Journal of Bodywork and Movement Therapies, 2014/04, 18(2):165–73. doi: 10.1016/j.jbmt.2013.09.010, type of study: ,srma,,,,,,,,,

Full text    (https://www.bodyworkmovementtherapies.com/article/S1360-8592(13)00136-8/fulltext)

Keywords:

osteopathic manipulative treatment [3945]
OMT [3924]
trigger points [33]
strain and counterstrain [33]
strain counterstrain [31]
patient positioning [3]
systematic review [445]
meta analysis [80]

Abstract:

BACKGROUND: Strain counterstrain (SCS) is an indirect osteopathic manipulative technique that uses passive positioning to relieve tender point (TP) palpation pain and associated dysfunction. OBJECTIVE: The purposes of this systematic review with meta-analysis were to 1) determine the pooled effect of SCS on TP palpation pain compared to a control condition and 2) assess the quality of the overall evidence. DATA SOURCE: A search conducted using the MEDLINE with AMED, PUBMED, CINAHL, and SCOPUS databases for publications from January 2002 and April 2012 yielded 29 articles for eligibility screening. STUDY SELECTION: Included studies were limited to randomized control trials comparing TP palpation pain after isolated SCS treatment compared to control conditions assessed with a visual analog scale. Other study designs or manipulative treatments were excluded. DATA EXTRACTION: Two reviewers adhered to a predetermined study protocol following current Cochrane Collaboration recommendations to independently extract the data with standardized extraction forms and assess studies for methodological quality and determine risks of bias. RESULTS: Five randomized control trials were included for qualitative and quantitative analysis. The pooled effect of SCS was a reduction of TP palpation pain (p < 0.001, 95% CI -0.291 to -0.825). The overall evidence quality was low: while all studies met at least 8 of 12 methodological quality criteria, most were low quality. CONCLUSIONS: This systematic review and meta-analysis found low quality evidence suggesting that SCS may reduce TP palpation pain. Future studies with larger samples of better quality studies with patient populations that assess long-term pain, impairment, and dysfunction outcomes could enrich the literature.