Dermal-Fascial Restoration

Dermal-Fascial Restoration℠ (DFR℠) is an innovative approach developed by Dr. Paul Mettler to treat musculoskeletal conditions. Through DFR, physical therapists are able to restructure (or release) scar tissue that connects the deeper layers to muscle fascia—without causing further injury.

Dermal-Fascial Restoration is a new approach for addressing the effect of inflammatory processes on the muscular-skeletal system. When combined with traditional therapy methods, the rate and magnitude of recovery is improved dramatically. Dr. Mettler and his associates have successfully treated more than 7,500 patients with average scores of 70% to 90% in functional improvement and over 98% in patient satisfaction. Results are objective, immediate, and long-lasting.

DFR can benefit anyone newly referred to physical therapy, as well as those with acute or chronic conditions who have not responded to other forms of physical therapy or medical treatments.

We combine DFR with traditional therapy methods (e.g., conventional medical treatments, manual physical therapy, exercise and massage) to dramatically improve the rate and magnitude of recovery from a variety of injuries.

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^ Based on a randomized sample of new Mettler patients treated from 2009–2012 using the Oswestry, DASH, NDI and LEFS self-report outcomes scoring systems with a comparison to the following studies:

Low Back (Oswestry)

  1. Nunn N. Practical challenges and limitations using the Oswestry Disability Low Back Pain Questionnaire in a private practice setting in New Zealand. A clinical audit. New Zealand J of Physiother. 2012;40(1):24-28.
  2. Unsgaard-Tøndel M, Fladmark A, Salvesen &, Vasseljen O. Motor control exercises, sling exercises, and general exercises for patients with chronic low back pain: a randomized controlled trial with 1-year follow-up. Phys Ther. 2010;90(10):1426-1440.
  3. Unlu Z, Tasci S, Tarhan S, Pabuscu Y, Islak S. Comparison of 3 physical therapy modalities for acute pain in lumbar disc herniation measured by clinical evaluation and magnetic resonance imaging. J Of Manip & Phys Therapeutics. 2008;31(3):191-198.

Upper Extremity/Shoulder (DASH)

  1. Camargo P, Haik M, Ludewig P, Filho R, Mattiello-Rosa S, Salvini T. Effects of strengthening and stretching exercises applied during working hours on pain and physical impairment in workers with subacromial impingement syndrome. Physiotherapy Theory & Practice. 2009;25(7):463-475.
  2. Badke M, Wooden M, Fly K, Boissonault W, Ekedahl S. Patient Outcome Following Rehabilitation for Rotator Cuff Repair Surgery: The Impact of Selected Medical Comorbidities. J Orthop Sports Phys Ther. 2007;37(6):312-319.
  3. Brennan G, Parent E, Cleland J. Description of Clinical Outcomes and Postoperative Utilization of Physical Therapy Services Within 4 Categories of Shoulder Surgery. J Orthop Sports Phys Ther. 2010;40(1):20-29.

Cervical/Neck (NDI)

  1. Fritz J, Brennan G. Preliminary examination of a proposed treatment-based classification system for patients receiving physical therapy interventions for neck pain. Physical Therapy. 2007;87(5):513-524.
  2. Dunning J, Cleland J, Waldrop M, Arnot C, Young I, Turner M, Sigurdsson G. Upper Cervical and Upper Thoracic Thrust Manipulation Versus Nonthrust Mobilization in Patients With Mechanical Neck Pain: A Multicenter Randomized Clinical Trial. J Orthop Sports Phys Ther. 2012;42(1):5-18.
  3. Young I, Michener L, Cleland J, Aguilera A, Snyder A. Manual therapy, exercise, and traction for patients with cervical radiculopathy: a randomized clinical trial. Phys Ther. 2009;89(7):632-642.
  4. Ask T, Strand L, Skouen J. The effect of two exercise regimes; motor control versus endurance/strength training for patients with whiplash-associated disorders: a randomized controlled pilot study. Clin Rehab. 2009;23(9):812-823.

Hip, leg, knee, foot and ankle (LEFS)

  1. Abbott J, Kidd M, Stockwell S, Cheney S, Gerrad D, Flynn T, Cleland J. Manual Physical Therapy and Exercise Versus Electrophysical Agents and Exercise in the Management of Plantar Heel Pain: A Multicenter Randomized Clinical Trial. J Orthop Sports Phys Ther. 2009;39(8):573-585.