The effectiveness of diacutaneous fibrolysis on pain, range of motion and functionality in musculoskeletal disorders: A systematic review and meta-analysis

Objective: To assess the effectiveness of diacutaneous fibrolysis in reducing musculoskeletal disorders symptoms such as pain, range of motion and functionality. Data sources: A systematic review of MEDLINE, Cochrane, PEDro and Science Direct was conducted until September 2020. Review methods: Computerized search strategy was performed to identify randomized controlled trials applying diacutaneous fibrolysis, on subjects with musculoskeletal disorders. Eligible articles and data extraction were conducted independently by two reviewers. Methodology quality and risk of bias were assessed by Risk of Bias 2 tool from the Cochrane Collaboration and Physiotherapy Evidence Database. Outcomes assessed were pain intensity, range of motion and functionality. Results: Search strategy identified 98 potential randomized control trials and six studies involving 386 participants, were finally included. Diacutaneous fibrolysis intervention added to usual physiotherapy treatment was compared to control group. Pain intensity immediately after treatment showed a pooled Standard Mean Difference (SMD) of –0.58 with 95% confidence interval (CI) from –1.12 to –0.04, and in the longest follow-up SMD was –0.63 with 95% CI (–1.21 to –0.05). Functionality showed a pooled SMD of –1.02 with 95% CI (–1.67 to –0.36) immediately after intervention and a SMD of –0.84 with 95% CI (–1.54 to –0.14). Range of motion could not be included in the quantitative synthesis. Conclusion: Diacutaneous fibrolysis is an effective treatment, when combined with conventional physiotheraphy, reducing pain immediately after treatment and long term follow-up and improving function in both, short and long term in musculoskeletal disorders.