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Nombre de la técnica con pretendida finalidad sanitária: Eficacia y seguridad del Zero Balancing como técnica con pretendida finalidad sanitaria en condiciones clíni cas selecionadas. Definición de la técnica e indicaciones clínicas: Zero Balancing (ZB) es una técnica o modalidad de trabajo corporal y manual mente/cuerpo que, según su fundador Fritz Frederick Smith, involucra 'energía' y 'estructura' logrando un equilibrio en el individuo. Calidad de la evidencia: No se han localizado estudios científicos, sólo artículos de opinión. Resultados claves: No se han localizado estudios que aporten informa ción científica sobre la eficacia y seguridad del Zero Balancing. Conclusión final: Con la información disponible en el momento actual, no existe evidencia científica sobre la seguridad y efi cacia de la técnica en ninguna condición clínica.

Name of the technique with health purposes: Efficacy and safety of Zero Balancing as a technique with an intented health purpose in selected clinical conditions. Definition of the technique and clinical indication: Zero Balancing (ZB) is a technique or modality of bod work and mind/body manual work that, according to its founder Fritz Frederick Smith, involves 'energy' and 'structure' achieving a balance in the individual. Quality of evidence: No scientific studies have been located, only opinion articles Key results: There are no studies that provide scientific information on the efficacy and safety of Zero Balancing Final conclusion: With the information available at the present time, there is no scientific evidence on the safety and efficacy of the technique in any clinical condition.

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Abstract Objective: To evaluate the impact of the originally-developed approach aimed at pre-treatment graphical modelling of soft-tissue changes (digital soft tissue design) for the optimization of patient-centered outcomes after Class I and Class II single gingival recessions treatment with the use of a xenogeneic dermal matrix. Material and Methods: Patients enrolled in the study group received single gingival recession treatment via CAF+XDM method supported by pre-treatment graphical modelling of potential soft-tissue changes (digital soft tissue design), while patients enrolled in the control group received single gingival recession treatment via CAF+CTG method with no pre-treatment graphical modeling of gingival level changes. Patient-centered outcomes were measured by visual analogue scale, OHIP-14, and Mahajan's scales. Results: Realization of pre-treatment graphical modelling of soft-tissue changes supported the achievement of better patient-centered outcomes, such as root coverage (p<0.05), surgical phase (p<0.05), post-surgical phase (p<0.05), cost-effectiveness (p<0.05) and diagnostics and patient-orientation (p<0.05) based on patient's personal perception grades. Conclusion: Patient-centered results were found to be more successful within the group using the xenogeneic type of graft accompanied with the implementation of pre-treatment graphical modeling of soft tissue changes, which helped to balance patients' pre-operative expectations and post-operative satisfaction with the received results, reduce post-operative morbidity and improve oral health-related quality of life (AU).

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OBJECTIVE: To investigate the effectiveness of spinal manipulation combined with myofascial release compared with spinal manipulation alone, in individuals with chronic non-specific low back pain (CNLBP). DESIGN: Randomized controlled trial with three months follow-up. SETTING: Rehabilitation clinic. PARTICIPANTS: Seventy-two individuals (between 18 and 50 years of age; CNLBP ≥12 consecutive weeks) were enrolled and randomly allocated to one of two groups: (1) Spinal manipulation and myofascial release - SMMRG; n=36) or (2) Spinal manipulation alone (SMG; n=36). INTERVENTIONS: Combined spinal manipulation (characterized by high velocity/low amplitude thrusts) of the sacroiliac and lumbar spine and myofascial release of lumbar and sacroiliac muscles vs manipulation of the sacroiliac and lumbar spine alone, twice a week, for three weeks. MAIN OUTCOME MEASURES: Assessments were performed at baseline, three weeks post intervention and three months follow-up. Primary outcomes were pain intensity and disability. Secondary outcomes were quality of life, pressure pain-threshold and dynamic balance. RESULTS: No significant differences were found between SMMRG vs SMG in pain intensity and disability post intervention and at follow-up. We found an overall significant difference between-groups for CNLBP disability (SMG-SMMRG: mean difference of 5.0; 95% confidence interval of difference 9.9; -0.1), though this effect was not clinically important and was not sustained at follow-up. CONCLUSIONS: We demonstrated that spinal manipulation combined with myofascial release was not more effective compared to spinal manipulation alone for patients with CNLBP. CLINICAL TRIAL REGISTRATION NUMBER: NCT03113292.

