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Carroll M, Ellis R, Kohut S, Garrett N, Fernández-de-Las-Peñas C. Associations Between Gluteus Medius Trigger Points With Hip Passive Range of Movement and Muscle Strength in Adults With Chronic Nonspecific Low Back Pain: A Cross-Sectional Study. J Manipulative Physiol Ther 2022; 45:641-651. [PMID: 37318387 DOI: 10.1016/j.jmpt.2023.03.001] [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: 08/21/2022] [Revised: 03/21/2023] [Accepted: 03/30/2023] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate whether there is a relationship between gluteus medius trigger points with hip passive range of motion and hip muscle strength in people with chronic nonspecific low back pain (LBP). METHODS This was a cross-sectional, blinded study that took place in 2 rural communities in New Zealand. Assessments were carried out in physiotherapy clinics in these towns. A total of 42 participants over 18 years old experiencing chronic nonspecific LBP were recruited. After meeting inclusion criteria, participants completed the following 3 questionnaires: Numerical Pain Rating Scale, Oswestry Disability Index, and Tampa Scale of Kinesiophobia. The primary researcher (a physiotherapist) assessed each participant's bilateral hip passive range of movement (using an inclinometer) and muscle strength (using a dynamometer). Following this, a blinded trigger point assessor examined the gluteus medius muscles for the presence of active and latent trigger points. RESULTS General linear modeling using univariate analysis revealed that there was a positive association between hip strength and trigger point status (P =.03 left internal rotation, P =.04 right internal rotation, and P =.02 right abduction). Participants with no trigger points showed higher strength values (eg, right internal rotation standard error: 0.64), and those with trigger points showed lower strength. Overall, muscles exhibiting latent trigger points were the weakest (eg, right internal rotation standard error: 0.67). CONCLUSION The presence of active or latent gluteus medius trigger points was associated with hip weakness in adults with chronic nonspecific LBP. There was no association between gluteus medius trigger points and hip passive range of movement.
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Affiliation(s)
- Marianne Carroll
- Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.
| | - Richard Ellis
- Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand; Active Living and Rehabilitation, Health and Rehabilitation Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Susan Kohut
- Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand; Active Living and Rehabilitation, Health and Rehabilitation Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Nick Garrett
- Department of Biostatistics and Epidemiology, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Madrid, Spain
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Valera-Calero JA, Sánchez-Mayoral-Martín A, Varol U. Short-term effectiveness of high- and low-intensity percutaneous electrolysis in patients with patellofemoral pain syndrome: A pilot study. World J Orthop 2021; 12:781-790. [PMID: 34754834 PMCID: PMC8554351 DOI: 10.5312/wjo.v12.i10.781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/03/2021] [Accepted: 08/04/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Unilateral patellofemoral pain syndrome (PFPS) is the most frequently diagnosed knee condition in populations aged < 50 years old. Although the treatment of myofascial trigger points (MTrPs) is a common and effective tool for reducing pain, previous studies showed no additional benefits compared with placebo in populations with PFPS. Percutaneous electrolysis is a minimally invasive approach frequently used in musculotendinous pathologies which consists of the application of a galvanic current through dry needling (DN). AIM To evaluate changes in sensitivity, knee pain perception and perceived pain during the application of these three invasive techniques. METHODS A triple-blinded, pilot randomized controlled trial was conducted on fifteen patients with unilateral PFPS who were randomized to the high-intensity percutaneous electrolysis (HIPE) experimental group, low-intensity percutaneous electrolysis (LIPE) experimental group or DN active control group. All interventions were conducted in the most active MTrP, in the rectus femoris muscle. The HIPE group received a 660 mA galvanic current for 10 s, the LIPE group 220 mA × 30 s and the DN group received no galvanic current. The MTrP and patellar tendon pain pressure thresholds (PPTs) and subjective anterior knee pain perception (SAKPP) were assessed before, after and 7 d after the single intervention. In addition, perceived pain during the intervention was also assessed. RESULTS Both groups were comparable at baseline as no significant differences were found for age, height, weight, body mass index, PPTs or SAKPP. No adverse events were reported during or after the interventions. A significant decrease in SAKPP (both HIPE and LIPE, P < 0.01) and increased patellar tendon PPT (all, P < 0.001) were found, with no differences between the groups (VAS: F = 0.30; η2 = 0.05; P > 0.05; tendon PPT immediate effects: F = 0.15; η2 = 0.02; P > 0.05 and tendon PPT 7-d effects: F = 0.67; η2 = 0.10; P > 0.05). A significant PPT increase in rectus femoris MTrP was found at follow-up in both the HIPE and LIPE groups (both, P < 0.001) with no differences between the groups (immediate effects: F= 1.55; η2 = 0.20; P > 0.05 and 7-d effects: F = 0.71; η2 = 0.10; P > 0.05). Both HIPE and LIPE interventions were considered less painful compared with DN (F = 8.52; η2 = 0.587; P < 0.01). CONCLUSION HIPE and LIPE induce PPT changes in MTrPs and patellar tendon and improvements in SAKPP, and seem to produce less pain during the intervention compared with DN.
