Helle Borgstrøm, Chairman of DSMM
This was my first participation in the Academy's annual conference.
Academy, or IAMMM, is the international organization of individual members, who are active in the scientific and educational area of Musculoskeletal Medicine. It is obvious that I belong to the last category, the educational field of musculoskeletal medicine. It was my luck that Berit Schiøttz-Christensen, rheumatologist and professor at University of Southern Denmark, participated too. She was able to guide me through the scientific language and set the stage for exciting discussions. I still wonder about her very simple question:
"What can IAMMM do for DSMM?" - I now send on the question to you, members of DSMM. Here are some options we have not fully exploited - also for the individual scientific interested members.
The conference took place in Padua, Italy, at the university where Carla and Antonio Stecco have continued their father, Luigi Steccos research around the fascia. Naturally the main topic was the fascia, and Carla Stecco did a very interesting lecture on the role of fascia in proprioception and pain.
Additionally, there was an extensive program with the presentation of large and small projects. All were given 10 minutes for presentation and 5 minutes for discussion. The level was fluctuating, everything from a large Dutch cohort study to a more "lyrical" Finnish study on the fascial manipulation on 8 violin players. The Dutch study followed 599 patients who visited musculoskeletal physicians for treatment. 60% of the patients had symptoms for more than 1 year before treatment, and most were treated with spinal manipulation. 72% of the patients reported an improvement through the first six months after the start of treatment. The effect was generally sustained at one year follow-up. There were still many data back to analyse in this study.
German Wolfgang von Heymann presented a clinical interesting project. The background for the study was the lack of "golden standard" tests for the diagnosis of dysfunctions in the sacroiliac joints. 10 different functional and pain provocation tests was examined for reliability and compared with previously evaluated pain provocation tests. The data collection is not completed yet, but Wolfgang von Heymann expects that the study will lead to a recommendation for a set of mixed both functional and pain provocation tests.
Berit Schiøttz-Christensen reflected about the best way to select patients for treatments. She is seeking questionnaires of more cognitive nature, e.g. what does the pain do for the patients in their daily functioning.
On the general assembly Berit was elected as a member of the Science Board. She will work for a different and more dynamic structure of the conferences.
I noted that the projects do not distinguish between the different musculoskeletal treatments. I think the main focus is on HV-manipulation. An exception was an American project where Larry Steinbeck and others examined Fascial Manipulation compared to standard physical therapy including manipulation. They found a significant improvement in the group of patients who received Fascial Manipulation.
An Italian study has examined fascia with Ultrasound. They couldn’t detect a less densification of the deep fascia after Fascial Manipulation.
Steccos Facial Manipulation works mechanically by breaking the fibres, which has become thickened or placed in inappropriate direction. The treatment triggers an inflammation and is painful. The MFR treatment, as we know it, is very different. It probably works neurophysiological by changing reflex patterns. It would be interesting if it’s possible by Ultrasound to demonstrate a change in the fascial density after a MFR treatment.
My impression of the conference was that the topics for science are endless. Each project opens up new questions to be answered.
DSMM calls for Danish researchers, who have the time and patience to explore the musculoskeletal area for the benefit of the education and the patients we treat.
Berit Schiøttz-Christensen and Finn Johannsen, rheumatologist and sports physician, are willing to give professional support to get started. DSMM has a research award of 15,000 DDK. It hasn’t been given since 2009. We look forward to an application by the right recipient.