Abdominal Wall-targeted Myofascial Release Therapy in Pediatric Patients with Irritable Bowel Syndrome: A Feasibility and Acceptability Study

Background: Myofascial release (MFR) is a form of massage therapy that involves identifying and releasing restrictions in the fascia and muscles. MFR-like techniques have shown improvement in abdominal pain, distention, constipation, and quality of life (QoL) in adults. Therefore, MFR may be helpful in patients with irritable bowel syndrome (IBS), a disorder of gut-brain interaction or functional gastrointestinal disorder, mainly presenting with prolonged abdominal pain, bloating, and altered defecation patterns, leading to impairment in QoL. Treatments for IBS are limited and do not always completely relieve pain. To date, no studies have evaluated the feasibility and acceptability of MFR for children with IBS as a potential therapy.

Purpose: The aim of the study is to assess the feasibility and acceptability of administering abdominal wall-targeted MFR in children with IBS.

Setting: This study was approved and conducted at Children's Hospital of Philadelphia.

Participants: Males and females aged 13-18 years meeting Rome IV criteria for IBS were included in the study.

Research design: Participants underwent six 1-h weekly sessions of abdominal wall-targeted MFR with a licensed massage therapist (LMT) and performed self-MFR at home between sessions. Feasibility and acceptability data were collected via REDCap (Research Electronic Data Capture) by the study team and LMTs. Symptoms and QoL were assessed before and after the intervention period using child and parent versions of validated pediatric questionnaires.

Results: Of 10 participants aged 14-18 years, 60% females underwent the MFR intervention and completed the 6-week protocol. The median visit compliance with questionnaire completion was 90%. All participants received self-MFR education and performed self-MFR between sessions. Fascia restrictions were identified and released in all participants, as reported by the LMTs. Most participants voluntarily provided positive feedback on MFR. All participants reported no or minimal soreness during or after MFR, and no adverse events were reported.

Conclusions: Abdominal wall-targeted MFR is feasible to administer and well accepted in pediatric IBS patients.