 512-517.
6.	Stecco C, Stern R, Porzionato A, et al. Hyaluronan within fascia in the etiology of myofascial pain. Surg Radiol Anat, 2011, 33(10): 891-896.
7.	Fede C, Porzionato A, Petrelli L, et al. Fascia and soft tissues innervation in the human hip and their possible role in post-surgical pain. J Orthop Res, 2020, 38(7): 1646-1654.
8.	Maetzler M, Ruescher M, Punzenberger F, et al. Progressive rehabilitation of the sprained ankle: a novel treatment method. Foot (Edinb), 2020, 43: 101645.
9.	Luigi Stecco. 筋膜手法治疗肌肉骨骼疼痛. 关玲, 蒋天裕, 赖明德, 译. 人民卫生出版社, 2018.
10.	Cotti A, Del Corso M, Diana R, et al. Inter and intra operator reliability of motor and palpation evaluation in fascial manipulation in individuals with coxarthrosis. J Man Manip Ther, 2019: 1-10.
11.	Pintucci M, Simis M, Imamura M, et al. Successful treatment of rotator cuff tear using Fascial Manipulation^® in a stroke patient. J Bodyw Mov Ther, 2017, 21(3): 653-657.
12.	Kurth T, Walker AM, Glynn RJ, et al. Results of multivariable logistic regression, propensity matching, propensity adjustment, and propensity-based weighting under conditions of nonuniform effect. Am J Epidemiol, 2006, 163(3): 262-270.
13.	Rosen AB, Johnston M, Chung S, et al. The reliability and validity of a digital version of the cumberland ankle instability tool. Disabil Rehabil, 2019: 1-4.
14.	Çelik D, Malkoç M, Martin R. Evidence for reliability, validity and responsiveness of Turkish Foot and Ankle Ability Measure (FAAM). Rheumatol Int 2016, 36(10): 1469-1476.
15.	Hale SA, Fergus A, Axmacher R, et al. Bilateral improvements in lower extremity function after unilateral balance training in individuals with chronic ankle instability. J Athl Train 2014, 49(2): 181-191.
16.	Cain MS, Ban RJ, Chen YP, et al. Four-week ankle-rehabilitation programs in adolescent athletes with chronic ankle instability. J Athl Train, 2020, 55(8): 801-810.
17.	Kerin F, Delahunt E. Physiotherapists’ understanding of functional and mechanical insufficiencies contributing to chronic ankle instability. Athle Train Sports Health Care, 2011, 3(3): 125-130.
18.	Doherty C, Bleakley C, Hertel J, et al. Recovery from a first-time lateral ankle sprain and the predictors of chronic ankle instability: a prospective cohort analysis. Am J Sports Med, 2016, 44(4): 995-1003.
19.	Gribble PA, Bleakley CM, Caulfield BM, et al. Evidence review for the 2016 international ankle consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med, 2016, 50(24): 1496-1505.
20.	McKeon PO, Ingersoll CD, Kerrigan DC, et al. Balance training improves function and postural control in those with chronic ankle instability. Med Sci Sports Exerc, 2008, 40(10): 1810-1819.
21.	Busato M, Quagliati C, Magri L, et al. Fascial manipulation associated with standard care compared to only standard postsurgical care for total hip arthroplasty: a randomized controlled trial. PM R, 2016, 8(12): 1142-1150.
22.	Brandolini S, Lugaresi G, Santagata A, et al. Sport injury prevention in individuals with chronic ankle instability: fascial manipulation^® versus control group: a randomized controlled trial. J Bodyw Mov Ther, 2019, 23(2): 316-323.
23.	Needle AR, Lepley AS, Grooms DR. Central nervous system adaptation after ligamentous injury: a summary of theories, evidence, and clinical interpretation. Sports Med, 2017, 47(7): 1271-1288.
24.	Sliz D, Smith A, Wiebking C, et al. Neural correlates of a single-session massage treatment. Brain Imaging Behav, 2012, 6(1): 77-87.
25.	Needle AR, Swanik CB, Schubert M, et al. Decoupling of laxity and cortical activation in functionally unstable ankles during joint loading. Eur J Appl Physiol, 2014, 114(10): 2129-2138.
26.	Rolf IP. Rolfing: the integration of human structures. Santa Monica, CA: Dennis-Landman Publication, 1977.
27.	Twomey L, Taylor J. Flexion creep deformation and hysteresis in the lumbar vertebral column. Spine (Phila Pa 1976), 1982, 7(2): 116-122.
28.	Juhan D. Job’s body. Barrytownm: Station Hill Press, 2003.
29.	Schleip R. Fascial plasticity a new neurobiological explanation: Part 1. J Bodyw Mov Ther, 2003, 7(1): 11-19.
30.	Matteini P, Dei L, Carretti E, et al. Structural behavior of highly concentrated hyaluronan. Biomacromolecules, 2009, 10(6): 1516-1522.
31.	Stecco A, Meneghini A, Stern R, et al. Ultrasonography in myofascial neck pain: randomized clinical trial for diagnosis and follow-up. Surg Radiol Anat, 2014, 36(3): 243-253.
32.	Chytil M, Pekař M. Rheological studies of hyaluronan/modified hyaluronan mixtures and the structure of hyaluronic solutions. Ann Transac Nordic Rheol Soc, 2007, 15: 221.

1. Kosik KB, McCann RS, Terada M, et al. Therapeutic interventions for improving self-reported function in patients with chronic ankle instability: a systematic review. Br J Sports Med, 2017, 51(2): 105-112.
2. Waterman BR, Owens BD, Davey S, et al. The epidemiology of ankle sprains in the United States. J Bone Joint Surg Am, 2010, 92(13): 2279-2284.
