Investigating the Effects of Percussion Therapy on Ultrasonography-Diagnosed Thoracolumbar Fascia on Trigger Points and Hyperlordosis in Low Back Pain: A Placebo-Controlled Trial.

BACKGROUND

Thoracolumbar fascia (TLF) is crucial for stabilization and load distribution. Individuals with non-specific low back pain (NSLBP) and hyperlordosis present with trigger points (TrPs) and tight TLF. Instrument-assisted percussion therapy (IAPT) is a form of vibration therapy used for the release of fascia. However, the effect of IAPT has not been well understood on TrPs in TLF and its effect on posture.

PRIMARY STUDY

OBJECTIVE

To determine the effect of IAPT on hyperlordotic posture, pelvic inclination, TrPs, and disability in NSLBP. Another aim was to evaluate the tangible effect of IAPT on TrPs.

METHODS/

DESIGN

Double-blinded placebo-controlled trial conducted on NSLBP patients with lumbar hyperlordosis.

PARTICIPANTS

Thirty-two participants with NSLBP were randomly allocated into IAPT and placebo groups.

INTERVENTION: The Interventional group (n = 16) underwent IAPT and the placebo group (n = 16) underwent sham IAPT along with interferential therapy (IFT) and cryotherapy for alternate days over two weeks.

PRIMARY OUTCOME MEASURES: Pre- and post-intervention (2 weeks) both the groups were evaluated for TrPs using a pressure algometer, diagnostic USG to assess dimensions of TrPs on TLF, Index of lumbar lordosis (ILL), Lumbar lordosis curve (LLC) using flexicurve, pelvic tilt (PT) angle using bubble inclinometer, and Modified Oswestry Disability Index (MODI).

RESULTS

Upon between-group comparison, for PT (P = .0009), ILL (P = .0001), LLC (P = .0033), length (P = .0007), and breadth of TrPs (P = .0004), the improvements were significantly better in IAPT group than the control group except for PPT (P = .2834) and MODI (P = .0135) where both the groups were equally effective.

CONCLUSION

IAPT is an effective method of releasing TrPs and correcting hyperlordotic lumbar and pelvic posture in individuals with NSLBP. Further, the study created confirmatory evidence that IAPT is effective for treating TrPs and is not merely a placebo effect.