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Objectives: To evaluate the clinical effect of sciatic neural mobilization in combination with the treatment of surrounding structures for sciatica patients. Secondly, we were also interested in identifying possible baseline characteristics that may be associated with improvements in pain and disability for sciatica patients. Methods: Twenty-eight patients with a clinical diagnosis of sciatica were treated with neural mobilization, joint mobilization and soft tissue techniques. Pain intensity and lumbar disability were assessed at baseline and after treatment using a Numerical Rating Scale (0-10) and the Oswestry Disability Index (0-100), respectively. The pre- and post-intervention data were compared. The research protocol was registered under the number NCT03663842. Results: Participants attended an average of 16 (SD±5.6) treatmentsessions over an average of 12 weeks. Decrease in pain scores (before median = 8, after median = 2; p < 0.001) and improvement in lumbar disability scores (before median = 33.3%, after median = 15.6%; p < 0.001) were observed. A multiple linear regression analysis showed that duration of pain and age of the patient predicted the disability improvement: F (2, 24) = 4.084, p < 0.030, R2 = 0.254. Discussion: Patients with sciatica may benefit from neural mobilization in combination with manual therapy for pain and lumbar disability. Longer pain duration and younger age had a negative influence on lumbar disability improvement.

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OBJECTIVES: to evaluate the evidence from the literature regarding the effects of cupping therapy on chronic back pain in adults, the most used outcomes to evaluate this condition, the protocol used to apply the intervention and to investigate the effectiveness of cupping therapy on the intensity of chronic back pain. METHOD: systematic review and meta-analysis carried out by two independent researchers in national and international databases. Reference lists of systematic reviews were also explored. The quality of evidence was assessed according to the Jadad scale. RESULTS: 611 studies were identified, of which 16 were included in the qualitative analysis and 10 in the quantitative analysis. Cupping therapy has shown positive results on chronic back pain. There is no standardization in the treatment protocol. The main assessed outcomes were pain intensity, physical incapacity, quality of life and nociceptive threshold before the mechanical stimulus. There was a significant reduction in the pain intensity score through the use of cupping therapy (p = 0.001). CONCLUSION: cupping therapy is a promising method for the treatment of chronic back pain in adults. There is the need to establish standardized application protocols for this intervention.

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OBJECTIVES: The role of a myofascial release (MFR) on flexion contractures after total knee arthroplasty (TKA) has not yet been elucidated. Therefore, the purpose of this study was to determine its immediate effect on such patients. METHODS: In this A-B single subject experimental study, 33 TKA's patients with knee flexion contracture had their gluteal, posterior fascia lata, posterior crural and plantar fasciae released. Patients' knee range of motion (KROM), pain and muscle electric activity were assessed pre- and post-intervention. RESULTS: An increase in electric activity of the biceps femoris muscle was identified after treatment (pre RMS = 0.087 ± 0.066 V; post RMS = 0.097 ± 0.085 V; p = 0.037). Mean gain of KROM was 5.72 ± 6.27, correspondent to an 11.9% improvement (p = 0.01). Eight subjects had their pain decreased on 56.9% (p = 0.04). CONCLUSIONS: MFR increased muscle activity, reduced pain and improved the KROM of TKA patients. Thus, MFR is a useful resource of rehabilitation after TKA.

