综述：被动与主动肌筋膜技术对运动员恢复期间疼痛、关节活动度及疲劳感知的影响：系统综述与Meta分析

《Journal of Bodywork and Movement Therapies》：Effects of passive and active myofascial techniques on pain, range of motion, and fatigue perception in athlete recovery: A systematic review and meta-analysis

　　Here is the cleaned and formatted text from the HTML content provided:***# Effects of Myofascial Techniques on Pain, Joint Range of Motion, and Perceived Fatigue during Athlete Recovery**Authors:**Vinícius Perezin Mizuta, Maria Eduarda Casagrande Carli, Kamili Victoria da Silva, Rodrigo Okubo**Affiliation:** University of Itajaí Valley, Itajaí, SC, Brazil---### Abstract**Objective**This study aimed to evaluate the effects of myofascial techniques on pain, joint range of motion, and perceived fatigue during athlete recovery.**Methods**A systematic review following PRISMA guidelines was conducted, with searches in PubMed (MEDLINE), Scopus, SportDISCUS, Embase, and PEDro. We included randomized controlled trials published in English between 2000 and 2024 that evaluated the effects of passive (PMT) or active myofascial techniques (AMT) on pain, joint range of motion, and/or perceived fatigue. Methodological quality was assessed using the PEDro scale, and risk of bias was evaluated using RoB-2. Meta-analysis was conducted using R software v4.4.2.**Results**The reviewed trials included 412 athletes, with sample sizes ranging from 20 to 78 participants and intervention sessions averaging 17 minutes (range 7–30 minutes). PMTs were associated with a statistically significant reduction in pain (MD = ?0.85, 95% CI = [?1.53 to ?0.16]). Effects on joint range of motion were inconsistent, as were the effects of both PMT and AMT on fatigue perception. A single session of AMT showed no significant impact on pain (p = 0.0763).**Conclusion**PMTs appear effective in reducing pain during athlete recovery; however, the clinical relevance of these effects remains questionable, as they do not reach the minimum clinically important difference.---### IntroductionThe search for effective training and recovery strategies is essential to maximize athletic performance. However, balancing intense training with efficient recovery is crucial to prevent overloads that lead to inflammation, delayed-onset muscle soreness (DOMS), and increased fatigue perception. This physiological stress, common in competitive sports, may temporarily reduce muscle strength, compromise athletic performance, and increase the risk of injury (BARNETT, 2006; DUPUY et al., 2018).Given the high frequency of training and competitions, the interval between sessions is often insufficient for complete recovery. This scenario is further exacerbated by factors that impair the return to homeostasis, such as sleep quality, psychological aspects, nutrition, and the recovery strategies employed (PUJALTE; BENJAMIN, 2018; GUO et al., 2017; DUPUY et al., 2018; DOHERTY et al., 2021). Recovery, which aims to restore the body to its baseline state, is a crucial practice for maintaining balance and preventing injury (PASTRE et al., 2009).Currently, several recovery methods are widely used in sports, including cryotherapy, contrast baths, active recovery, stretching, compression garments and boots, hyperbaric therapy, electrotherapy, percussive or vibratory therapy, massage, and myofascial techniques (CULLEN; CASAZZA; DAVIS, 2021; MEDEIROS et al., 2023; PASTRE et al., 2009). Among these, myofascial techniques applied passively, such as massage and myofascial release performed by a trained therapist, or actively, such as self-myofascial release with foam rollers or massage sticks (DAVIS; ALABED; CHICO, 2020) stand out for their potential benefits in regulating acute inflammatory markers and improving pain and fatigue perception (PEDRELLI; STECCO; DAY, 2009; SULOWSKA-DASZYK & SKIBA, 2022; MANCINELLI et al., 2006; DELEXTRAT et al., 2012; ZüGEL et al., 2018; ARROYO-MORALES et al., 2008; GAY et al., 2013; GUO et al., 2017).Previous reviews have generally examined massage or self-myofascial release separately and have often included broader exercise populations rather than focusing specifically on athletes during post-exercise recovery (PARRAVICINI; BERGNA, 2017; GAY et al., 2013; GUO et al., 2017). Consequently, uncertainty remains regarding optimal application parameters and the comparative effects of passive and active methods on pain, joint range of motion, and perceived fatigue. This systematic review therefore aimed to evaluate these outcomes after myofascial techniques used for athlete recovery and to identify clinically relevant differences and gaps in the available evidence.---### Methods (Snippets)**Registration**This systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guidelines (MOHER et al., 2009; PAGE et al., 2021).The protocol was registered on October 2, 2023, in the PROSPERO database (International Prospective Register of Systematic Reviews), under registration number CRDxxxxxxxxxxx.**Types of Studies**Full-text randomized controlled trials were included, which compared passive or active myofascial techniques with placebo or...---### ResultsThe systematic literature review initially identified 609 articles. After removing duplicates (96 studies), titles of 513 articles were screened, resulting in 41 selected for abstract review. Of these, 15 met the eligibility criteria and were selected for full-text reading by the reviewers (VPM and MEC). Following this stage, eight studies were included in the systematic review (see Table 2). A detailed summary of the process can be found in the PRISMA flow diagram (Figure 1).*Note: Text indicates "Exclusion of 505" likely referring to the exclusion count in the flow diagram.*---### DiscussionThis systematic review and meta-analysis provide a comprehensive evaluation of the effectiveness of passive (PMT) and active (AMT) myofascial techniques in post-exercise recovery among athletes, drawing evidence from eight randomized controlled trials (RCTs). The findings highlight that PMT produced a statistically significant reduction in pain, as evidenced by the meta-analysis, whereas the results regarding perceived fatigue and range of motion were inconsistent.These results are consistent...---### ConclusionPassive myofascial techniques (PMT), including myofascial release and massage, show a slight reduction in pain during athlete recovery, whereas active myofascial techniques (AMT) did not demonstrate significant differences compared to the control group. Regarding perceived fatigue, although the meta-analysis did not identify statistically significant changes, some studies support the improvement of this outcome following PMT interventions. In contrast, joint range of motion (ROM) yielded...---### Declarations & Metadata**CRediT Authorship Contribution Statement*** **Maria Eduarda Casagrande Carli:** Writing – review & editing, Methodology, Formal analysis.* **Rodrigo Okubo:** Writing – review & editing, Formal analysis.* **Kamili Victoria da Silva:** Visualization.* **Vinícius Perezin Mizuta:** Writing – original draft, Investigation, Formal analysis.**Uncited Reference*** KINSER et al., 2009;.**Patient Consent**Patient Consent – not applicable – systematic review and meta-analysis.**Ethical Approval**Not applicable.**Declaration of Competing Interest**We certify that this manuscript is original, has not been published previously, and is not under consideration by any other journal. All authors have read and approved the final manuscript and have no conflicts of interest to declare.? The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.**Funding**Not applicable.---*Note: The PROSPERO registration number in the text appears as a placeholder ("CRDxxxxxxxxxxx").*