1
|
Wagner TD, Paul ME, Youngson LR, Levin DR. Lessons Learned on a High-Altitude Expedition to Mount Kilimanjaro. Wilderness Environ Med 2023; 34:354-360. [PMID: 37147268 DOI: 10.1016/j.wem.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 03/03/2023] [Accepted: 03/03/2023] [Indexed: 05/07/2023]
Abstract
High-altitude expeditions expose teams to particular medical, environmental, and social challenges that can have unintended and severe consequences for crew members. In June 2017, the 9-d Equal Playing Field (EPF) expedition to Mount Kilimanjaro to set a world record for the highest-altitude soccer match ever played demonstrated the variety of challenges that may arise during these types of trips. This trip included a full-length soccer match at 5714 m (18,746 ft), leading to additional challenges for expedition members participating in the athletic event. The EPF medical team identified the challenges that occurred during the expedition and documented the methods used to resolve these challenges in real time. From the challenges faced during the expedition, we describe the lessons learned for future expeditions to Mount Kilimanjaro and other high-altitude environments. Challenges arose with medical tent visibility, medical disqualification, underreporting of medical events, and acute pain management, while anticipated challenges with interpersonal conflict did not occur. The rigorous preparation and anticipation by the EPF medical team prior to expedition departure may have helped mitigate this conflict as well as prevented unintended severe medical events from occurring.
Collapse
Affiliation(s)
- Thomas D Wagner
- Columbia University Vagelos College of Physicians & Surgeons, New York, NY.
| | - Megan E Paul
- Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Dana R Levin
- Department of Emergency Medicine, Weill Cornell Medical Center, New York, NY; Department of Aerospace Medicine, University of Texas Medical Branch, Galveston, TX; Department of Emergency Medicine, University of Colorado Anschutz School of Medicine, Aurora, CO
| |
Collapse
|
2
|
Baxter AL, Thrasher A, Etnoyer-Slaski JL, Cohen LL. Multimodal mechanical stimulation reduces acute and chronic low back pain: Pilot data from a HEAL phase 1 study. FRONTIERS IN PAIN RESEARCH 2023; 4:1114633. [PMID: 37179530 PMCID: PMC10169671 DOI: 10.3389/fpain.2023.1114633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/22/2023] [Indexed: 05/15/2023] Open
Abstract
Background Effective non-opioid pain management is of great clinical importance. The objective of this pilot study was to evaluate the effectiveness of multimodal mechanical stimulation therapy on low back pain. Methods 11 female and 9 male patients aged 22-74 years (Mean 41.9 years, SD 11.04) receiving physical rehabilitation for acute (12) or chronic (8) low back pain chose heat (9) or ice (11) to accompany a 20-minute session of mechanical stimulation (M-Stim) therapy (Registered with Clinicaltrials.gov NCT04494841.) The M-Stim was delivered in 12 possible repeating "therapy cycle" patterns by three vibration motors (50 Hz, 100 Hz, 200 Hz) with amplitudes between 0.1-0.3 m/s2. Ten patients used a contained motor chassis attached to a thermoconductive single-curve metal plate. The next 10 patients' device had motors attached directly to a multidimensionally curved plate. Results Mean pain on a 10 cm Visual Analog Scale (VAS) with the first motor/plate configuration went from 4.9 ± 2.3 cm to 2.5 ± 2.1 cm (57% decrease, p = 0.0112), while the second reduced pain from 4.8 ± 2.0 cm to 3.2 ± 1.9 cm (45%, p = 0.0353). Initial pain was greater with acute injury (5.8 ± 2.0 cm vs. 3.98 ± 1.8, p = 0.025) and for patients older than 40 (5.44 vs. 4.52), but pain reduction was proportional for chronic and younger patients. There was no significant difference between plate configurations. Conclusions A Phase I clinical pilot investigation on a multi-motor multi-modal device was promising for drug free pain relief. Results suggested pain relief independent of thermal modality, patient age, or pain chronicity. Future research should investigate pain reduction over time for acute and chronic pain. Clinical Trial Registration https://ClinicalTrials.gov, identifier: NCT04494841.
Collapse
Affiliation(s)
- Amy L Baxter
- Pain Care Labs, Atlanta, GA, United States
- Department of Emergency Medicine, Augusta University, Augusta, GA, United States
| | | | | | - Lindsey L Cohen
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| |
Collapse
|
3
|
van Amstel RN, Jaspers RT, Pool-Goudzwaard AL. Skin Displacement as fascia tissue manipulation at the lower back affects instantaneously the flexion-and extension spine, pelvis, and hip range of motion. Front Physiol 2022; 13:1067816. [PMID: 36505071 PMCID: PMC9727291 DOI: 10.3389/fphys.2022.1067816] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/31/2022] [Indexed: 11/24/2022] Open
Abstract
Low back pain (LBP), associated with spine, pelvis, and hip mobility impairments can be caused by tight muscle contractions, to protect sensitized lumbar fasciae. Fascia tissue manipulations are used to treat lumbar fascia in LBP. The effect of fascia tissue manipulations through lumbodorsal skin displacement (SKD) on mobility is inconclusive likely depending on the location and displacement direction of the manipulation. This study aimed to assess whether lumbodorsal SKD affects the flexion -and extension range of motion (ROM), in healthy subjects. Furthermore, we aimed to test the effect of SKD at different locations and directions. Finally, to assess intertester and intratester reliability of SKD. Effects of SKD were tested in a motion capture, single-blinded, longitudinal, experimental study. Sixty-three subjects were randomly assigned to SKD- or sham group. SKD group was subjected to either mediolateral directed SKD during flexion or extension movement, versus a sham. The thoracic, lumbar, and hip angles and finger floor distance were measured to assess the change in ROM. Statistics indicated that the effect size in instantaneously change of flexion -and extension ROM by SKD was large (Effect size: flexion η2 p = 0.12-0.90; extension η2 p = 0.29-0.42). No significant effect was present in the sham condition. Flexion ROM decreased whereas the extension ROM increased, depending on SKD location- and displacement direction (p < 0.05). The ICC indicates a good intertester and intratester reliability (resp. ICC3,k = 0.81-0.93; ICC3,1 = 0.70-0.84). Lumbodorsal SKD affects the flexion- and extension spine, pelvis, and hip range of motion. The effects of SKD are direction- and location dependent as well as movement (flexion/extension) specific. Lumbodorsal SKD during flexion and extension may be useful to determine whether or not a patient would benefit from fascia tissue manipulations. Further research is required to obtain insight into the mechanisms via which the SKD affects ROM and muscle activation, in healthy, asymptomatic-LBP, and LBP subjects.