3. Terada M, Bowker S, Thomas AC, et al. Alterations in stride-to-stride variability during walking in individuals with chronic ankle instability. Hum Mov Sci, 2015, 40: 154-162.
4. 施晓剑, 韩甲, 刘宇, 等. 慢性踝关节不稳的病理机制和评估诊断研究进展. 中国运动医学杂志, 2019, 38(9): 816-824.
5. Stecco A, Gilliar W, Hill R, et al. The anatomical and functional relation between gluteus maximus and fascia lata. J Bodyw Mov Ther, 2013, 17(4): 512-517.
6. Stecco C, Stern R, Porzionato A, et al. Hyaluronan within fascia in the etiology of myofascial pain. Surg Radiol Anat, 2011, 33(10): 891-896.
7. Fede C, Porzionato A, Petrelli L, et al. Fascia and soft tissues innervation in the human hip and their possible role in post-surgical pain. J Orthop Res, 2020, 38(7): 1646-1654.
8. Maetzler M, Ruescher M, Punzenberger F, et al. Progressive rehabilitation of the sprained ankle: a novel treatment method. Foot (Edinb), 2020, 43: 101645.
9. Luigi Stecco. 筋膜手法治疗肌肉骨骼疼痛. 关玲, 蒋天裕, 赖明德, 译. 人民卫生出版社, 2018.
10. Cotti A, Del Corso M, Diana R, et al. Inter and intra operator reliability of motor and palpation evaluation in fascial manipulation in individuals with coxarthrosis. J Man Manip Ther, 2019: 1-10.
11. Pintucci M, Simis M, Imamura M, et al. Successful treatment of rotator cuff tear using Fascial Manipulation^® in a stroke patient. J Bodyw Mov Ther, 2017, 21(3): 653-657.
12. Kurth T, Walker AM, Glynn RJ, et al. Results of multivariable logistic regression, propensity matching, propensity adjustment, and propensity-based weighting under conditions of nonuniform effect. Am J Epidemiol, 2006, 163(3): 262-270.
13. Rosen AB, Johnston M, Chung S, et al. The reliability and validity of a digital version of the cumberland ankle instability tool. Disabil Rehabil, 2019: 1-4.
14. Çelik D, Malkoç M, Martin R. Evidence for reliability, validity and responsiveness of Turkish Foot and Ankle Ability Measure (FAAM). Rheumatol Int 2016, 36(10): 1469-1476.
15. Hale SA, Fergus A, Axmacher R, et al. Bilateral improvements in lower extremity function after unilateral balance training in individuals with chronic ankle instability. J Athl Train 2014, 49(2): 181-191.
16. Cain MS, Ban RJ, Chen YP, et al. Four-week ankle-rehabilitation programs in adolescent athletes with chronic ankle instability. J Athl Train, 2020, 55(8): 801-810.
17. Kerin F, Delahunt E. Physiotherapists’ understanding of functional and mechanical insufficiencies contributing to chronic ankle instability. Athle Train Sports Health Care, 2011, 3(3): 125-130.
18. Doherty C, Bleakley C, Hertel J, et al. Recovery from a first-time lateral ankle sprain and the predictors of chronic ankle instability: a prospective cohort analysis. Am J Sports Med, 2016, 44(4): 995-1003.
19. Gribble PA, Bleakley CM, Caulfield BM, et al. Evidence review for the 2016 international ankle consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med, 2016, 50(24): 1496-1505.
20. McKeon PO, Ingersoll CD, Kerrigan DC, et al. Balance training improves function and postural control in those with chronic ankle instability. Med Sci Sports Exerc, 2008, 40(10): 1810-1819.
21. Busato M, Quagliati C, Magri L, et al. Fascial manipulation associated with standard care compared to only standard postsurgical care for total hip arthroplasty: a randomized controlled trial. PM R, 2016, 8(12): 1142-1150.
22. Brandolini S, Lugaresi G, Santagata A, et al. Sport injury prevention in individuals with chronic ankle instability: fascial manipulation^® versus control group: a randomized controlled trial. J Bodyw Mov Ther, 2019, 23(2): 316-323.
23. Needle AR, Lepley AS, Grooms DR. Central nervous system adaptation after ligamentous injury: a summary of theories, evidence, and clinical interpretation. Sports Med, 2017, 47(7): 1271-1288.
24. Sliz D, Smith A, Wiebking C, et al. Neural correlates of a single-session massage treatment. Brain Imaging Behav, 2012, 6(1): 77-87.
25. Needle AR, Swanik CB, Schubert M, et al. Decoupling of laxity and cortical activation in functionally unstable ankles during joint loading. Eur J Appl Physiol, 2014, 114(10): 2129-2138.
26. Rolf IP. Rolfing: the integration of human structures. Santa Monica, CA: Dennis-Landman Publication, 1977.
27. Twomey L, Taylor J. Flexion creep deformation and hysteresis in the lumbar vertebral column. Spine (Phila Pa 1976), 1982, 7(2): 116-122.
28. Juhan D. Job’s body. Barrytownm: Station Hill Press, 2003.
29. Schleip R. Fascial plasticity a new neurobiological explanation: Part 1. J Bodyw Mov Ther, 2003, 7(1): 11-19.
30. Matteini P, Dei L, Carretti E, et al. Structural behavior of highly concentrated hyaluronan. Biomacromolecules, 2009, 10(6): 1516-1522.
31. Stecco A, Meneghini A, Stern R, et al. Ultrasonography in myofascial neck pain: randomized clinical trial for diagnosis and follow-up. Surg Radiol Anat, 2014, 36(3): 243-253.
32. Chytil M, Pekař M. Rheological studies of hyaluronan/modified hyaluronan mixtures and the structure of hyaluronic solutions. Ann Transac Nordic Rheol Soc, 2007, 15: 221.

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