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- Diagnostic ultrasound assessment of deep fascia sliding mobility in vivo: A scoping review – Part 1: Thoracolumbar and abdominal fasciaePublication . Soares, Hélio Rafael; Pinheiro, Ana Rita; Crasto, Carlos; Barbosa, Pedro; Dias, Nuno; Carvalho, Paulo deFailure of fascial sliding may occur in cases of excessive or inappropriate use, trauma, or surgery, resulting in local inflammation, pain, sensitization, and potential dysfunction. Therefore, the mechanical properties of fascial tissues, including their mobility, have been evaluated in vivo by ultra-sound (US) imaging. However, this seems to be a method that is not yet properly standardized nor validated. To identify, synthesize, and collate the critical methodological principles that have been described in the literature for US evaluation of deep fascia sliding mobility in vivo in humans. Methods: A systematic literature search was conducted on ScienceDirect, PubMed (Medline), Web of Science and B-On databases, according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. The OCEBM LoE was used to evaluate the level of evidence of each study. From a total of 104 full-text articles retrieved and assessed for eligibility, 18 papers were included that evaluate the deep fasciae of the thoracolumbar (n ¼ 4), abdominal (n ¼ 7), femoral (n ¼ 4) and crural (n ¼ 3) regions. These studies addressed issues concerning either diagnosis (n ¼ 11) or treatment benefits (n ¼ 7) and presented levels of evidence ranging from II to IV. Various terms were used to describe the outcome measures representing fascial sliding. Also, different procedures to induce fascial sliding, positioning of the individuals being assessed, and features of US devices were used. The US analysis methods included the comparison of start and end frames and the use of cross-correlation software techniques through automated tracking algorithms. These methods had proven to be reliable to measure sliding between TLF, TrA muscle-fascia junctions, fascia lata, and crural fascia, and the adjacent epimysial fascia. However, the papers presented heterogeneous terminologies, research questions, populations, and methodologies. This two-part paper reviews the evidence obtained for the thoracolumbar and abdominal fasciae (Part 1) and for the femoral and crural fasciae (Part 2). The US methods used to evaluate deep fascia sliding mobility in vivo in humans include the comparison of start and end frames and the use of cross-correlation software techniques through automated tracking algorithms. These seem reliable methods to measure sliding of some fasciae, but more studies need to be systematized to confirm their reliability for others. Moreover, specific standardized protocols are needed to assess each anatomical region as well as study if age, sex-related characteristics, body composition, or specific clinical conditions influence US results.
- Immediate effects of suboccipital myofascial induction on postural stability: a pilot studyPublication . Pinheiro, Ana Rita; Faria, Ana; Mesquita Montes, António; Crasto, Carlos; Silva, Cláudia; Carvalho, Paulo; Santos, Rubim; Cunha, ChristineStanding is a constant postural challenge due to high position of the center of mass regarding the small size of base of support. Somatosensory, vestibular and visual inputs are crucial to preserve the upright orientation and stability]
- Immediate effects of myofascial induction of quadratus lumborum in postural orientation of standing asymptomatic subjectsPublication . Pinheiro, Ana Rita; Cunha, Christine; Fernandes, Ana Rita; Pastilha, Tiago; Nuno, Vanessa Catarino; Crasto, Carlos; Silva, Cláudia; Santos, Rubim; Carvalho, PauloStanding represents a challenging posture that requires upright orientation of body segments (Winter 1995). The thoracolumbar fascia (TLF), a complex network of fascial layers that establishes a direct relationship with several trunk muscles (Willard et al 2012), might be a privileged structure to influence standing posture, either by the direct transmission of forces to the muscle fibers (Turrina et al 2013; Willard et al 2012), influencing its tension, or by the inputs to the central nervous system, ultimately influencing body schema and motor control. Therefore, this study aimed at analyzing the immediate effects of a myofascial induction technique over TLF on the postural orientation of asymptomatic standing subjects.
- Diagnostic ultrasound assessment of deep fascia sliding mobility in vivo: A scoping review – Part 2: Femoral and crural fasciaePublication . Soares, Hélio Rafael; Pinheiro, Ana Rita; Crasto, Carlos; Barbosa, Pedro; Dias, Nuno; Carvalho, PauloFailure of fascial sliding may occur in cases of excessive or inappropriate use, trauma, or surgery, resulting in local inflammation, pain, sensitization, and potential dysfunction. Therefore, the mechanical properties of fascial tissues, including their mobility, have been evaluated in vivo by ultrasound (US) imaging. However, this seems to be a method that is not yet properly standardized nor validated. To identify, synthesize, and collate the critical methodological principles that have been described in the literature for US evaluation of deep fascia sliding mobility in vivo in humans. A systematic literature search was conducted on ScienceDirect, PubMed (Medline), Web of Science and B-On databases, according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. The OCEBM LoE was used to evaluate the level of evidence of each study. ́ From a total of 104 full-text articles retrieved and assessed for eligibility, 18 papers were included that evaluate the deep fasciae of the thoracolumbar (n ¼ 4), abdominal (n ¼ 7), femoral (n ¼ 4) and crural (n ¼ 3) regions. These studies addressed issues concerning either diagnosis (n ¼ 11) or treatment benefits (n ¼ 7) and presented levels of evidence ranging from II to IV. Various terms were used to describe the outcome measures representing fascial sliding. Also, different procedures to induce fascial sliding, positioning of the individuals being assessed, and features of US devices were used. The US analysis methods included the comparison of start and end frames and the use of cross-correlation software techniques through automated tracking algorithms. These methods had proven to be reliable to measure sliding between TLF, TrA muscle-fascia junctions, fascia lata, and crural fascia, and the adjacent epimysial fascia. However, the papers presented heterogeneous terminologies, research questions, populations, and methodologies. This two-part paper reviews the evidence obtained for the thoracolumbar and abdominal fasciae (Part 1) and for the femoral and crural fasciae (Part 2). The US methods used to evaluate deep fascia sliding mobility in vivo in humans include the comparison of start and end frames and the use of cross-correlation software techniques through automated tracking algorithms. These seem reliable methods to measure sliding of some fasciae, but more studies need to be systematized to confirm their reliability for others. Moreover, specific standardized protocols are needed to assess each anatomical region as well as study if age, sex-related characteristics, body composition, or specific clinical conditions influence US results.