Collapse
Affiliation(s)
- Robbert N. van Amstel
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands,Fysio Science Department, Fysio Physics Group, IJsselstein, Netherlands,*Correspondence: Robbert N. van Amstel, ; Annelies L. Pool-Goudzwaard,
| | - Richard T. Jaspers
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Annelies L. Pool-Goudzwaard
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands,SOMT, University of Physiotherapy, Amersfoort, Netherlands,*Correspondence: Robbert N. van Amstel, ; Annelies L. Pool-Goudzwaard,
| |
Collapse
|
4
|
Lara-Palomo IC, Gil-Martínez E, Antequera-Soler E, Castro-Sánchez AM, Fernández-Sánchez M, García-López H. Electrical dry needling versus conventional physiotherapy in the treatment of active and latent myofascial trigger points in patients with nonspecific chronic low back pain. Trials 2022; 23:238. [PMID: 35346331 PMCID: PMC8961901 DOI: 10.1186/s13063-022-06179-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background Chronic low back pain is considered to be one of the main causes of absenteeism from work and primary and specialized consultations. The symptoms of nonspecific chronic low back pain may be accompanied by the activation of myofascial trigger points in the muscles, together with local and/or referred pain. Electrical dry needling is increasingly used in the treatment of lumbar myofascial pain. Conventional physiotherapy, however, is a popular approach to chronic pathologies, and there is evidence of different modalities of physiotherapy being used in the treatment of chronic low back pain. The aim of this study has been to determine the effectiveness of electrical dry needling versus conventional physiotherapy when applied to active and latent myofascial trigger points in patients with nonspecific chronic low back pain. Methods This is a controlled, randomized, two-arm, double-blind study. A total of 92 patients with chronic low back pain (time to onset ≥ 3 months, Roland Morris Disability Questionnaire score ≥ 4) will be recruited from the University of Almería. Participants will be divided into two study groups (n = 40) to receive treatment of low back pain with electrical dry needling and conventional physiotherapy (ischaemic compression, analytic stretching and postural education training dossier). A total of 6 sessions will be administered once a week for 6 weeks. Pain intensity, disability, fear of movement, quality of life, quality of sleep, anxiety and depression, pressure pain threshold, abdominal strength and lumbar mobility will be recorded at 6 weeks (post-immediate) and 2 months after the end of treatment. Discussion We believe that an approach including electrical dry needling to chronic low back pain dysfunction will be more effective in these patients. The results of this study will inform clinicians on which type of treatment is more beneficial for patients with chronic low back pain. Trial registration ClinicalTrials.gov NCT04804228. Registered on 14 January 2021 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06179-y.
Collapse
Affiliation(s)
- Inmaculada Carmen Lara-Palomo
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Ctra. Sacramento s/n La Cañada de San Urbano, 04120, Almeria, Spain.
| | - Esther Gil-Martínez
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Ctra. Sacramento s/n La Cañada de San Urbano, 04120, Almeria, Spain
| | - Eduardo Antequera-Soler
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Ctra. Sacramento s/n La Cañada de San Urbano, 04120, Almeria, Spain
| | - Adelaida María Castro-Sánchez
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Ctra. Sacramento s/n La Cañada de San Urbano, 04120, Almeria, Spain
| | - Manuel Fernández-Sánchez
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Ctra. Sacramento s/n La Cañada de San Urbano, 04120, Almeria, Spain
| | - Héctor García-López
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Ctra. Sacramento s/n La Cañada de San Urbano, 04120, Almeria, Spain
| |
Collapse
|
5
|
Yuan S, Wang H, Zhou J. Prevalence and risk factors of low back and pelvic pain in women with rectus abdominis diastasis: a multicenter retrospective cohort study. Korean J Pain 2022; 35:86-96. [PMID: 34966015 PMCID: PMC8728546 DOI: 10.3344/kjp.2022.35.1.86] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/11/2021] [Accepted: 09/23/2021] [Indexed: 11/05/2022] Open
Abstract
Background To explore the association between low back pain (LBP) and pelvic pain (PP) and rectus abdominis diastasis (RAD) in postpartum women and identify the characteristics and risk factors. Methods Women diagnosed with RAD and a history of labor and delivery, between 2009 and 2018, were identified from six hospitals within the Partners Healthcare System. Univariate and multivariable binary logistic regression analyses were used to identify the risk factors associated with pain. Results Age at onset of RAD in the non-cesarean delivery group was earlier than those in cesarean delivery (CD) group (P = 0.017). Women who underwent CD demonstrated 4.5 times greater risk of RAD than those who had no CD exposure. The cumulative composition ratio of LBP at every age stage of the period from 8 years pre-first delivery to 8 years post-first delivery was significantly higher than the other five conditions (RAD, umbilical hernia, PP, depressive disorder [DD], and strain of muscle, fascia, and tendon [SMFT]) (P for trend < 0.001). Women with DD, SMFT, and PP were more likely to have LBP (odds ratio [OR] = 1.91, 95% confidence interval [CI] 1.06 to 3.47, P = 0.032; OR = 4.50, 95% CI 1.64 to 12.36, P = 0.003; OR = 2.14, 95% CI 1.17 to 3.89, P = 0.013; respectively). Conclusions In postpartum women with RAD, DD, SMFT, and PP were found to be risk factors contributing to the development of LBP. Race and LBP also played roles in the development of PP.