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Affiliation(s)
| | | | - Umut Varol
- Business Analytics and Big Data, IE School of Human Sciences and Technology, Madrid 28006, Spain
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3
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Rozenfeld E, Strinkovsky A, Finestone AS, Kalichman L. Reliability of trigger points evaluation in the lower leg muscles. PAIN MEDICINE 2021; 22:2283-2289. [PMID: 34048586 DOI: 10.1093/pm/pnab148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Myofascial trigger point diagnosis is a clinical palpatory skill dependent on the patient's subjective response. The inter- and intra-rater reliability of trigger point physical evaluation in the lower leg muscles has rarely been reported. Previous reliability studies suffered from the Kappa paradox. OBJECTIVE To evaluate the inter- and intra-rater reliability of trigger point recognition in the lower leg muscles implying a specific method to overcome the 1st Kappa paradox. DESIGN A reliability study with pre-second examiner exclusion to correct prevalence index. SETTING Physical therapy outpatient clinic, Beer-Sheva, Israel. SUBJECTS 86 soldiers aged 18-30 referred for physical therapy with a diagnosis of musculoskeletal pain consented to take part in this study. 26 were excluded for lacking trigger points, leaving 60 subjects for analysis (31 women, 29 men). METHODS Both legs were evaluated, and the results were analyzed separately for symptomatic (N = 87) and asymptomatic legs (N = 31).Each subject was evaluated three times, twice by one examiner, and once by a second examiner. Dichotomous findings including palpable taut-band, tenderness, referred pain, and relevance of referred pain were recorded. RESULTS Inter-rater reliability for active trigger points ranged from 0.49 to 0.75 (median: 0.52) and intra-rater reliability ranged from 0.41 to 0.84 (median: 0.65) and. For total trigger points intra-rater reliability ranged from 0.52 to 0.79 (median: 0.67), and inter-rater reliability ranged from 0.44 to 0.77 (median: 0.66). CONCLUSIONS Physical examination is a reliable method of trigger point evaluation in lower leg muscles, and it can be used as a diagnostic method for trigger point evaluation.
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Affiliation(s)
- Evgeni Rozenfeld
- Israel Defense Force, Medical Corps, Israel.,Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Asia Strinkovsky
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Aharon S Finestone
- Israel Defense Force, Medical Corps, Israel.,Shamir Medical Center, Zerifin, Affiliated to the Faculty of Medicine, Tel Aviv University, Israel
| | - Leonid Kalichman
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Ceballos-Laita L, Jiménez-Del-Barrio S, Marín-Zurdo J, Moreno-Calvo A, Marín-Boné J, Albarova-Corral MI, Estébanez-de-Miguel E. Effectiveness of Dry Needling Therapy on Pain, Hip Muscle Strength, and Physical Function in Patients With Hip Osteoarthritis: A Randomized Controlled Trial. Arch Phys Med Rehabil 2021; 102:959-966. [PMID: 33567336 DOI: 10.1016/j.apmr.2021.01.077] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/14/2020] [Accepted: 01/16/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the short-term effects of dry needling (DN) on physical function, pain, and hip muscle strength in patients with hip osteoarthritis (OA). DESIGN A double-blind, placebo-control, randomized controlled trial. SETTING Private practice physiotherapy clinic. PARTICIPANTS Patients with unilateral hip OA (N=45) were randomly allocated to a DN group, sham DN group, or control group. INTERVENTIONS Patients in the DN and sham groups received 3 treatment sessions. Three active myofascial trigger points (MTrPs) were treated in each session with DN or a sham needle procedure. The treatment was applied in active MTrPs of the iliopsoas, rectus femoris, tensor fasciae latae, and gluteus minimus muscles. MAIN OUTCOME MEASURES Physical function was assessed with the Western Ontario and McMaster Universities (WOMAC) physical function subscale, the timed Up and Go test, and the 40-meter self-paced walk test. Intensity of hip pain related to physical function was evaluated using the visual analog scale and WOMAC pain subscale. The maximal isometric force of hip muscles was recorded with a handheld dynamometer. RESULTS Significant group by time interactions were shown for physical function, pain, and hip muscle force variables. Post hoc tests revealed a significant reduction in hip pain and significant improvements in physical function and hip muscle strength in the DN group compared with the sham and control groups. The DN group showed within- and between-groups large effect sizes (d>0.8). CONCLUSIONS DN therapy in active MTrPs of the hip muscles reduced pain and improved hip muscle strength and physical function in patients with hip OA. DN in active MTrPs of the hip muscles should be considered for the management of hip OA.
