Kritische Betrachtung des
                    Fasziendistorsionsmodells

Christoph Thalhamer

doi:10.1055/a-0882-7098

manuelletherapie, Table of Contents

manuelletherapie 2019; 23(02): 81-89
DOI: 10.1055/a-0882-7098

Fachwissen

Kritische Betrachtung des Fasziendistorsionsmodells

Critical Examination of the Fascial Distortion Model

Authors

Christoph Thalhamer

Orthopädisches Spital Speising, A-Wien

Abstract

Zusammenfassung

Obwohl die Behandlungsmethode des Fasziendistorsionsmodells (FDM) bereits seit den 1990er-Jahren existiert, liegen nur wenige klinische Studien zu deren Wirksamkeit vor. Beim FDM handelt es sich also immer noch um eine expertenbasierte und nicht um eine auf externe Evidenz gestützte Methode.

Die eingesetzten Techniken sind meist äußerst schmerzhaft. Daher bleibt die strittige ethische Frage, ob Patienten trotz ungeklärten Nutzens Schmerzen ausgesetzt werden sollten.

Abstract

Although the treatment modality of the fascial distortion model exists since the 1990ies, clinical studies on its effectiveness are still rare. Consequently, FDM is still an expert-based rather than a method supported by external evidence.

The employed techniques are usually extremely painful. Therefore, the ethical question remains, whether patients should be exposed to pain despite unclear benefit.