Collapse
Affiliation(s)
- Sue Yuan
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Honghong Wang
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Jie Zhou
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
6
|
George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, Gilliam JR, Hendren S, Norman KS. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther 2021; 51:CPG1-CPG60. [PMID: 34719942 PMCID: PMC10508241 DOI: 10.2519/jospt.2021.0304] [Citation(s) in RCA: 200] [Impact Index Per Article: 66.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Low back pain (LBP) remains a musculoskeletal condition with an adverse societal impact. Globally, LBP is highly prevalent and a leading cause of disability. This is an update to the 2012 Academy of Orthopaedic Physical Therapy (AOPT), formerly the Orthopaedic Section of the American Physical Therapy Association (APTA), clinical practice guideline (CPG) for LBP. The overall objective of this update was to provide recommendations on interventions delivered by physical therapists or studied in care settings that included physical therapy providers. It also focused on synthesizing new evidence, with the purpose of making recommendations for specific nonpharmacologic treatments. J Orthop Sports Phys Ther 2021;51(11):CPG1-CPG60. doi:10.2519/jospt.2021.0304.
Collapse
|
7
|
Guo G, Xie S, Cai F, Zhou X, Xu J, Wu B, Wu G, Xiao R, Xu X, Lu P, Fang M. Effectiveness and safety of massage for athletic injuries: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e26925. [PMID: 34397936 PMCID: PMC8360410 DOI: 10.1097/md.0000000000026925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 07/27/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Athletic injuries have been a major area of interest in the field of sports and clinical medicine. Implemented on people's skin, muscles, and joints as an important part of complementary and alternative medicine (CAM), massage therapy has a positive effect on athletic injuries. This protocol is to provide the methods used to evaluate the effectiveness and safety of massage therapy for patients with athletic injuries. METHODS A systematic search will be performed in the following electronic databases for randomized controlled trials (RCTs) to evaluate the effectiveness and safety of massage therapy in treating athletic injuries: PubMed, the Cochrane Library, EMBASE and four Chinese databases (CNKI, Wan Fang, CBMdisc and VIP). Each database will be searched from inception to July 2021. The entire process will include study selection, data extraction, risk of bias assessment and meta-analysis. RESULTS A high-quality synthesis of current evidence of massage therapy for patients with athletic injuries will be provided. CONCLUSIONS This systematic review will provide evidence for assessing the credibility of massage therapy for patients with athletic injuries. DISSEMINATION AND ETHICS The results of this review will be disseminated through peer-reviewed publication. This review does not require ethical approval because all the data used in this systematic review and meta-analysis have already been published. Furthermore, all of these data will be analyzed anonymously during the review process. INPLASY REGISTRATION NUMBER INPLASY202170066.
Collapse
Affiliation(s)
- Guangxin Guo
- School of Acupuncture-moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Shengji Xie
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Feihong Cai
- School of Acupuncture-moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xu Zhou
- School of Acupuncture-moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jianghan Xu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Boyi Wu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Guanghui Wu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Ran Xiao
- School of Acupuncture-moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xiruo Xu
- School of Acupuncture-moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Ping Lu
- School of Acupuncture-moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Min Fang
- School of Acupuncture-moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
- Research Institute of Tuina, Shanghai Academy of Traditional Chinese Medicine, Shanghai 200437, China
| |
Collapse
|
8
|
Price JW. A mixed treatment comparison of selected osteopathic techniques used to treat acute nonspecific low back pain: a proof of concept and plan for further research. J Osteopath Med 2021; 121:571-582. [PMID: 33694350 DOI: 10.1515/jom-2020-0268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/15/2020] [Indexed: 11/15/2022]
Abstract
CONTEXT Back injuries have a high prevalence in the United States and can be costly for both patients and the healthcare system at large. While previous guidelines from the American College of Physicians for the management of acute nonspecific low back pain (ANLBP) have encouraged nonpharmacologic management, those treatment recommendations involved only superficial heat, massage, acupuncture, and spinal manipulation. Investigation about the efficacy of spinal manipulation in the management of ANLBP is warranted. OBJECTIVES To compare the results in previously-published literature documenting the outcomes of osteopathic manipulative treatment (OMT) techniques used to treat ANLBP. The secondary objective of this study was to demonstrate the utility of using Bayesian network meta-analysis (NMA) to perform a mixed treatment comparison (MTC) of a variety of osteopathic techniques. METHODS A literature search for randomized controlled trials (RCTs) of ANLBP treatments was performed in April 2020 according to PRISMA guidelines by searching MEDLINE/PubMed, OVID, Cochrane Central, PEDro, and OSTMED.Dr databases; scanning the reference lists of articles; and using the Canadian Agency for Drugs and Technologies in Health grey literature checklist. Each database was searched from inception to April 1, 2020. The following search terms were used: acute low back pain, acute low back pain plus physical therapy, acute low back pain plus spinal manipulation, and acute low back pain plus osteopathic manipulation. The validity of eligible trials was assessed by the single author using an adapted National Institute for Health and Care Excellence methodology checklist for randomized, controlled trials and an extraction form based on that checklist. The outcome measure chosen for this NMA was the Visual Analogue Scale of pain. The NMA were performed using the GeMTC user interface for automated NMA utilizing a Bayesian hierarchical model of random effects. RESULTS The literature search initially found 483 unduplicated records. After screening and full text assessment, five RCTs were eligible for the MTC, yielding a total of 430 participants. Results of the MTC model suggested that there was no statistically significant decrease in reported pain when exercise, high-velocity low-amplitude (HVLA), counterstrain, muscle energy technique, or a mix of techniques were added to conventional treatment to treat ANLBP. However, the rank probabilities assessment determined that HVLA and the OMT mixed treatment protocol plus conventional care were ranked superior to conventional care alone for improving ANLBP. CONCLUSIONS While this study failed to provide definitive evidence upon which clinical recommendations can be based, it does demonstrate the utility of performing NMA for MTCs of osteopathic modalities used to treat ANLBP. However, to take full advantage of this statistical technique, future studies should be designed with consideration for the methodological shortcomings found in past osteopathic research.
