The Effect of Diacutaneous Fibrolysis on Local and Widespread Hyperalgesia and Muscle Length in Patients With Patellofemoral Pain Syndrome: Secondary Analysis of a Pretest-Posttest Clinical Trial.
CONTEXT
Localized and widespread hyperalgesia has been observed in patients with patellofemoral pain. Diacutaneous fibrolysis (DF) has shown to be effective in reducing pain in several musculoskeletal conditions including patellofemoral pain syndrome, but no studies have evaluated the effects of this technique in reducing localized and widespread hyperalgesia.


OBJECTIVE
To assess the effect of DF on the pressure pain threshold and muscle length tests in patients with patellofemoral pain syndrome.


DESIGN
A single-group, pretest-posttest clinical trial.


SETTING
University of Zaragoza.


PARTICIPANTS
Forty-six subjects with patellofemoral pain (20 males and 26 females: age 27.8 [6.9] y).


INTERVENTION
Three sessions of DF.


MAIN OUTCOME MEASURES
Pressure pain threshold using a handheld pressure algometer (4 sites around the knee, on tibialis anterior muscle, and one remote site on the upper contralateral limb); muscle length test of the iliotibial band, rectus femoris, and hamstring muscles; and patient-perceived treatment effect score.


RESULTS
The application of 3 sessions of DF significantly increased the pressure pain threshold in all sites at posttreatment evaluation (P < .001) and at a 1-week follow-up (P < .001). A significant increase in muscle length was also observed at the posttreatment evaluation (P < .001) and 1-week follow-up (P < .001). Ninety-seven percent of the patients reported subjective improvement at posttreatment and at 1-week follow-up.


CONCLUSION
This study found that local and widespread hyperalgesia was significantly reduced after 3 sessions of diacutaneous fibrolysis and at the 1-week follow-up. A significant improvement on muscle length tests was also observed, with high clinical satisfaction among patients.
['Fanlo-Mazas|Pablo|P|', 'Bueno-Gracia|Elena|E|', 'Ruiz de Escudero-Zapico|Alazne|A|', 'López-de-Celis|Carlos|C|', 'Hidalgo-García|César|C|', 'Rodríguez-Sanz|Jacobo|J|', 'Lucha-López|María Orosia|MO|']
D000328:Adult D005260:Female D000070633:Hamstring Muscles D006801:Humans D006930:Hyperalgesia D007717:Knee D008297:Male D018482:Muscle, Skeletal D026201:Musculoskeletal Manipulations D009929:Organ Size D017288:Pain Threshold D046788:Patellofemoral Pain Syndrome D056888:Patient Positioning D011312:Pressure D052097:Quadriceps Muscle
pain clinical trial knee manual therapy