What is evidence-based about myofascial chains? A systematic review.
- 1Goethe University Frankfurt/Main, Department of Sports Medicine, Frankfurt am Main, Germany. Electronic address: firstname.lastname@example.org.
- 2Goethe University Frankfurt/Main, Department of Sports Medicine, Frankfurt am Main, Germany.
To provide evidence for the existence of six myofascial meridians proposed by Myers (1997) based on anatomical dissection studies.
Relevant articles published between 1900 and December 2014 were searched in MEDLINE (Pubmed), ScienceDirect and Google Scholar.
Peer-reviewed human anatomical dissection studies reporting morphological continuity between the muscular constituents of the examined meridians were included. If no study demonstrating a structural connection between two muscles was found, papers on general anatomy of the corresponding body region were targeted.
A continuity between two muscles was only documented if two independent investigators agreed that it was reported clearly. Also, two independent investigators rated methodological quality of included studies by means of a validated assessment tool (QUACS).
The literature search identified 6589 articles. Of these, 62 papers met the inclusion criteria. The studies reviewed suggest strong evidence for the existence of three myofascial meridians: the superficial back line (all three transitions verified, based on 14 studies), the back functional line (all three transitions verified, 8 studies) and the front functional line (both transitions verified, 6 studies). Moderate to strong evidence is available for parts of the spiral line (five of nine verified transitions, 21 studies) and the lateral line (two of five verified transitions, 10 studies). No evidence exists for the superficial front line (no verified transition, 7 studies).
The present systematic review suggests that most skeletal muscles of the human body are directly linked by connective tissue. Examining the functional relevance of these myofascial chains is the most urgent task of future research. Strain transmission along meridians would both open a new frontier for the understanding of referred pain and provide a rationale for the development of more holistic treatment approaches.
Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
PMID: 26281953[PubMed – as supplied by publisher]
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