Collapse
Affiliation(s)
- James W Price
- Ascension St. Vincent Occupational Medicine Clinic, Evansville, IN, USA
| |
Collapse
|
9
|
Li L, Stoop R, Clijsen R, Hohenauer E, Fernández-de-Las-Peñas C, Huang Q, Barbero M. Criteria Used for the Diagnosis of Myofascial Trigger Points in Clinical Trials on Physical Therapy: Updated Systematic Review. Clin J Pain 2020; 36:955-967. [PMID: 32841969 DOI: 10.1097/ajp.0000000000000875] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The objective of this study was to conduct an updated systematic review of diagnostic criteria for myofascial trigger points (MTrPs) used in clinical trials of physical therapy interventions from 2007 to 2019. METHODS MEDLINE and Physiotherapy Evidence Database (PEDro) were searched using the following MeSH keywords: "trigger points," "trigger point," "myofascial trigger point," "myofascial trigger points," "myofascial pain," and "myofascial pain syndrome." The MeSH keywords were combined by using Boolean operators "OR"/"AND." All physiotherapy clinical trials including patients with musculoskeletal conditions characterized by at least 1 active MTrP or latent MTrP in any body area were selected. We pooled data from an individual criterion and criteria combinations used to diagnose MTrPs. The protocol was developed in accordance with the PRISMA-P guidelines. RESULTS Of 478 possibly relevant publications, 198 met the inclusion criteria. Of these 198 studies, 129 studies (65.1%) stated specifically the diagnostic criteria used for MTrPs in the main text, 56 studies (28.3%) failed to report any method whereby MTrP was diagnosed, and 13 studies (6.6%) adopted expert-based definitions for MTrPs without specification. Of 129 studies, the 6 criteria applied most commonly were: "spot tenderness" (n=125, 96.9%), "referred pain" (95, 73.6%), "local twitch response" (63, 48.8%), pain recognition (59, 45.7%), limited range of motion" (29, 22.5%), and "jump sign" (10, 7.8%). Twenty-three combinations of diagnostic criteria were identified. The most frequently used combination was "spot tenderness," "referred pain," and "local twitch response" (n=28 studies, 22%). CONCLUSIONS A number of the included studies failed in properly reporting the MTrP diagnostic criteria. Moreover, high variability in the use of MTrP diagnostic was also observed. Spot tenderness, referred pain, and local twitch response were the 3 most popular criteria (and the most frequently used combination). A lack of transparency in the reporting of MTrP diagnostic criteria is present in the literature. REGISTRY This systematic review was registered under the Centre for Reviews and Dissemination, PROSPERO number: CRD42018087420.
Collapse
Affiliation(s)
- Lihui Li
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- School of Medicine, Southern University of Science and Technology, Shenzhen
- Department of Sport Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai, China
| | - Rahel Stoop
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- International University of Applied Sciences THIM, Landquart, Switzerland
| | - Ron Clijsen
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Erich Hohenauer
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Qiangmin Huang
- Department of Sport Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai, China
| | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
| |
Collapse
|
10
|
da Silva AC, De Noronha M, Liberatori-Junior RM, Aily JB, Gonçalves GH, Arrais-Lima C, de Araújo Vieira LMSM, Mattiello SM. The Effectiveness of Ischemic Compression Technique on Pain and Function in Individuals With Shoulder Pain: A Systematic Review. J Manipulative Physiol Ther 2020; 43:234-246. [PMID: 32747150 DOI: 10.1016/j.jmpt.2019.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 07/29/2019] [Accepted: 10/10/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To systematically review current literature to determine the effectiveness of the ischemic compression (IC) technique on pain and function in individuals with shoulder pain. METHODS This review was conducted according to recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Collaboration for Systematic Reviews; a search was performed in the electronic databases PubMed, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, Physiotherapy Evidence Database, and Web of Science. Randomized clinical trials and quasi-randomized clinical trials were included, and the methodological quality was evaluated through the Physiotherapy Evidence Database scale. RESULTS The search found 572 studies; of these, 71 were selected by title and, subsequently, 29 were selected through abstract analyses. After critical analyses, 5 studies were included. The methodological quality ranged from 4 (reasonable) to 9 (excellent) points. Pain was assessed by all studies using the visual analog scale, Global Perceived Effect scale, Numerical Rating Scale, pressure pain threshold, or Perceived Amelioration Numerical Scale. Function was evaluated by 3 studies through the Shoulder Pain and Disability Index; Neck Disability Index; American Shoulder and Elbow Surgeons Standardized Shoulder Assessment; and Disabilities of the Arm, Shoulder, and Hand questionnaires. The studies showed that the IC technique produces immediate and short-term positive effects for pain, and positive short-term effects for shoulder function in individuals with shoulder pain. CONCLUSION The IC technique seems to be beneficial for pain and shoulder function. However, caution is needed when considering this evidence owing to the limited quality of some studies, the few articles found, and the lack of standardization of the application parameters of the technique to facilitate its reproducibility.
