Active Myofascial Therapy (AMT) combines manual and movement therapy in an integrated biopsychosocial approach to promote recovery in clients with injuries, pain, or restricted movement
by Irene Diamond, San Francisco California, United States
published May 25, 2018
The science and anecdotal responses from patients and clients who've received AMT, supports our belief that Active Myofascial Therapy is more effective than passive modalities of traditional physical therapy, chiropractic treatments, massage therapy and other therapies where the patient passively receives their treatment.
Due to the client/patient being an active partner in their care, and physically active throughout their therapy session, AMT provides long-lasting, fast, comprehensive relief for pain, injuries, and restricted movement,
Although the name, Active Myofascial Therapy, might seem to indicate an adherence to earlier tissue-based explanatory mechanisms that the modern pain science community has moved past, it is instead a link to the history and the style of the work which officially began in 1988 — retaining the name, while replacing the underlying ideas with scientifically plausible theory as the knowledge progressed (1). The retention of the name AMT also provides continuity for clients to base their treatment decisions on, in light of the track record that it has amassed over decades of practice.
AMT continues to evolve with scientific knowledge about therapeutic mechanisms and outcomes, incorporating more factors than just a simple tissue-based orientation, and it is consistent with modern anatomy, physiology, pathology, psychology, neuroscience, and pain science (2).
During the Active Myofascial Therapy Session the Client Partners With the Practitioner:
- The client and practitioner work together to communicate clearly throughout the continuum of care so they are both aware of the expectations and responsibilities of each other as therapy progresses, to reach the determined clinical goal.
- The client is directed to move in prescribed ways, while the practitioner is applying the manual manipulation and is always in control of their perceived level of comfort/discomfort. AMT uses a client-subjective scale of 0-10, where the client should never experience anything they would consider 'painful'. This means the manual pressure applied to their body will always be less than or equal to an 8/10 on their subjective scale. (We believe this level to be the therapeutic, appropriate manually-applied pressure).
- The client is guided to be aware of and observe any changes they notice throughout receiving the therapy as well as after the therapy session.
- The client will have Home Exercises suggested for development and improvement of strength, flexibility, stability and neurophysiology. (AMT refers to the corrective exercises as "Actions")
Massage and manual manipulation has repeatedly and reliably demonstrated strong effectiveness in reducing pain and its associated anxiety and depression, both in the short term and in the long term (3-23). Movement therapy similarly has demonstrated promising results that are consistent with emergent neuroscience findings regarding rehabilitation and recovery, motor learning, brain plasticity, and the effects of self-efficacy and resilience on activities of daily living and quality of life (24-30).
AMT integrates these therapies in a systemic way, utilizing multiple physical and neurophysiological mechanisms. Drawing upon the strengths of both therapies, AMT offers clients individualized care and lasting results based on the non-invasive and low-risk methods of skilled manual therapists and interactive exercises, as well as health education to help them maintain their clinical progress.
Interactor Model of Interactivity:
Adding the client-active component of interactive movement therapy, and practicing manual manipulation in a way that is less passive for the client than the way that massage and other manual therapies are generally practiced, means that AMT is closer to Jacobs' and Silvernail's more client-centered "interactor" model than to the "operator" model on a passive client, that had been a previous understanding of clinical roles (31, 32).
The interactivity involved in AMT's engagement among the client, the intervention, the therapist, and the environment builds upon the strengths of its component modalities by engaging, mirroring, and guiding the client, providing an opportunity for increasing the client's self-efficacy, resiliency, well-being, and feelings of empowerment—lasting changes that maintain outcome improvements outside of the clinic, and crucial reasons that the attest research evidence in neuroscience supports the more active approach.
Social Aspects of Pain:
Additionally, while it is very early to claim firm linkages, the work by Mogil and by Koban (33-41) on the social aspects of pain—how pain is experienced and mediated by the presence of trusted and caring others—holds the promise of eventually providing insight on the effectiveness of the interactive aspect of AMT, and the therapeutic alliance it creates.
For all these reasons, we believe that AMT is strongly consistent with the evidence-based and science-based practice of massage, and other manual and movement-based treatments.
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