2016 – Evaluating the impact of General Swedish Massage, Cross Fiber Frictions, Neuromuscular and Myofascial Techniques on Range of Motion, Skin sensation and Nerve pain in a Third-Fourth Degree Chronic Burned Victim: A Case Study

Posted:Friday, February 10, 2017

Nicole Gnadt, LMT

Objective: To determine if Myofascial release, Swedish massage, Neuromuscular therapy, and frictions performed local to affected bilateral chest; combined with pain free stretch and strengthen exercises has an impact on pain, itch, anxiety, range of motion, sensory of the skin, and nerve pain in a chronic burned victim. The goal is to decrease adhesions, hypertonicity, improve tissue elasticity in the client’s bilateral chest area, and restore range of motion to the bilateral glenohumeral joints.

Case Selection: A Caucasian male, age thirty, with no history of illness nor use of other therapies, who has a chronic third-fourth degree burn to his bilateral chest and the right side of his neck. The client has a full thickness graft in the form of an oval shape to the middle section of his throat and normal skin grafts to his bilateral chest and the right side of his neck.

Methods: Seven 60-minute treatments were conducted, twice a week. Prior to each treatment, 30-minutes of assessments were collected, including the McGill pain questionnaire, state trait anxiety form, and active/passive range of motion tests. Resisted muscle testing, pec contractor test, a two-point discrimination test, and a modified nerve pain test were done prior to the first treatment and after the seventh treatment. The 60-minute massage treatment consisted of Myofascial release, Neuromuscular therapy, Swedish massage and Cross Fiber frictions. Homecare recommended included the use of a stretch and strengthen exercise with a moisturizer.

Results: The client had a significant increase in nerve pain and skin sensation to his chest bilaterally. Upper/middle trapezius strength increased, as well as range of motion of his bilateral glenohumeral joints. The client had a significant decrease in the McGill pain score and itch with use of certain massage techniques. Following the seventh treatment, the pec contracture test was negative but no difference was found in state trait anxiety.

Conclusion: Massage was beneficial in reducing itching and pain levels, as well as increasing overall range of motion, nerve pain and skin sensation in a third-fourth degree chronic burned victim.