Collapse
Affiliation(s)
- Alyssa Conte da Silva
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Marcos De Noronha
- Department of Allied Health, La Trobe University, Bendigo, Victoria, Australia
| | | | - Jéssica Bianca Aily
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Glaucia Helena Gonçalves
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Cristina Arrais-Lima
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | | | - Stela Marcia Mattiello
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.
| |
Collapse
|
11
|
[Myofascial chronic pelvic pain in women : A retrospective evaluation of the effects of specific diagnostics and therapy]. Schmerz 2020; 34:388-399. [PMID: 32725502 DOI: 10.1007/s00482-020-00488-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND The prevalence of chronic pelvic pain of 11.8% in the general population underlines the importance of this disease. However, the specific diagnostics and therapy of the muscles of this region are not yet part of the standard examination. The following study examines the effects of specific diagnostics and therapy on myofascial chronic pelvic pain. OBJECTIVES The effectiveness of targeted diagnostics and multimodal therapy in the context of chronic pelvic pain and the need for a complementary drug adjustment. MATERIALS AND METHODS This study retrospectively evaluated the data of 59 patients, who were referred to a pain center for treatment-resistant chronic pelvic pain in the period from January 2012 to April 2017. The pain needed to be clearly identified as myofascial. A previous minimum duration of pain as well as previous operations or other treatment procedures did not constitute exclusion criteria. Previous traumatization was a reason for exclusion. Therapy components included manual therapeutic treatment, training in self-stretching exercises, medication with the active ingredients flupirtine or methocarbamol, as well as relaxation procedures. Therapy was evaluated on the basis of the German Pain Questionnaire. RESULTS After the treatment interval, the following statistically significant improvements were recorded: The average pain intensity decreased by 29.95 points (standard deviation [SD] = 20.61). General quality of life (Marburg questionnaire on habitual well-being, MFHW) increased by 1.1 points (SD = 0.73). The depression and anxiety assessment decreased by 2.56 (SD = 3.99) and 2.63 points (SD = 5.21) respectively. CONCLUSION A multimodal therapy concept with a manual therapeutic treatment focus can lead to an improvement in pain symptoms and quality of life in patients with myofascial chronic pelvic pain after a treatment period of 120 days. Myofascial syndromes of urogenital muscles must be considered in the assessment of the cause of chronic pelvic pain.
Collapse
|
12
|
Dayanır IO, Birinci T, Kaya Mutlu E, Akcetin MA, Akdemir AO. Comparison of Three Manual Therapy Techniques as Trigger Point Therapy for Chronic Nonspecific Low Back Pain: A Randomized Controlled Pilot Trial. J Altern Complement Med 2020; 26:291-299. [DOI: 10.1089/acm.2019.0435] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ismail Oguz Dayanır
- Neurosurgery Clinic, Ministry of Health Haseki Training and Research Hospital, Istanbul, Turkey
| | - Tansu Birinci
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ebru Kaya Mutlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Mustafa Ali Akcetin
- Neurosurgery Clinic, Ministry of Health Haseki Training and Research Hospital, Istanbul, Turkey
| | - Ali Osman Akdemir
- Neurosurgery Clinic, Ministry of Health Haseki Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
13
|
Kodama K, Takamoto K, Nishimaru H, Matsumoto J, Takamura Y, Sakai S, Ono T, Nishijo H. Analgesic Effects of Compression at Trigger Points Are Associated With Reduction of Frontal Polar Cortical Activity as Well as Functional Connectivity Between the Frontal Polar Area and Insula in Patients With Chronic Low Back Pain: A Randomized Trial. Front Syst Neurosci 2019; 13:68. [PMID: 31798422 PMCID: PMC6863771 DOI: 10.3389/fnsys.2019.00068] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 10/28/2019] [Indexed: 12/20/2022] Open
Abstract
Background Compression of myofascial trigger points (MTrPs) in muscles is reported to reduce chronic musculoskeletal pain. Although the prefrontal cortex (PFC) is implicated in development of chronic pain, the mechanisms of how MTrP compression at low back regions affects PFC activity remain under debate. In this study, we investigated effects of MTrP compression on brain hemodynamics and EEG oscillation in subjects with chronic low back pain. Methods The study was a prospective, randomized, parallel-group trial and an observer and subject-blinded clinical trial. Thirty-two subjects with chronic low back pain were divided into two groups: subjects with compression at MTrPs (n = 16) or those with non-MTrPs (n = 16). Compression at MTrP or non-MTrP for 30 s was applied five times, and hemodynamic activity (near-infrared spectroscopy; NIRS) and EEGs were simultaneously recorded during the experiment. Results The results indicated that compression at MTrPs significantly (1) reduced subjective pain (P < 0.05) and increased the pressure pain threshold (P < 0.05), (2) decreased the NIRS hemodynamic activity in the frontal polar area (pPFC) (P < 0.05), and (3) increased the current source density (CSD) of EEG theta oscillation in the anterior part of the PFC (P < 0.05). CSD of EEG theta oscillation was negatively correlated with NIRS hemodynamic activity in the pPFC (P < 0.05). Furthermore, functional connectivity in theta bands between the medial pPFC and insula cortex was significantly decreased in the MTrP group (P < 0.05). The functional connectivity between those regions was positively correlated with subjective low back pain (P < 0.05). Discussion The results suggest that MTrP compression at the lumbar muscle modulates pPFC activity and functional connectivity between the pPFC and insula, which may relieve chronic musculoskeletal pain. Trial registration This trial was registered at University Hospital Medical Information Network Clinical Trials Registry (UMIN000033913) on 27 August 2018, at https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000038660.
