Can surface electromyography differentiate muscle activity between upper trapezius muscles with active versus latent trigger points?

Assessment of the influence of intermittent ischemic compression of latent trigger points on changes on the range of the lumbar spine mobility and myoelectric changes in the dorsal extensor muscle

Introduction: Pain in the lumbar spine (L) is a very serious health problem. The appearance of pain in the area of the back muscles with palpable small, sensitive points may indicate the presence of myofascial trigger points. There are many techniques used in the therapy of trigger points, including ischemic compression, which gives a therapeutic effect in the form of biomechanical normalization of muscle tissue restoring the normal functional state of a given muscle. Aim of the study: The aim of the study was to assessment of the influence of intermittent ischemic compression of latent trigger points on changes on the range of motion of the L spine and on myoelectric changes in the back extensor muscle. Material and Methods: The study included 32 students who were subjected to a single technique of intermittent ischemic compression according to Chaitow. The participants of the study performed the Thomayer test before and after the therapy to assess the range of spine mobility. The myoelectric changes in the back extensor muscle were assessed using NORAXON's EMG before and after the treatments following a protocol specifically developed for this purpose. The statistical analysis of the data was calculated using the Statistica 13 program. Results: One-time ischemic intermittent compression of the back extensor muscle statistically significantly increased the range of spine motion. The mean value of the tension of the back extensor muscle at rest after the therapy was reduced, showing statistically significant changes. The myoelectric changes in the back extensor muscle during flexion were not statistically significant Conclusions: The results showed the effectiveness of the ischemic intermittent compression technique in increasing the range of spine mobility after the treatment on the back extensor muscle. Intermittent ischemic compression leads to a decrease in the resting tension of the back extensor muscle, without affecting any significant changes during the flexion movement.

The immediate effect of multiple mechanical impulses on electromyography and pressure pain threshold of lumbar latent trigger points: an experimental study

BACKGROUND

Myofascial pain is a common syndrome, which has not been studied extensively in the low back. Despite a variety of manual and instrument assisted interventions available, little work has targeted the possible effects of fast mechanical impulses on myofascial trigger points (MTrPs) on its sensitivity and electrical activity. The purpose of this experimental study was to quantify the immediate effect of one session of mechanical impulses to lumbar latent MTrPs and to normal muscle tissue with pressure pain threshold (PPT) and surface electromyography (sEMG) as outcome measures.

METHODS

During the autumn of 2009, in 41 asymptomatic subjects between 17-40 years of age the lumbar musculature was searched for a latent MTrP by a trained clinician. Using 3 disposable pre-gelled electrodes bilaterally, sEMG was recorded continuously from muscle containing either latent or no MTrP. Both the trigger point group and control group received the intervention and were blinded to group allocation. The immediate effects of mechanical impulses were assessed by sEMG and PPT before and after intervention using Wilcoxon matched-pairs signed-ranks test, Mann-Whitney U test and paired t-tests.

RESULTS

The PPT increased significantly across both groups (p < 0.01) after intervention. The proportionate increase (14.6 %) was comparable in both MTrP and control groups. The electrical activity on the MTrP side was not significantly higher in the MTrP group compared to the contralateral side. The decrease of resting electrical activity after intervention was significant in the MTrP group on the side of the latent MTrP (P = 0.001) as well as the contralateral side (p=0.022), and not significant in the control group on either side (p=0.33 and p=0.93).

CONCLUSION

In this study, the immediate effect of one session of mechanical impulses was associated with a significant increase in PPT for both groups and a significant decrease in the resting electrical activity of the lumbar muscles only in the MTrP group. It is unknown if these effects have clinical significance.

Evidence-based pain management: is the concept of integrative medicine applicable?

This article is dedicated to the concept of predictive, preventive, and personalized (integrative) medicine beneficial and applicable to advance pain management, overviews recent insights, and discusses novel minimally invasive tools, performed under ultrasound guidance, enhanced by model-guided approach in the field of musculoskeletal pain and neuromuscular diseases. The complexity of pain emergence and regression demands intellectual-, image-guided techniques personally specified to the patient. For personalized approach, the combination of the modalities of ultrasound, EMG, MRI, PET, and SPECT gives new opportunities to experimental and clinical studies. Neuromuscular imaging should be crucial for emergence of studies concerning advanced neuroimaging technologies to predict movement disorders, postural imbalance with integrated application of imaging, and functional modalities for rehabilitation and pain management. Scientific results should initiate evidence-based preventive movement programs in sport medicine rehabilitation. Traditional medicine and mathematical analytical approaches and education challenges are discussed in this review. The physiological management of exactly assessed pathological condition, particularly in movement disorders, requires participative medical approach to gain harmonized and sustainable effect.