Cyril Dupuis
4th Fascia Research Congress (Reston, VA, USA), 2015.
Actes publiés par Kiener, éditeurs : Wearing, Schleip, Chaitow, Findley
BACKGROUND: Pain is a complex phenomenom(1) which, when it becomes chronic, affects the whole person. Fibromyalgia is a chronic pain syndrome, medically unexplained, which is characterised by widespread pain, linked with sleeping problems, chronic fatigue, and psychological problems(2). Fascia is a sensitive organ(3) wich has a nociception particularly linked with affective pain(4). Its implication in fibromyalgia has regularly been evoqued by researchers(5, 6, 7).
APPROACH: Here, I propose a double evaluation methodology which combines qualitative and quantitative approaches, to evaluate the effect of DBM Fasciatherapy, a manual therapy, on the pain of fibromyalgia patients. To measure the intensity of the overall pain, I used the Visual Analogic Scale (VAS), a commonly used method for pain measurement(8, 9). To evaluate the affective pain, I undertook a recorded guided research interview technique. 7 fibromyalgic patients were included in the research. They all assessed their pain on a VAS before, just after, one hour after, and one day after the treatment session.
RESULTS: A statistical analysis was performed on the VAS data. 3 patients reported significant reduction in pain level. The 4 participants who reported no change in the level of pain participated in a recorded guided research interview. The interviews were conducted with the aid of a grid focusing on 3 dimensions of pain and 5 issues linked with their pain (sleep, fatigue, behavior, cognition, social). The interviews were analysed with the help of a classification and interpretation method, which enabled an understanding of what people said about what they felt in their bodies. During the treatment session, the patients reported feeling muscle and mental relaxation, as well as a positive effect on the acute phases of pain. This was not shown in the VAS analysis.
CONCLUSIONS: After the final analysis, it appeared clearly that the qualitative approach greatly enriched the VAS data. This research points a new way for the exploration of the effects of a therapy targetted on fascia.
References:
[x_icon type=”caret-right”] S. Marchand. The Phenomenon of Pain. IASP Press, 2012.
[x_icon type=”caret-right”] Frederick Wolfe, Daniel J Clauw, Mary-Ann Fitzcharles, Don L Goldenberg, Robert S Katz, Philip Mease, Anthony S Russell, I Jon Russell, John B Winfield, and [x_icon type=”caret-right”] Muhammad B Yunus. The american college of rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care & Research, 62(5) :600–610, May 2010. PMID: 20461783.
[x_icon type=”caret-right”] Robert Schleip and Jager Heike. Interoception : A new correlate for intricate connections between fascial receptors, emotion, and self recognition, chapter Fascia as an organ of communication, pages 89–94. Elsevier Health Sciences, 2013.
[x_icon type=”caret-right”] Andreas Schilder, Ulrich Hoheisel, Walter Magerl, Justus Benrath, Thomas Klein, and Rolf- Detlef Treede. Sensory findings after stimulation of the thoracolumbar fascia with hypertonic saline suggest its contribution to low back pain. PAIN, 155(2) :222–231, 2014.
[x_icon type=”caret-right”] Ginevra L. Liptan. Fascia : A missing link in our understanding of the pathology of fibromyalgia. Journal of Bodywork and Movement Therapies, 14(1) :3–12, 2010.
[x_icon type=”caret-right”] Kirstie Bender Segarra. Managing fascial health for individuals with fibromyalgia. IASI Yearbook of Structural Integration, 2014.
[x_icon type=”caret-right”] R. Schleip,W. Klingler, and F. Lehmann-Horn. Fascia is able to contract in a smooth muscle- like manner and thereby influence musculoskeletal mechanics. Journal of Biomechanics, 39(1) : 488, 2006.
[x_icon type=”caret-right”] GB Langley and H. Sheppeard. The visual analogue scale : its use in pain measurement. Rheumatology international, 5(4) :145–148, 1985.
[x_icon type=”caret-right”] Bement MH Arendt-Nielsen L, Barbe MF. Global year against musculoskeletal pain. Assessment of musculoskeletal pain : Experimental and clinical. International Association for the Study of Pain, 2009.