Collapse
Affiliation(s)
- Kanae Kodama
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kouichi Takamoto
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan.,Department of Sports and Health Sciences, Faculty of Human Sciences, University of East Asia, Shimonoseki, Japan
| | - Hiroshi Nishimaru
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Jumpei Matsumoto
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yusaku Takamura
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Shigekazu Sakai
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Taketoshi Ono
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hisao Nishijo
- Department of System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
| |
Collapse
|
14
|
Effect of manual compressive therapy on latent myofascial trigger point pressure pain thresholds. J Bodyw Mov Ther 2019; 23:792-798. [PMID: 31733763 DOI: 10.1016/j.jbmt.2019.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 06/26/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study compared the effects of 90 s of manual compressive therapy (MCT) on latent myofascial trigger points (LTPs) for 3 sessions per week for 4 weeks to determine changes in individual pressure pain threshold (PPT). A total of 30 (15 males, 15 females; age = 22 ± 4 y/o, height = 175 ± 18 cm, weight = 162.5 ± 57.5 kg) symptomatic subjects with LTPs volunteered for the study. METHODS PPT was measured at baseline and pre- and post-treatment for all 12 sessions with a pressure algometer across the 4-week treatment time frame. The MCT was applied to the control group on their LTP at pressure intended to provide a sham condition (1/10 on verbalized analog scale (VAS)). Two experimental groups had MCT applied either directly on the LTP (d-TP) or in close-proximity to their LTP (cp-TP) at moderate pressure (7/10 on VAS). RESULTS There was a significant increase in PPT from the first through twelfth treatment sessions (p < 0.001, partial η2 = 0.914). A significant increase in PPTs between treatment groups was acutely observed from pre- to post-therapy tests (p = 0.001, partial η2 = 0.146). The differences between pre- versus post-treatment PPT measures indicated significant differences (d-TP vs. control, p < 0.001; cp-TP vs. control, p = 0.007). No differences were observed between experimental groups (p = 0.215). CONCLUSIONS PPT continued to increase after several weeks of MCT when applied directly on or within 2.5 cm of an identified LTP compared to control.
Collapse
|
15
|
Abdelhalim NM, Samhan AF, Abdelbasset WK. Short-Term impacts of pulsed electromagnetic field therapy in middle-aged university's employees with non-specific low back pain: A pilot study. Pak J Med Sci 2019; 35:987-991. [PMID: 31372129 PMCID: PMC6659051 DOI: 10.12669/pjms.35.4.49] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: Non-specific low back pain (non-specific LBP) is common problem between office-work employees. This study aimed to evaluate the short-term impacts of Pulsed Electromagnetic Field (PEMF) therapy in the treatment of non-specific LBP symptoms as pain, back mobility, LBP disabilities, and Health–Related Quality of Life (HRQOL). Methods: Forty-two University’s employees with non-specific LBP and aged from 35 to 55 years who participated in this study from January to June 2018 were divided into two groups: group A; received PEMF therapy and group B; received sham treatment. The outcome measures were; numerical rating scale, Modified Oswestry LBP Disability Score, Modified Schober test, and the Short Form-36 questionnaire. Evaluations were performed for both groups before and after finishing treatment. Results: All outcome measures were significantly improved statistically in the experimental group at the end of the intervention (p<0.05). On the other hand, there were non-significant differences in all outcome measures in the sham group (p>0.05). Conclusions: PEMT therapy may decrease pain, LBP disability, increase lumbar spine mobility, and improve HRQOL in middle-aged university’s employees with nonspecific LBP.
Collapse
Affiliation(s)
- Nermeen Mohamed Abdelhalim
- Nermeen Mohamed Abdelhalim, Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj City, Saudi Arabia
| | - Ahmed Fathy Samhan
- Ahmed FathySamhan, Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj City, Saudi Arabia
| | - Walid Kamal Abdelbasset
- Walid Kamal Abdelbasset Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj City, Saudi Arabia
| |
Collapse
|
16
|
Moraska AF, Hickner RC, Rzasa-Lynn R, Shah JP, Hebert JR, Kohrt WM. Increase in Lactate Without Change in Nutritive Blood Flow or Glucose at Active Trigger Points Following Massage: A Randomized Clinical Trial. Arch Phys Med Rehabil 2018; 99:2151-2159. [DOI: 10.1016/j.apmr.2018.06.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 06/21/2018] [Accepted: 06/25/2018] [Indexed: 01/03/2023]
|
17
|
Wang CK, Fang YHD, Lin LC, Lin CF, Kuo LC, Chiu FM, Chen CH. Magnetic Resonance Elastography in the Assessment of Acute Effects of Kinesio Taping on Lumbar Paraspinal Muscles. J Magn Reson Imaging 2018; 49:1039-1045. [PMID: 30284358 DOI: 10.1002/jmri.26281] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/18/2018] [Accepted: 07/19/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Kinesio tape (KT) is an elastic therapeutic tape used for treating sports-related injuries and a number of other disorders. To date, the objective evidence to link pathophysiological effects and actual reactions triggered by KT is limited. PURPOSE To explore the effect of KT on the lumbar paraspinal muscles by magnetic resonance (MR) elastography. STUDY TYPE Prospective observational study. POPULATION Sixty-six asymptomatic volunteers with 31 women and 35 men. FIELD STRENGTH/SEQUENCE 3.0T MRI and elastography with vibration frequency of 120 Hz. ASSESSMENT The 5-cm-width KT with full tension was placed on a single side of the lumbar paraspinal muscle. The taping side and adhering direction were randomly decided. Two rectangular regions of interest (ROIs) of 5- and 2.5-cm-width were positioned at the bilateral paraspinal regions from the L2 to L4 level on the confidence map of MR elastography before and after KT taping. The mean shear stiffness values of the ROIs at the superficial, middle, and deep depths were recorded; then the differences between the taping and reference sides were calculated. STATISTICAL TESTS Paired t-test and Pearson correlations were used to evaluate the stiffness changes after KT application and intraoperator errors of the stiffness measures on the reference side, respectively. RESULTS A significant decrease in the muscle stiffness value between taping and reference sides (-0.71 kPa ± 0.60 with KT and -0.25 kPa ± 0.78 without KT, P < 0.0001 for 5-cm ROI; -0.67 kPa ± 1.12 with KT and -0.16 kPa ± 1.17 without KT, P = 0.0004 for 2.5-cm ROI) was found in the superficial depth, but no significant differences in the middle and deep depths (P = 0.25 and P = 0.79 for 5-cm ROI; P = 0.09 and P = 0.67 for 2.5-cm ROI, respectively). There were no significant differences of muscle stiffness differences between gender (P = 0.11 for superficial, P = 0.37 for middle, P = 0.78 for deep) and taping direction (P = 0.18 for superficial, P = 0.13 for middle, P = 0.15 for deep). DATA CONCLUSION Our results demonstrate that KT can reduce the MR elastography-derived shear stiffness in the superficial depth of paraspinal muscles. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1039-1045.