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BACKGROUND: The analysis of heart rate variability is important to the investigation of stimuli from the autonomic nervous system. Osteopathy is a form of treatment that can influence this system in healthy individuals as well as those with a disorder or disease. OBJECTIVES: The aim of the present study was to perform a systematic review of the literature regarding the effect of spinal manipulation and myofascial techniques on heart rate variability. METHODS: Searches were performed of the Pubmed, Scielo, Lilacs, PEDro, Ibesco, Cochrane and Scopus databases for relevant studies. The PEDro scale was used to assess the methodological quality of each study selected. RESULTS: A total of 505 articles were retrieved during the initial search. After an analysis of the abstracts, nine studies were selected for the present review. CONCLUSION: Based on the findings, osteopathy exerts an influence on the autonomic nervous system depending on the stimulation site and type. A greater parasympathetic response was found when stimulation was performed in the cervical and lumbar regions, whereas a greater sympathetic response was found when stimulation was performed in the thoracic region.

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OBJECTIVES: To investigate aquatic myofascial release (AMR) effects on flexibility and delayed onset muscle soreness, after high intensity exercises. STUDY DESIGN: 15 participants, control (CON) and intervention (INT), 3 moments, pre (Pre), after (Post) and 50 min after (Post 50/Post AMR). 6 exercises, 5 sets, 15 reps at 85% of 1 maximum repetition, followed, or not, by 50 min of AMR. VARIABLES: Heart rate, lactate, rate of perceived exertion, pain and flexibility. RESULTS: Pain perception decreased in all moments (CON4.47 ± 2.36; INT1.13 ± 1.46, p = 0.0002). Flexibility only increased for the fingertip to floor test in both phases in the Post50/Post AMR compared to Post (CON14.33 ± 9.19Pre, 15.07 ± 9.37Post (p = 0.7) and 12.8 ± 4.69Post50 (p = 0.4); INT14.53 ± 9.06Pre, 13.87 ± 9.88Post (p = 0.2) and 11.03 ± 8.96Post AMR (p = 0.001)). The Well's bench improved only for the Post AMR compared to Pre in the INT phase (INT24.79 ± 9.91Pre; 27.67 ± 9.46Post AMR p = 0.0000023). CONCLUSION: We concluded that AMR is effective to reduce pain perception and to improve flexibility of the studied population submitted to a high intense exercise session.

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Rotator cuff tear is a common disease affecting patients after stroke. It's a cause of pain and dysfunction that may compromise normal stroke rehabilitation. For many cases there is still controversy between whether to use surgical or conservative intervention. Treatment for cuff tears range from physical therapy to surgery. This paper describes for the first time the effect of Fascial Manipulation® (FM®) on rotator cuff tear in a post stroke patient. A 69 year old female stroke patient with full absence of distal components of the tendons of the rotator cuff, functional limitations on active movement of shoulder flexion and abduction of the left arm and perceived pain scored 10/10 on the Visual Analogic Scale, was assessed and treat with one session of FM® A basic theory that explains the healing results of FM® is that mechanoreceptors, such as spindle cells and other receptors, are located in the deep fascia and activated when movement are performed. Increased viscosity of the deep fascia and muscles due to increased viscosity of hyaluronic acid (HA) molecules prevents the normal gliding of fascia during movement inhibiting normal proprioception and muscle function.

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Anterior knee pain is a common complaint and can cause difficulty with its inability to bear weight. The aim of the study was to analyse the effect of adding myofascial techniques to an exercise programme for patients with anterior knee pain. A clinical trial with 18 patients with a clinical diagnosis of anterior knee pain was conducted. One group (E) with nine individuals was treated with hip muscle strengthening exercises; another group (EM), with nine individuals, had myofascial techniques added. To quantify the results, the Numeric Pain Rating Scale (NPRS) and the Lower Extremity Functional Scale (LEFS) were used. The E group showed an improvement in pain (p = 0.02), but not in the mean degree of disability. The EM group showed an improvement in pain (p = 0.01), as well as the degree of disability (p = 0.008). The effect size analysis showed that participants of the EM group had a greater impact on clinical pain and disability (Cohen's d = .35 and .30, respectively). The addition of myofascial techniques should be considered to improve the functionality of the lower limbs and reduce pain in patients with anterior knee pain.

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