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Affiliation(s)
- Luis Ceballos-Laita
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy. Faculty of Health Sciences, University of Valladolid, Soria.
| | - Sandra Jiménez-Del-Barrio
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy. Faculty of Health Sciences, University of Valladolid, Soria
| | - Javier Marín-Zurdo
- ID_ERGO Research Group, I3A, Department of Design and Manufacturing Engineering, University of Zaragoza, Zaragoza
| | - Alejandro Moreno-Calvo
- ID_ERGO Research Group, I3A, Department of Design and Manufacturing Engineering, University of Zaragoza, Zaragoza
| | - Javier Marín-Boné
- ID_ERGO Research Group, I3A, Department of Design and Manufacturing Engineering, University of Zaragoza, Zaragoza
| | | | - Elena Estébanez-de-Miguel
- Department of Physiatrist and Nursery, Faculty of Health Science, University of Zaragoza, Zaragoza, Spain
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5
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Kordi Yoosefinejad A, Samani M, Jabarifard F, Setooni M, Mirsalari R, Kaviani F, Jazayeri Shooshtari SM. Comparison of the prevalence of myofascial trigger points of muscles acting on knee between patients with moderate degree of knee osteoarthritis and healthy matched people. J Bodyw Mov Ther 2020; 25:113-118. [PMID: 33714481 DOI: 10.1016/j.jbmt.2020.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/31/2020] [Accepted: 10/20/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Trigger points have been implicated in the development of several musculoskeletal disorders. Trigger points harbored in lower limb muscles might represent a ubiquitous source of pain in patients with knee osteoarthritis (OA). This study was carried out to evaluate the prevalence of Myofascial Trigger Points (MTrPs) in muscles acting on the knee in patients with OA. METHODS Thirty-seven patients aged at least 55 years old with a moderate degree of OA (grade III of Kellgren and Lawrence scale) were recruited. Thirty asymptomatic people, matched on age and body mass index, were considered as the control group. Ten muscles acting on the knee joint were selected. Taut bands were also identified using a skin rolling method. A pressure of 3 kg/cm2 was used to identify myofascial trigger points in all muscles except the popliteus (8 kg/cm2). RESULTS Chi-square was performed to compare the prevalence of trigger points between the groups. The McNemar test was administered to compare the prevalence of trigger points in the right and left sides of participants. Prevalence of the trigger points was significantly higher in patients with knee OA compared with asymptomatic people in all muscles except for right (p = 0.17) and left (p = 0.41) rectus femoris, right (p = 0.61) and left (p = 0.22) sartorius and left biceps femoris (p = 0.08). Comparison of the prevalence of MTrPs bilaterally revealed that only the right and left sartorius differed significantly (p = 0.008). CONCLUSIONS The prevalence of MTrPs in the muscles acting on the knee joint is higher in patients with a moderate degree of knee OA compared with asymptomatic subjects.
