Immediate effect of myofascial release on range of motion, pain, and electromyographic activity in patients undergoing total knee arthroplasty

Abstract

Introduction: Myofascial release has been popular these days among manual therapists, although it needs further study to determine its true collaboration on functional improvement after surgery. Objective: Therefore, the aim of this study was to analyze de immediate effect of lower limb posterior fascial chain myofascial release on knee range of motion (ROM), electromyographic activity and pain before and after intervention of patients submitted to total knee arthroplasty (TKA). Methods: At this quasi-experimental pre/post intervention study, 33 TKA patients were assessed in the Rehabilitation Unit of Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro-RJ, Brazil. Subjects were submitted to a single myofascial intervention based on Myers’s Anatomy Trains. Investigated variables before and after manipulation were: flexion-extension knee ROM assessed by photogrammetry; muscle recruitment on maximal voluntary isometric contraction of biceps femoris and rectus femoris muscle; pain relief percentage. Statistical analysis was processed on SPSS 20 IBM and means of ROM, pain and electromyografic signal were compared by t-test (p value ≤0,05). Results: An increase in electric activity of rectus and biceps femoris muscles was identified after treatment, although only the latter (pre - μV=0,087 ± 0,066; post - μV=0,097±0,085) was statistically significant (p=0,037). Mean gain of ROM was 5,72o± 6,27 (p=0.01), correspondent to an 11,9% improvement. Eight subjects had their pain decreased on 56,9% (p=0.04). Conclusion: The results suggest that myofascial release increases muscle activity, reduces pain and improves ROM on TKA patients. However, more studies, especially longitudinal and randomized clinical trials, are necessary to fully elucidate the real mechanisms and physiological responses of myofascial release. To conclude, this Anatomy Trains based therapy is a useful resource to reduce stiffness after TKA.