# Impact of Manual Therapy on Plantar Pressures in Patients with Fibromyalgia: A Single-Arm, Non-Randomized Pilot Clinical Trial

## TL;DR

This study found that manual therapy on the lower back improved plantar pressure distribution in fibromyalgia patients, especially those with normal BMI.

## Contribution

The study introduces a novel manual therapy protocol targeting dorsal muscles to improve plantar pressure in fibromyalgia patients.

## Key findings

- Manual therapy significantly improved plantar pressure distribution in both feet of fibromyalgia patients.
- Patients with normal BMI showed greater improvements compared to those who were overweight.
- No significant changes were observed in strength or peak pressure metrics.

## Abstract

Background: Fibromyalgia (FM) is a chronic disorder causing widespread musculoskeletal pain, often leading to physical deconditioning that affects posture and gait. This study evaluates the effects of a manual therapy protocol targeting dorsal muscles in the lower back on plantar pressure modifications, considering body mass index (BMI) influence. Methods: A single-arm, non-randomized clinical trial included 24 women diagnosed with FM for at least three years. They underwent an eight-session manual therapy protocol over four weeks, applying moderate pressure to dorsal muscles in the lower back. Baropodometric analyses were conducted pre- and post-intervention under dynamic conditions. Statistical analyses used paired t-tests and effect size calculations to assess intervention effects and BMI impact. Results: Significant improvements in plantar pressure distribution were observed in both the left foot (p = 0.01, d = −0.54) and the right foot (p = 0.008, d = −0.59). However, strength and peak pressure metrics showed no significant changes. Patients with normal BMI exhibited greater improvements than those in the overweight category. Conclusions: Preliminary findings suggest that manual therapy positively influenced plantar pressure distribution in FM patients, particularly in those with normal BMI. Further research is needed to explore long-term effects and broader clinical applications.