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Affiliation(s)
- Amin Kordi Yoosefinejad
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahbobeh Samani
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Fatemeh Jabarifard
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Setooni
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rezvan Mirsalari
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Kaviani
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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6
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The effect of dry needling on gastrocnemius muscle stiffness and strength in participants with latent trigger points. J Electromyogr Kinesiol 2020; 55:102479. [PMID: 33075711 DOI: 10.1016/j.jelekin.2020.102479] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 09/13/2020] [Accepted: 10/05/2020] [Indexed: 01/29/2023] Open
Abstract
Abnormal muscle stiffness is a potential complication after injury and identifying interventions that modify muscle stiffness may be useful to promote recovery. The purpose of this study was to identify the short-term effects of dry needling (DN) on resting and contracted gastrocnemius muscle stiffness and strength of the triceps surae in individuals with latent myofascial trigger points (MTrPs). In this randomized controlled trial, 52 individuals received two DN treatment sessions to latent MTrPs and 50 individuals received two sham needling sessions. Resting and contracted muscle stiffness were assessed both at the treatment site and a standardized central site in the medial gastrocnemius head immediately post-treatment and one week after the last session. There were significant group by time interactions for resting muscle stiffness at the site of the MTrP (p = .03), but not at the central site (p = .29). Post-needling between group comparison indicated that the DN group had significantly lower resting muscle stiffness at the site of the MTrP than the sham group after adjusting for baseline differences. There were no significant between group differences in contracted muscle stiffness or muscle strength. Identifying strategies that can reduce aberrant muscle stiffness may help to guide management of individuals with neuromuscular pain-related conditions. Level of evidence: Therapy, level 2.
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7
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Zhu J, Zheng Z, Liu Y, Lawrie S, Esser P, Izadi H, Dawes H, Xia Z, Wang C, Xiong Y, Ma X, Wade DT. The effects of small-needle-knife therapy on pain and mobility from knee osteoarthritis: a pilot randomized-controlled study. Clin Rehabil 2020; 34:1497-1505. [PMID: 32602373 PMCID: PMC7649921 DOI: 10.1177/0269215520938852] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the effect of small needle-knife therapy in people with painful knee osteoarthritis. DESIGN Pilot randomised, controlled trial. SETTING Rehabilitation hospital. SUBJECTS In-patients with osteo-arthritis of the knee. INTERVENTIONS Either 1 to 3 small needle-knife treatments over seven days or oral Celecoxib. All patients stayed in hospital three weeks, receiving the same mobility-focused rehabilitation. MEASURES Oxford Knee Score (OKS), gait speed and kinematics were recorded at baseline, at three weeks (discharge) and at three-months (OKS only). Withdrawal from the study, and adverse events associated with the small needle knife therapy were recorded. RESULTS 83 patients were randomized: 44 into the control group, of whom 10 were lost by three weeks and 12 at 3 months; 39 into the experimental group of whom eight were lost at three weeks and three months. The mean (SE) OKS scores at baseline were Control 35.86 (1.05), Exp 38.38 (0.99); at three weeks 26.64 (0.97) and 21.94 (1.23); and at three months 25.83 (0.91) and 20.48 (1.14) The mean (SE) gait speed at baseline was 1.07 (0.03) m/sec (Control) and 0.98 (0.03), and at three weeks was 1.14 (0.03) and 1.12 (0.03) (P < 0.05). Linear mixed model statistical analysis showed that the improvements in the experimental group were statistically significant for total OKS score at discharge and three months. CONCLUSIONS Small needle-knife therapy added to standard therapy for patients with knee osteoarthritis, was acceptable, safe and reduced pain and improved global function on the Oxford Knee Score. Further research is warranted.
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Affiliation(s)
- Junchen Zhu
- The Department of Orthopaedics, the Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui Province, China
| | - Zhiwen Zheng
- The Department of Orthopaedics, the Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui Province, China
| | - Yaomeng Liu
- Centre for Movement and Occupational Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Sophie Lawrie
- Centre for Movement and Occupational Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Patrick Esser
- Centre for Movement and Occupational Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Hooshang Izadi
- Centre for Movement and Occupational Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Helen Dawes
- Centre for Movement and Occupational Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Zhidao Xia
- Centre for Movement and Occupational Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Chao Wang
- The Department of Orthopaedics, the Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui Province, China
| | - Yingzong Xiong
- The Department of Orthopaedics, the Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui Province, China
| | - Xingfu Ma
- The Department of Orthopaedics, the Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui Province, China
| | - Derick T Wade