Schlüsselwörter

Faszendistorsionsmodell - Wirksamkeit - expertenbasiert - Ethik

Key words

fascial distorsion model - effectiveness - expert-based - ethics

Full Text

References

Literatur
1 Barral JP, Mercier P. Lehrbuch der Viszeralen Osteopathie. Bd. 1. München: Urban & Fischer; 2005
2 Rolf IP. Rolfing: Reestablishing the Natural Alignment and Structural Integration of the Human Body for Vitality and Well-Being. Rochester: Inner Traditions Bear and Company; 1977
3 Chila AC. Fascial-ligamentous tension techniques. In: Ward RC. (ed). Foundations for osteopathic medicine. Philadelphia: Lippincott, Williams & Wilkins; 2002
4 Ward RC. Integrated neuromusculoskeletal release and myofascial release. In: Ward RC. (ed). Foundations for osteopathic medicine. Philadelphia: Lippincott, Williams & Wilkins; 2002
5 European Fascial Distortion Model Association (EFDMA). Das Fasziendistorsionsmodell nach Stephen Typaldos D. O. Die Typaldos-Methode. Wien: European Fascial Distortion Model Association; 2012
6 Typaldos S. Introducing the fascial distortion model. AAO Journal 1994; 4: 14-18
7 Typaldos S. FDM – Clinical and Theoretical Application of the Fascial Distortion Model within the Practice of Medicine and Surgery. Bangor: Self-publication; 2002
8 Stecco L. Fascial Manipulation for Musculoskeletal Pain. Padua: Piccin; 2004
9 Müller DG, Schleip R. Fascial fitness: suggestions for a fascia-oriented training approach in sports and movement therapies. In: Schleip R. et al. (eds). Fascia. The Tensional Network of the Human Body. London: Churchill Livingstone, Elsevier; 2012
10 Myers T, Frederick C. Stretching and fascia. In: Schleip R. et al. (eds). Fascia. The Tensional Network of the Human Body. London: Churchill Livingstone, Elsevier; 2012
11 Schroeder AN, Best TM. Is self-myofascial release an effective preexercise and recovery strategy? A literature review. Curr Sports Med Rep 2015; 14: 200-208
12 Ajimsha MS, Al-Mudahka NR, Al-Madzhar JA. Effectiveness of myofascial release: systematic review of randomized controlled trials. J Bodyw Mov Ther 2015; 19: 102-112
13 Anker S. Interrater-Reliabilität bei der Beurteilung der Körpersprache nach dem Fasziendistorsionsmodell (FDM). 2011 www.osteopathic-research.com/paper_pdf/Anker%20Stefan.pdf (13.09.2018)
14 Breineßel M. Faszientherapie nach FDM. www.dr-breinessl.at (13.09.2018)
15 Team Physios. FDM. www.teamphysios.at/osteopathie-wien/fdm-therapie-wien (05.10.2018)
16 Hölle-Gindorf J. Fasziendistorsionsmodell stellt keine Therapieoption bei Achillessehnenruptur dar. Man Med 2018; 56: 188
17 Thalhamer C. A fundamental critique of the fascial distortion model and its application in clinical practice. J Bodyw Mov Ther 2018; 22: 112-117
18 Bartels EM. How to perform a systematic search. Best Pract Res Clin Rheumatol 2013; 27: 295-306
19 Avila Gonzalez CA, Driscoll M, Schleip R. et al. Frontiers in fascia research. J Bodyw Mov Ther 2018; 22: 873-880
20 Baird CJ, Shumate SM, Tancredi MP. et al. The Effects of the Fascial Distortion Model on Chronic Hamstring Tightness. Topics in Integrative Health Care 2014; 5 ID: 5.3004
21 Boucher JD, Figueroa J. Restoration of full shoulder range of motion after application of the Fascial Distortion Model. J Am Osteopath Assoc 2018; 118: 341-344
22 Fink M, Schiller J, Buhck H. Wirksamkeit einer manuellen Behandlungstechnik nach dem Fasziendistorsionsmodell bei schmerzhaft eingeschränkter Schulterbeweglichkeit (Frozen Shoulder). Z Orthop Unfall 2012; 150: 420-427
23 Fischer A, Fischer I. Behandlung einer akuten Achillessehnenruptur mit Methoden des Fasziendistorsionsmodells. Man Med 2017; 55: 383-388
24 James SJ, Hudnall J. Use of the Fascial Distortion Model to Evaluate a Limp in a Child. J Am Osteopath Assoc 2017; 117: 399-402
25 Maśliński P, Woldańska-Okońska M. [The use of fascial distorsion model (FDM) in patient with limited mobility in the shoulder joint – a case report]. Pol Merkur Lekarski 2017; 42: 214-218
26 Richter D, Karst M, Buhck H. et al. Efficacy of Fascial Distortion Model Treatment for Acute, Nonspecific Low-Back Pain in Primary Care: A Prospective Controlled Trial. Altern Ther Health Med. 2017 pii: AT5522. [Epub ahead of print]
27 Rogala A, Molik B. Fascial Distortion Model Manual Therapy and Painful Shoulder Syndrome. 2018. ClinicalTrials. 2018 https://clinicaltrials.gov/ct2/show/record/NCT03521778 (03.10.2018)
28 Schulze C, Finze S, Bader R. et al. Treatment of Medial Tibial Stress Syndrome according to the Fascial Distortion Model: A Prospective Case Control Study. 2014 www.hindawi.com/journals/tswj/2014/790626 (01.10.2018)
29 Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale VersorgungsLeitlinie nicht-spezifischer Kreuzschmerz – Langfassung. 2017 (01.10.2018). www.kreuzschmerz.versorgungsleitlinien.de
30 Da C Menezes Costa L, Maher CG, Hancock MJ. et al. The prognosis of acute and persistent low-back pain: a meta-analysis. CMAJ 2012; 184: E613-E624
31 Hartvigsen J, Hancock MJ, Kongsted A. et al. What low back pain is and why we need to pay attention. Lancet 2018; 391: 2356-2367 doi: 10.1016/S0140–6736(18)30480-X
32 Koes BW, van Tulder M, Lin CW. et al. An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J 2010; 19: 2075-2094
33 Bekelman JE, Li Y, Gross CP. Scope and impact of financial conflicts of interest in biomedical research: a systematic review. JAMA 2003; 289: 454-465
34 Gøtzsche PC, Ioannidis JP. Content area experts as authors: helpful or harmful for systematic reviews and meta-analyses?. BMJ 2012; 345: e7031
35 Ioannidis JPA. Evidence-based medicine has been hijacked: a report to David Sackett. J Clin Epidemiol 2016; 73: 82-86