Collapse
Affiliation(s)
- Chien-Kuo Wang
- Department of Radiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Hua Dean Fang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Liang-Ching Lin
- Department of Statistics, National Cheng Kung University, Tainan, Taiwan
| | - Cheng-Feng Lin
- Department of Physical Therapy, National Cheng Kung University, Tainan, Taiwan
| | - Li-Chieh Kuo
- Department of Occupational Therapy, National Cheng Kung University, Tainan, Taiwan
| | | | - Chia-Hui Chen
- College of Photonics, National Chiao Tung University, Tainan, Taiwan.,Department of Medical Imaging and Radiological Science, Central Taiwan University of Science and Technology, Taichung, Taiwan
| |
Collapse
|
18
|
Myofascial Pain Syndrome. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00066-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
19
|
Anatomical Basis of the Myofascial Trigger Points of the Gluteus Maximus Muscle. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4821968. [PMID: 29349073 PMCID: PMC5733974 DOI: 10.1155/2017/4821968] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 11/01/2017] [Indexed: 01/24/2023]
Abstract
Myofascial pain syndrome is characterized by pain and limited range of motion in joints and caused by muscular contracture related to dysfunctional motor end plates and myofascial trigger points (MTrPs). We aimed to observe the anatomical correlation between the clinically described MTrPs and the entry point of the branches of the inferior gluteal nerve into the gluteus maximus muscle. We dissected twenty gluteus maximus muscles from 10 human adult cadavers (5 males and 5 females). We measured the muscles and compiled the distribution of the nerve branches into each of the quadrants of the muscle. Statistical analysis was performed by using Student's t-test and Kruskal-Wallis tests. Although no difference was observed either for muscle measurements or for distribution of nerve branching among the subjects, the topography of MTrPs matched the anatomical location of the entry points into the muscle. Thus, anatomical substract of the MTrPs may be useful for a better understanding of the physiopathology of these disorders and provide basis for their surgical and clinical treatment.
Collapse
|
20
|
Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial. Am J Phys Med Rehabil 2017; 96:639-645. [PMID: 28248690 DOI: 10.1097/phm.0000000000000728] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to assess the effects of single and multiple massage treatments on pressure-pain threshold (PPT) at myofascial trigger points (MTrPs) in people with myofascial pain syndrome expressed as tension-type headache. DESIGN Individuals (n = 62) with episodic or chronic tension-type headache were randomized to receive 12 twice-weekly 45-min massage or sham ultrasound sessions or wait-list control. Massage focused on trigger point release (ischemic compression) of MTrPs in the bilateral upper trapezius and suboccipital muscles. PPT was measured at MTrPs with a pressure algometer pre and post the first and final (12th) treatments. RESULTS PPT increased across the study timeframe in all four muscle sites tested for massage, but not sham ultrasound or wait-list groups (P < 0.0001 for suboccipital; P < 0.004 for upper trapezius). Post hoc analysis within the massage group showed (1) an initial, immediate increase in PPT (all P values < 0.05), (2) a cumulative and sustained increase in PPT over baseline (all P values < 0.05), and (3) an additional immediate increase in PPT at the final (12th) massage treatment (all P values < 0.05, except upper trapezius left, P = 0.17). CONCLUSIONS Single and multiple massage applications increase PPT at MTrPs. The pain threshold of MTrPs have a great capacity to increase; even after multiple massage treatments additional gain in PPT was observed. TO CLAIM CME CREDITS Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Understand the contribution of myofascial trigger points to myofascial pain; (2) Describe an effective treatment for decreasing tenderness of a myofascial trigger point; and (3) Discuss the relative values of single vs. multiple massage sessions on increasing pressure-pain thresholds at myofascial trigger points. LEVEL Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Collapse
|
21
|
Preventive Chair Massage with Algometry to Maintain Psychosomatic Balance in White-Collar Workers. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1022:77-84. [DOI: 10.1007/5584_2017_45] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
|
22
|
Ishiki H, Kinkawa J, Watanabe A, Watanabe C, Chiba T, Yasui H, Shimada N, Ariyoshi K, Nojima M, Iwase S, Tojo A, Imai K. Prevalence of myofascial pain syndrome in patients with incurable cancer. J Bodyw Mov Ther 2017; 22:328-332. [PMID: 29861227 DOI: 10.1016/j.jbmt.2017.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/05/2017] [Accepted: 05/05/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Myofascial pain syndrome (MPS) is a condition that involves skeletal muscles. It is caused by overload or disuse of muscles and is characterized by extreme tenderness in the muscles with taut bands. Treatment for MPS is different from that for cancer-related pain. Cancer patients have many factors that cause restriction of body movement and posture. Although cancer patients appear to demonstrate risk factors for MPS, its prevalence has not been reported in patients with incurable cancer. This study was conducted to investigate the prevalence of MPS in patients with incurable cancer. METHODS A retrospective chart review. The data for patients with incurable cancer who received palliative care at our department between September 2015 and March 2016 were investigated. We examined the prevalence of MPS, which was diagnosed on the basis of the Rivers criteria (RC) and Simons criteria (SC). We also examined the following factors associated with MPS: performance status (PS), use of medical devices, and primary cancer sites. The primary outcome was the prevalence of MPS based on RC. Secondary outcomes included the prevalence of MPS based on SC and the relationship between MPS and either PS or medical devices. RESULTS Thirty-four patients with incurable cancer were identified. MPS based on RC or SC was detected in 10 (29%) and 20 (59%) patients, respectively. Twenty-two of 34 patients who complained of pain, 10 (45%) had MPS based on RC and 20 (90%) had MPS based on SC. Age and central venous port were risk factors for MPS by multivariate analysis. CONCLUSION A very high prevalence of MPS was detected in our study population. MPS should be considered when patients with incurable cancer complain of pain.
