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The Role of Fascia in Pain Perception and Manual Therapy

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A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Biomedical Engineering and Biomaterials".

Deadline for manuscript submissions: closed (15 April 2023) | Viewed by 9166

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Special Issue Editors

Dr. Caterina Fede

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Guest Editor

Department of Neuroscience, University of Padova, 35122 Padova, Italy
Interests: fascia; pain; extracellular matrix; hyaluronan; collagen; sex hormones; aging
Special Issues, Collections and Topics in MDPI journals

Dr. Chiara Giulia Fontanella

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Guest Editor

Department of Industrial Engineering, University of Padova, Padova, Italy
Interests: mechanics of biological tissues; computational biomechanics; experimental biomechanics; biomechanics for surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Bioengineering is a discipline which deals with the application of engineering principles to problems of medical and/or biological interest. It allows to describe a process, a tissue, or a cell using an engineering approach, and to develop tools for diagnosis, therapy, and rehabilitation, involving different disciplines in physiological and pathological contests. In the last few decades, the fasciae have received huge interest from researchers and clinicians for their role in proprioception and motor coordination (deep fasciae), thermoregulation, lymphatic and blood circulation and exteroception (superficial fasciae). The characterization of mechanical behaviour plays a crucial role in the comprehensive analysis of the fasciae functionality and for the investigation of pathological phenomena. In addition, fasciae disorders can be identified on conventional imaging modalities, such as plain radiography, ultrasound, and MRI, thus representing a valuable guide to the proper diagnosis of disease.

The knowledge of the structural organization and mechanical behavior of these tissues in the different regions of the body in normal and pathological conditions can influence the results of manual therapy. This Special Issue, “The Role of Fascia in Pain Perception and Manual Therapy”, aims to publish the latest developments in the role of the different fasciae in pain perception with a major emphasis on the tools for diagnosis, on the mechanism of action of manual therapy with a difference between superficial or deep massage, on the bioimages analysis, and on the investigation of the mechanical behaviour. Original research, brief reports, and review articles are invited.

Dr. Caterina Fede
Dr. Chiara Giulia Fontanella
Guest Editors

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Keywords

superficial fascia
deep fascia
manual therapy
mechanical behavior
pain perception
diagnostic tool
proprioception/exteroception

Published Papers (3 papers)

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Research

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16 pages, 4999 KiB

Open AccessArticle

Effects of a Myofascial Technique on the Stiffness and Thickness of the Thoracolumbar Fascia and Lumbar Erector Spinae Muscles in Adults with Chronic Low Back Pain: A Randomized before-and-after Experimental Study

by Karine Devantéry, Mélanie Morin, Julien Grimard and Nathaly Gaudreault

Bioengineering 2023, 10(3), 332; https://doi.org/10.3390/bioengineering10030332 - 6 Mar 2023

Viewed by 3416

Abstract

The thoracolumbar fascia (TLF) may be a pain generator, given its rich innervation. Structural and biomechanical changes have also been documented in adults with chronic non-specific low back pain (LBP). Myofascial techniques (MFTs) are commonly used in manual therapy and are hypothesized to reduce tissue stiffness and pain. However, evidence for these effects is limited. The objective of this study was to evaluate the immediate effects of a standardized MFT compared to a simulated MFT on: (1) the stiffness of the TLF and erector spinae muscles (shear-wave sonoelastography), (2) the thickness of the TLF (B-mode ultrasound), and (3) pain intensity (numerical rating scale). Forty-nine participants with chronic non-specific LBP were included in a randomized before-and-after experimental study. Outcome measures were collected before (T0) and immediately after the intervention (T1). Pain intensity was also assessed on day two (T2) and seven (T7). The MFT group showed a significant decrease in left erector spinae muscle stiffness and left TLF thickness compared to the simulated group. In addition, there was a significant reduction in pain intensity in the MFT group compared to the simulated group at T1 and T2. The results of this study suggest that MFT results in immediate tissue changes and transient pain reduction in patients with LBP. Full article

(This article belongs to the Special Issue The Role of Fascia in Pain Perception and Manual Therapy)

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13 pages, 1857 KiB

Open AccessArticle

Mechanical Characterization of Human Fascia Lata: Uniaxial Tensile Tests from Fresh-Frozen Cadaver Samples and Constitutive Modelling

by Lorenza Bonaldi, Alice Berardo, Carmelo Pirri, Carla Stecco, Emanuele Luigi Carniel and Chiara Giulia Fontanella

Bioengineering 2023, 10(2), 226; https://doi.org/10.3390/bioengineering10020226 - 7 Feb 2023

Cited by 4 | Viewed by 1916

Abstract

Human Fascia Lata (FL) is a connective tissue with a multilayered organization also known as aponeurotic fascia. FL biomechanics is influenced by its composite structure formed by fibrous layers (usually two) separated by loose connective tissue. In each layer, most of the collagen fibers run parallel in a distinct direction (with an interlayer angle that usually ranges from 75–80°), mirroring the fascia’s ability to adapt and withstand specific tensile loads. Although FL is a key structure in several musculoskeletal dysfunctions and in tissue engineering, literature still lacks the evidence that proves tissue anisotropy according to predominant collagen fiber directions. For this purpose, this work aims to analyze the biomechanical properties of ex-vivo FL (collected from fresh-frozen human donors) by performing uniaxial tensile tests in order to highlight any differences with respect to loading directions. The experimental outcomes showed a strong anisotropic behavior in accordance with principal collagen fibers directions, which characterize the composite structure. These findings have been implemented to propose a first constitutive model able to mimic the intra- and interlayer interactions. Both approaches could potentially support surgeons in daily practices (such as graft preparation and placement), engineers during in silico simulation, and physiotherapists during musculoskeletal rehabilitation, to customize a medical intervention based on each specific patient and clinical condition. Full article

(This article belongs to the Special Issue The Role of Fascia in Pain Perception and Manual Therapy)

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Other

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17 pages, 1329 KiB

Open AccessSystematic Review

Deep Learning-Based Medical Images Segmentation of Musculoskeletal Anatomical Structures: A Survey of Bottlenecks and Strategies

by Lorenza Bonaldi, Andrea Pretto, Carmelo Pirri, Francesca Uccheddu, Chiara Giulia Fontanella and Carla Stecco

Bioengineering 2023, 10(2), 137; https://doi.org/10.3390/bioengineering10020137 - 19 Jan 2023

Cited by 6 | Viewed by 2827

Abstract

By leveraging the recent development of artificial intelligence algorithms, several medical sectors have benefited from using automatic segmentation tools from bioimaging to segment anatomical structures. Segmentation of the musculoskeletal system is key for studying alterations in anatomical tissue and supporting medical interventions. The clinical use of such tools requires an understanding of the proper method for interpreting data and evaluating their performance. The current systematic review aims to present the common bottlenecks for musculoskeletal structures analysis (e.g., small sample size, data inhomogeneity) and the related strategies utilized by different authors. A search was performed using the PUBMED database with the following keywords: deep learning, musculoskeletal system, segmentation. A total of 140 articles published up until February 2022 were obtained and analyzed according to the PRISMA framework in terms of anatomical structures, bioimaging techniques, pre/post-processing operations, training/validation/testing subset creation, network architecture, loss functions, performance indicators and so on. Several common trends emerged from this survey; however, the different methods need to be compared and discussed based on each specific case study (anatomical region, medical imaging acquisition setting, study population, etc.). These findings can be used to guide clinicians (as end users) to better understand the potential benefits and limitations of these tools. Full article

(This article belongs to the Special Issue The Role of Fascia in Pain Perception and Manual Therapy)

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