36 Ioannidis JPA. Hijacked evidence-based medicine: stay the course and throw the pirates overboard. J Clin Epidemiol 2017; 84: 11-13
37 Lundh A, Sismondo S, Lexchin J. et al. Industry sponsorship and research outcome. Cochrane Database Syst Rev 2017; 12: MR000033 doi:10.1002/14651858.MR000033.pub2
38 Adstrum S, Hedley G, Schleip R. et al. Defining the fascial system. J Bodyw Mov Ther 2017; 21: 173-177
39 Benjamin M. The fascia of the limbs and back – a review. J Anat 2009; 214: 1-18
40 Schleip R, Jäger H, Klingler W. What is “fascia”? A review of different nomenclatures. J Bodyw Mov Ther 2012; 16: 496-502
41 Standring S. (Hrsg). Gray’s Anatomy – the Anatomical Basis of Clinical Practice. Edinburg: Elsevier; 2008
42 Stecco C, Adstrum S, Hedley G. et al. Update on Fascial Nomenclature. J Bodyw Mov Ther 2018; 22: 354
43 Bialosky JE, Beneciuk JM, Bishop MD. et al. Unravelling the mechanisms of manual therapy: modeling an approach. J Orthop Sports Phys Ther 2018; 48: 8-18
44 Chaudhry H, Schleip R, Ji Z. et al. Three-Dimensional Mathematical Model for Deformation of Human Fasciae in Manual Therapy. J Am Osteopath Assoc 2008; 108: 379-390
45 Seffinger MA, Najm WI, Mishra SI. et al. Reliability of spinal palpation for diagnosis of back and neck pain: a systematic review of the literature. Spine 2004; 29: E413-E425
46 Klingler W, Jäger H, Pedro MT. et al. Faszien als Ursache von Schmerzsyndromen. Aktuelle Schmerzmedizin 2014; 4: 1-7
47 Schleip R, Findley TW, Chaitow L. et al. Fascia. The Tensional Network of the Human Body. London: Churchill Livingstone Elsevier; 2012
48 Langevin HM, Huijing PO. Communicating about fascia: history, pitfalls and recommendations. Int J Thera Massage Bodywork 2009; 2: 3-8
49 Glasziou P. Non-drug treatments and the waste of research. EbM Kongress 2018. www.ebm-netzwerk.de/kongress/2018/keynote1-glasziou.pdf (15.03.2019)
50 Gorski DH, Novella SP. Clinical trials of integrative medicine: testing whether magic works?. Trends Mol Med 2014; 20: 473-476
51 Howick J, Glasziou P, Aronson JK. The evolution of evidence hierarchies: what can Bradford Hill’s “guidelines for causation” contribute?. J R Soc Med 2009; 102: 186-194
52 Lederman E. The fall of the postural-structural-biomechanical model in manual and physical therapies: Exemplified by lower back pain. J Bodyworks & Movement Therapies 2010; 16: 131-138
53 Moseley GL, Butler D. Fifteen Years of Explaining Pain: The Past, Present, and Future. J Pain 2015; 16: 807-813
54 Main C, George SZ. Psychologically informed practice for management of low back pain: future directions in practice and research. Phys Ther 2011; 91: 820-824
55 Pincus T, Kent P, Bronfort G. et al. Twenty-five years with the biopsychosocial model for low back pain – is it time to celebrate? A report from the twelfth international forum for primary care research on low back pain. Spine 2013; 38: 2118-2123
56 Bogduk N. Clinical and Radiological Anatomy of the Lumbar Spine. London: Churchill Livingstone Elsevier; 2012
57 Koch R. Über Bakteriologische Forschung. Address Presented at the 10^th International Medical Congress 1890 in Berlin; Verhandlungen des X. Internationalen medicinischen Congresses. Berlin: Hirschwald; 1891
58 Stecco C, Macchi V, Barbieri A. et al. Hand fasciae innervaton: The palmar aponeurosis. Clin Anat 2018; 31: 677-683
59 Willard FH, Vleeming A, Schuenke MD. et al. The thoracolumbar fascia: anatomy, function and clinical considerations. J Anat 2012; 221: 507-536
60 Schilder A, Hoheisel U, Magerl W. et al. Sensory findings after stimulation of the thoracolumbar fascia with hypertonic saline suggest its contribution to low back pain. Pain 2014; 155: 222-231
61 Schilder A, Magerl W, Hoheisel U. et al. Electrical high-frequency stimulation of the human thoracolumbar fascia evokes long-term potentiation-like pain amplification. Pain 2016; 157: 2309-2317
62 Schilder A, Magerl W, Klein T. et al. Assessment of pain quality reveals distinct differences between nociceptive innervation of low back fascia and muscle in humans. Pain Rep 2018; 3: e662
63 Guyatt G, Rennie D, Meadre MO. et al. User’s Guides to the Medical Literature. A Manual for Evidence-Based Clinical Practice. New York: McGraw Hill; 2008
64 Hackam DG, Redelmeier DA. Translation of research evidence from animals to humans. JAMA 2006; 296: 1731-1732
65 Ioannidis JPA. Why most published research findings are false. PLoS Med 2005; 2: e124
66 Perel P, Roberts I, Sena E. et al. Comparison of treatment effects between animal experiments and clinical trials: systematic review. BMJ 2007; 334: 197
67 Latremoliere A, Woolf CJ. Central Sensitization: A Generator of Pain Hypersensitivity by Central Neural Plasticity. J Pain 2009; 10: 895-926
68 Vierck Jr CJ. Mechanisms underlying development of spatially distributed chronic pain (fibromyalgia). Pain 2006; 124: 242-263
69 Woolf CJ. Central sensitization: Implications for the diagnosis and treatment of pain. Pain 2011; 152: S2-S15
70 Moseley GL. Teaching people about pain: why do we keep beating around the bush?. Pain Manag 2012; 2: 1-3
71 Bialosky JE, Bishop MD, Price DD. et al. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther 2009; 14: 531-538
72 Ernst E. Wer heilt, hat nicht immer recht. Wien Klin Wochenschr 2009; 121: 223-224
73 Grove WM. Clinical versus Statistical Prediction: The Contribution of Paul E. Meehl. J Clin Psych 2005; 61: 1233-1243
74 Sackett DL, Haynes RB, Guyatt GH. et al. Clinical Epidemiology. A Basic Science for Clinical Decision Making. London: Little Brown; 1991
75 Godlee F. Milestones on the long road to knowledge. BMJ 2007; 334 (Suppl. 01) s2-s3