- Centre for Movement and Occupational Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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Ceballos-Laita L, Jiménez-del-Barrio S, Marín-Zurdo J, Moreno-Calvo A, Marín-Boné J, Albarova-Corral MI, Estébanez-de-Miguel E. Effects of dry needling on pain, pressure pain threshold and psychological distress in patients with mild to moderate hip osteoarthritis: Secondary analysis of a randomized controlled trial. Complement Ther Med 2020; 51:102443. [DOI: 10.1016/j.ctim.2020.102443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/14/2020] [Accepted: 05/11/2020] [Indexed: 12/24/2022] Open
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Holm-Jensen A, Kjaer P, Schiøttz-Christensen B, Ziegler DS, Andersen S, Myburgh C. The Interexaminer Reproducibility and Prevalence of Lumbar and Gluteal Myofascial Trigger Points in Patients With Radiating Low Back Pain. Arch Rehabil Res Clin Transl 2020; 2:100044. [PMID: 33543073 PMCID: PMC7853331 DOI: 10.1016/j.arrct.2020.100044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective To determine the interexaminer reproducibility for judging the presence, number, and location of leg-pain referring myofascial trigger points, and their prevalence in patients with low back pain with and without concomitant leg pain referral. Design An interexaminer reproducibility study. Setting An outpatient public Hospital Spine Centre in Southern Denmark. Participants Examiners: experienced examiners (N=2), a chiropractor and a physiotherapist, respectively. Subjects: a case mix of patients with low back pain (N=32) with and without leg pain referral. Interventions A standardized palpation examination protocol of 4 bilateral lumbosacral muscles performed by each examiner. Main Outcome Measures Reproducibility on presence (measured in Cohen’s κ), number (difference and limits of agreement), location (distance between matching marks placed by examiners), and prevalence of myofascial trigger points. Results Kappa values of the examined muscles were as follows: quadratus lumborum (κ=0.42), gluteus medius (κ=0.83), gluteus minimus (κ=0.74), and piriformis (κ=0.62), with a mean of all examined muscles of kappa=0.66, assessed as substantial agreement. The mean difference in number of trigger points was 0.8, with limits of agreement ranging from −6.4 to 4.9. Mean distance between trigger point locations was 12.9 mm, with 57% only being identified by a single examiner. The prevalence of trigger points was 82.7%, highest in the gluteal region of the painful side. Conclusions Inadequate standardization and multiple trigger point sites complicate interexaminer reproducibility on location and number of patients with low back pain and leg pain referral. Nevertheless, substantial interexaminer reproducibility for the trigger point presence appears achievable. Implemented routinely, this relatively simple clinical evaluation procedure could meaningfully enhance diagnostic triage and eventual management.
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Affiliation(s)
- Aske Holm-Jensen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Per Kjaer
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Berit Schiøttz-Christensen
- Medical Research Department, Spine Centre of Southern Denmark, Hospital Lillebælt, Middelfart, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Dorthe Schøler Ziegler
- Medical Research Department, Spine Centre of Southern Denmark, Hospital Lillebælt, Middelfart, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark.,Spine Surgery and Research, Spine Center of Southern Denmark-part of Lillebaelt Hospital, Middelfart, Denmark
| | - Stina Andersen
- Medical Research Department, Spine Centre of Southern Denmark, Hospital Lillebælt, Middelfart, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Corrie Myburgh
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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10
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Ceballos-Laita L, Jiménez-Del-Barrio S, Marín-Zurdo J, Moreno-Calvo A, Marín-Boné J, Albarova-Corral MI, Estébanez-de-Miguel E. Effects of dry needling in HIP muscles in patients with HIP osteoarthritis: A randomized controlled trial. Musculoskelet Sci Pract 2019; 43:76-82. [PMID: 31352178 DOI: 10.1016/j.msksp.2019.07.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 07/20/2019] [Accepted: 07/22/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Dry needling (DN) in active myofascial trigger points (MTrPs) is effective to reduce pain, increase range of motion (ROM) and improve physical function in different musculoskeletal disorders. However, there is a lack of studies evaluating the effects of DN in active MTrPs in hip osteoarthritis (OA). OBJECTIVE To determine the short-term effects of DN on pain, hip ROM and physical function in patients with hip OA. DESIGN Double-blind randomized controlled trial. METHODS Thirty patients with unilateral hip OA were randomized into two groups: DN group and sham group. Participants received three treatment sessions. The treatment was applied in active MTrPs of the iliopsoas, rectus femoris, tensor fasciae latae and gluteus minimus muscles. Pain intensity (visual analogic scale), passive hip ROM (universal goniometer and digital inclinometer) and physical function (30s chair-stand test and 20m walk test) were assessed at baseline and after the three treatment sessions. RESULTS There was decreased pain intensity, increased hip ROM, and improved physical function following the DN treatment. These improvements were statistically significant (p < 0.05) compared to the sham group. The sham group had increased pain intensity and decreased hip ROM (p < 0.05). CONCLUSION Pain, hip ROM, and physical function improved after the application of DN in active MTrPs of the hip muscles in patients with hip OA.
