Dupuis C, Bertrand I, Courraud C. Poster presented during the 10th Congrès Mondial Interdisciplinaire sur la lombalgie et la douleur pelvienne – October 28-31 2019 – Anvers (Belgium)
Introduction : Low Back Pain (LBP) is a common disorder and a worldwide cause of disability. There are 4 phases: acute (aLBP), sub-chronic (scLBP), chronic (cLBP), and rehabilitation (rLBP).
Previous research has suggested that fascia is involved in LBP. Morphological changes, ischemia, innervation changes, loss of gliding, and mechanical changes have been studied.
DBM Fasciatherapy is a body/mind approach focused on fascia. It is a manual, exercise, and meditation therapy which takes a holistic approach to LBP.
Evidence Based Practice is an approach for optimizing decision-making, which has three principles: research evidence, clinical expertise, client preference.
In France, a study (AFREK, 2009) showed that the number of physiotherapy session was 13 for aLBP, and 20 for cLBP.
Purpose/Aim : This study aimed to evaluate the use of DBM Fasciatherapy by members of FasciaFrance, the French association of professional practicing this method.
Materials and Methods : The research was conducted with physiotherapists using DBM Fasciatherapy.
A questionnaire about DBM Fasciatherapy was sent to 365 practitioners. It contained 4 sections: How patients consult, Characteristics of the session, Techniques used, Evaluation of the training.
The 118 completed questionnaires were analyzed.
Results : Practitioners had a mean of 44 (σ=30) patients a week, including 16 (σ=18) LBP patients.
They saw LBP patients in direct access exclusively (n=5, 4%) or mainly (n=52, 44%).
Patients requested DBM Fasciatherapy exclusively (n=39, 33%) or mainly (n=22, 19%). 72% of patients (n=85) never requested a different therapy.
DBM Fasciatherapy was used for aLBP (94%), scLBP (89%), cLBP (92%), and rLBP (72%). The number of sessions was:
- aLBP: 1 to 5 (89%)
- scLBP: 1 to 5 (72%)
- cLBP: >5 (61%), >10 (30%)
- rLBP: 1 to 5 (76%)
Fasciatherapy was used mainly to alleviate pain (n=68, 58%); more for aLBP (n=39, 35%) or scLBP (30%) than for cLBP (19%) or rLBP (16%).
Manual therapy was used most (97%). Exercise was used by 57% of practitioners to complement manual therapy. It was used most for cLBP (n=65, 55%) and rLBP (n=63, 53%).
Meditation was not used much (14%).
The musculoskeletal and visceral approaches of manual therapy were the most used (92% and 84%). Exercise was used most for cLBP (55%) and rLBP (53%).
Conclusion : This study gives an insight into the clinical use of DBM Fasciatherapy. Practitioners were experienced with LBP patients. There is a demand for DBM Fasciatherapy, which patients are prepared to pay for – consequence of direct access in France. DBM Fasciatherapy is used at every phase of LBP, and the number of sessions is relatively small compared with physiotherapy alone. The manual approach is used most in every phase, exercise therapy is used most for chronic situations. Even if meditation has been shown to be effective in the literature, it is not used much by the study’s practitioners.
The pain relief reported may be explained by the action of DBM Fasciatherapy on fascia, but also by the effect of DBM Fasciatherapy on psycho-emotional factors.