Collapse
Affiliation(s)
- Hiroto Ishiki
- Department of Palliative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
| | - Junya Kinkawa
- Department of Joint Surgery, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Aya Watanabe
- Department of Pharmacy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Chie Watanabe
- Department of Palliative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Tsukuru Chiba
- Department of Palliative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Hiroki Yasui
- Department of Palliative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Naoki Shimada
- Department of Palliative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Keisuke Ariyoshi
- Department of Palliative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Masanori Nojima
- Center for Translational Research, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Satoru Iwase
- Department of Palliative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Arinobu Tojo
- Department of Palliative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; Department of Hematology/ Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Kohzoh Imai
- Academic Collaborative Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
23
|
The local twitch response during trigger point dry needling: Is it necessary for successful outcomes? J Bodyw Mov Ther 2017; 21:940-947. [PMID: 29037652 DOI: 10.1016/j.jbmt.2017.03.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/17/2017] [Accepted: 02/28/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Myofascial trigger point (MTrP) injection and trigger point dry needling (TrPDN) are widely accepted therapies for myofascial pain syndrome (MPS). Empirical evidence suggests eliciting a local twitch response (LTR) during needling is essential. OBJECTIVE This is the first review exploring the available literature, regardless of study design, on the neurophysiological effects and clinical significance of the LTR as it relates to reductions in pain and disability secondary to MTrP needling. METHODS PubMed, MEDLINE, Science Direct and Google Scholar were searched up until October 2016 using terms related to trigger point needling and the LTR. RESULTS and Discussion: Several studies show that eliciting a LTR does not correlate with changes in pain and disability, and multiple systematic reviews have failed to conclude whether the LTR is relevant to the outcome of TrPDN. Post needling soreness is consistently reported in studies using repeated in and out needling to elicit LTRs and increases in proportion to the number of needle insertions. In contrast, needle winding without LTRs to MTrPs and connective tissue is well supported in the literature, as it is linked to anti-nociception and factors related to tissue repair and remodeling. Additionally, the positive biochemical changes in the MTrP after needling may simply be a wash out effect related to local vasodilation. While the LTR during TrPDN appears unnecessary for managing myofascial pain and unrelated to many of the positive effects of TrPDN, further investigation is required.
Collapse
|
24
|
Webb TR, Rajendran D. Myofascial techniques: What are their effects on joint range of motion and pain? - A systematic review and meta-analysis of randomised controlled trials. J Bodyw Mov Ther 2016; 20:682-99. [PMID: 27634094 DOI: 10.1016/j.jbmt.2016.02.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 02/11/2016] [Accepted: 02/19/2016] [Indexed: 01/14/2023]
Abstract
BACKGROUND This systematic review aimed to determine the evidence for the effect of a single manually applied myofascial technique (MFT) on joint range of motion (JROM) and pain in non-pathological symptomatic subjects. METHODS Authors independently searched the following databases: PEDro; Cochrane Library; NLM PubMed; EMBASE; Academic Search Premier; MEDLINE; Psychology and Behavioural Sciences Collection; PsycINFO; SPORTSDiscus; CINAHL Plus from 2003 to 2015. All randomised controlled trials (RCTs) that used JROM as an outcome measure were identified. RCT quality was independently evaluated using PEDro and Cochrane Risk of Bias tools and all reported outcome data were independently abstracted and presented. If post-intervention central tendencies and variance were reported, these were assessed for heterogeneity with a view to performing a meta-analysis. RESULTS Nine RCTs (n = 534) were systematically reviewed and outcome data presented; all trials concluded that MFT increased JROM and reduced pain levels in symptomatic patients. Two RCTs (n = 161) were judged 'moderately' heterogeneous (I(2) = 47.2%; Cochran's Q = 5.69; p = 0.128, df = 3) and meta-analysis using a fixed effects model suggested a 'moderate' effect size of MFTs on jaw opening (ES = 0.578; 95%CI 0.302 to 0.853). CONCLUSION Although results reported by each RCT indicate that MFT increases JROM and reduces pain scores, there are a number of threats that challenge the statistical inferences underpinning these findings. Only two trials could be meta-analysed, the results of which suggest that applying MFTs to symptomatic patients diagnosed with latent trigger-points in masseter muscle can increase jaw JROM.
Collapse
Affiliation(s)
- Tamsyn R Webb
- Research Department, European School of Osteopathy, Boxley House, Boxley, Maidstone, Kent, ME14 3DZ, UK.
| | - Dévan Rajendran
- Research Department, European School of Osteopathy, Boxley House, Boxley, Maidstone, Kent, ME14 3DZ, UK.
| |
Collapse
|
25
|
Wu PIK, Meleger A, Witkower A, Mondale T, Borg-Stein J. Nonpharmacologic Options for Treating Acute and Chronic Pain. PM R 2015; 7:S278-S294. [DOI: 10.1016/j.pmrj.2015.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 09/15/2015] [Accepted: 09/16/2015] [Indexed: 12/19/2022]
|
26
|
Defrin R. Compression at myofascial trigger points for the management of acute low back pain. Eur J Pain 2015; 19:1057-8. [DOI: 10.1002/ejp.724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Ruth Defrin
- Department of Physical Therapy; Sackler Faculty of Medicine; Tel-Aviv University; Israel
| |
Collapse
|