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Affiliation(s)
- Luis Ceballos-Laita
- Department of Surgery, Ophthalmology and Physiotherapy, Faculty of Physiotherapy, University of Valladolid, Spain.
| | - Sandra Jiménez-Del-Barrio
- Department of Surgery, Ophthalmology and Physiotherapy, Faculty of Physiotherapy, University of Valladolid, Spain
| | - Javier Marín-Zurdo
- ID_ERGO Research Group, I3A, Department: Design and Manufacturing Engineering, University of Zaragoza, Spain
| | - Alejandro Moreno-Calvo
- ID_ERGO Research Group, I3A, Department: Design and Manufacturing Engineering, University of Zaragoza, Spain
| | - Javier Marín-Boné
- ID_ERGO Research Group, I3A, Department: Design and Manufacturing Engineering, University of Zaragoza, Spain
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11
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Do Self-Myofascial Release Devices Release Myofascia? Rolling Mechanisms: A Narrative Review. Sports Med 2019; 49:1173-1181. [DOI: 10.1007/s40279-019-01149-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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12
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Dommerholt J, Hooks T, Chou LW, Finnegan M. A critical overview of the current myofascial pain literature - November 2018. J Bodyw Mov Ther 2018; 23:65-73. [PMID: 30691765 DOI: 10.1016/j.jbmt.2018.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 02/01/2023]
Abstract
This is the first issue of this review column since the passing of Dr. Leon Chaitow. We would like to take a brief moment to acknowledge how much his mentorship, friendship, and confidence have meant to us. Leon was a force in osteopathic and naturopathic medicine and his influence reaches to all corners of the musculoskeletal realm crossing over many disciplines through his lectures, workshops, and of course, his many books, editorials, and articles. In the foreword to one of his books, Jan Dommerholt wrote that "Leon Chaitow […] continued the work of Travell and Simons, but also of many others, whose contributions he has skillfully woven into an intricate tapestry of clinical pearls, practical tips, and solid evidence-informed research." Dr. Chaitow was a synthesizer, who always considered what different clinicians and researchers could possibly contribute to a better understanding of pain and dysfunction and provide real solutions to real problems. Even when he would not necessarily agree with all suggested remedies, he maintained an open mind and was able to take a step back and consider the bigger picture. For example, Leon was not a big fan of dry needling, yet, he valued the importance of this approach and encouraged the inclusion of dry needling papers in this review article and in his journal. The Journal of Bodywork and Movement Therapies became his baby and, considering the growth of the journal, there is no question that Leon's intense focus and efforts are appreciated by many around the globe. We wish to extend our condolences to Leon's wife Alkmini and daughter Sasha. He will surely be missed, but we can find peace in knowing that his legacy will stay with us forever. In this issue, we have included several basic myofascial pain research articles. As usual, dry needling (DN) studies and case reports are the most commonly referenced papers, but we also included neuroscience and electromyography studies, sleep studies, interrater reliability studies, and case reports of adverse events.
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Affiliation(s)
- Jan Dommerholt
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA.
| | - Todd Hooks
- New Orleans Pelicans, New Orleans, LA, USA; Myopain Seminars, Bethesda, MD, USA.
| | | | - Michelle Finnegan
- Myopain Seminars, Bethesda, MD, USA; ProMove PT Pain Specialists, Bethesda, MD, USA.
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Dommerholt J, Finnegan M, Hooks T, Chou LW. A critical overview of the current myofascial pain literature - July 2018. J Bodyw Mov Ther 2018; 22:673-684. [PMID: 30100296 DOI: 10.1016/j.jbmt.2018.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 06/25/2018] [Indexed: 01/09/2023]
Abstract
In the current issue of this clinical overview, we are pleased to include several basic research studies ranging from the differentiation of radicular and non-radicular low back pain based on the presence of trigger points (TrPs) to the role of TrPs in patients with osteoarthritis, the diagnostic criteria of TrP, the accurate placement of needles in the piriformis muscle with dry needling (DN), and the reliability of TrP identification, among others. As usual, there are many new DN studies, but also several review papers, and manual TrP research. Contributing authors come from as many as 15 different countries!
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Affiliation(s)
- Jan Dommerholt
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA.
| | - Michelle Finnegan
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA.
| | - Todd Hooks
- New Orleans Pelicans, New Orleans, LA, USA.
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