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The Somatic Connection  |   October 2012
Myofascial Release Combined With Physical Therapy Improves Venous Blood Flow
Article Information
The Somatic Connection   |   October 2012
Myofascial Release Combined With Physical Therapy Improves Venous Blood Flow
The Journal of the American Osteopathic Association, October 2012, Vol. 112, 657. doi:10.7556/jaoa.2012.112.10.657
The Journal of the American Osteopathic Association, October 2012, Vol. 112, 657. doi:10.7556/jaoa.2012.112.10.657
Ramos-González E, Moreno-Lorenzo C, Matarán-Peñarrocha GA, Guisado-Barrilao R, Aguilar-Ferrándiz ME, Castro-Sánchez AM. Comparative study on the effectiveness of myofascial release manual therapy and physical therapy for venous insufficiency in postmenopausal women [published online ahead of print May 3, 2012]. Complement Ther Med. 2012;20(5):291-298.  
Manual therapies, such as massage and pedal lymphatic pump, as well as passive motion machines and compressive stockings are used as standard therapies to reduce swelling in the lower extremities for patients with venous insufficiency. It is not known, however, what the effectiveness of combination therapies is for this condition. Researchers in Spain assessed the comparative effectiveness of myofascial release (MFR) therapy and physical therapy on venous insufficiency, pain, and quality of life in postmenopausal patients. Inclusion criteria were age 40 to 75 years and the presence of stage I or II venous insufficiency according to the clinical, etiological, anatomical, and physiopathological, or CEAP, scale. Exclusion criteria were venous insufficiency more advanced than stage II, no evidence of a venous cause, uncompensated cardiorespiratory insufficiency, and recent venous thrombosis. 
Sixty-five postmenopausal women who met the study criteria were randomly assigned to a control group (n=32) or experimental group (n=33). Patients in both groups underwent physical venous return therapy (ie, kinesiotherapy) for a 10-week period, but the experimental group patients also received 20 sessions of MFR therapy. The MFR therapeutic protocol was administered by a physiotherapist expert in MFR therapy who applied it in several places: longitudinal sliding in a cephalad direction in all compartments of the thigh; hands crossed on external lateral and anterior compartment of the thigh; and MFR of the triceps fascia. Three MFRs were performed in each maneuver lasting 50 minutes for each session. Patients underwent a total of 20 sessions (2 sessions per week) during the same 10-week kinesiotherapy period. 
After 10 weeks, blood pressure, cell mass, intracellular water, basal metabolism, venous velocity, skin temperature, pain, and quality of life all showed improvement. Basal metabolism (P<.047), intracellular water (P<.041), diastolic blood pressure (P<.046), venous blood flow velocity (P<.048), pain (P<.039), and emotional role (P<.047) were significantly higher in the experimental group than in the control group after the 10-week treatment program. 
The limitations of the study were its length (a relatively short period), its population of only women, and its lack of blinding (the practitioners knew their patients). Furthermore, the MFR therapy performed in this study was not labeled direct or indirect. —M.A.S., K.M.,* and D.J.Z.* 
   *Kate McCaffrey, DO, and David Joyce Zuniga, OMS III, are guest authors from the Western University of Health Sciences College of Osteopathic Medicine of the Pacific-Northwest in Lebanon, Oregon.