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David M, Devantéry K, Nauche B, Chagnon M, Keezer M, Gaudreault N, Bureau NJ, Cloutier G. Ultrasound elastography of back muscle biomechanical properties: a systematic review and meta-analysis of current methods. Insights Imaging 2024; 15:206. [PMID: 39143409 PMCID: PMC11324641 DOI: 10.1186/s13244-024-01785-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/23/2024] [Indexed: 08/16/2024] Open
Abstract
OBJECTIVES To report the current elastography methods used to quantify back muscles' biomechanical characteristics in patients with musculoskeletal disorders (MSKd) and inform on their reliability, validity, and responsiveness. METHODS MEDLINE, Embase, CINAHL, Cochrane library and grey literature were consulted. Predefined criteria allowed for study selection and data extraction. The quality of evidence was rated using the COSMIN tool. Data were meta-analyzed in terms of pooled intraclass correlation coefficient (pICC) for reliability and pooled standardized mean difference (pSMD) for validity and responsiveness. Heterogeneity was assessed. RESULTS Seventy-nine studies were included in the meta-analysis (total number of participants N = 3178). Three elastography methods were identified: strain imaging (SI; number of cohorts M = 26), shear wave imaging (SWI; M = 50), and vibration sonoelastography (VSE; M = 3). Strain imaging and SWI studies reported good reliability measurement properties (pICC > 0.70) and a medium pSMD (0.58 for SI and 0.60 for SWI; p ≤ 0.020) in discriminating MSKd from controls' condition (validity). Strain imaging studies reported a medium pSMD (0.64; p = 0.005) in detecting within-group changes over time, whereas SWI pSMD was very high (1.24; p = 0.005). Only SWI reported significant but small pSMD (0.30; p = 0.003) in detecting between-group changes over time. The small number of VSE studies could not be meta-analyzed. Heterogeneity was high (I-squared > 90%; p < 0.001). CONCLUSIONS Elastography presents good reliability results and a medium pSMD in discriminating MSKd from control conditions. Responsiveness data suggest detectable changes within groups over time using SI and SWI, calling for long-term longitudinal studies. Assessing changes between groups over time using elastography still needs to be proven. Highly significant heterogeneity limits meta-analytic results. CRITICAL RELEVANCE STATEMENT While still in its early-stage exploration phase, musculoskeletal ultrasound elastography may reliably quantify back muscles' biomechanics in asymptomatic individuals, moderately discriminate back musculoskeletal disorders and detect biomechanical changes over time in these conditions, calling for long-term longitudinal studies. KEY POINTS Ultrasound elastography is reviewed for back pain and related musculoskeletal disorder assessments. Growing literature supports good reproducibility, some validity and responsiveness. Back muscle elastography considers assumptions calling for standardized protocols.
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Affiliation(s)
- Mercedes David
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montreal, QC, H2L 2W5, Canada
- Institute of Biomedical Engineering, University of Montreal, Montreal, QC, H3C 3J7, Canada
| | | | | | - Miguel Chagnon
- Department of Mathematics and Statistics, University of Montreal, Montreal, QC, H2C 3J7, Canada
| | - Mark Keezer
- University of Montreal Hospital, Montreal, QC, H3X 0C1, Canada
- Department of Neurology, University of Montreal, Montreal, QC, H2C 3J7, Canada
| | | | - Nathalie J Bureau
- University of Montreal Hospital, Montreal, QC, H3X 0C1, Canada
- Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montreal, QC, H3C 3J7, Canada
| | - Guy Cloutier
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montreal, QC, H2L 2W5, Canada.
- Institute of Biomedical Engineering, University of Montreal, Montreal, QC, H3C 3J7, Canada.
- Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montreal, QC, H3C 3J7, Canada.
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Haueise A, Le Sant G, Eisele-Metzger A, Dieterich AV. Is musculoskeletal pain associated with increased muscle stiffness? Evidence map and critical appraisal of muscle measurements using shear wave elastography. Clin Physiol Funct Imaging 2024; 44:187-204. [PMID: 38155545 DOI: 10.1111/cpf.12870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 11/13/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
INTRODUCTION AND AIMS Approximately 21% of the world's population suffers from musculoskeletal conditions, often associated with sensations of stiff muscles. Targeted therapy requires knowing whether typically involved muscles are objectively stiffer compared to asymptomatic individuals. Muscle stiffness is quantified using ultrasound shear wave elastography (SWE). Publications on SWE-based comparisons of muscle stiffness between individuals with and without musculoskeletal pain are increasing rapidly. This work reviewed and mapped the existing evidence regarding objectively measured muscle stiffness in musculoskeletal pain conditions and surveyed current methods of applying SWE to measure muscle stiffness. METHODS A systematic search was conducted in PubMed and CINAHL using the keywords "muscle stiffness", "shear wave elastography", "pain", "asymptomatic controls" and synonyms. The search was supplemented by a hand search using Google Scholar. Included articles were critically appraised with the AXIS tool, supplemented by items related to SWE methods. Results were visually mapped and narratively described. RESULTS Thirty of 137 identified articles were included. High-quality evidence was missing. The results comprise studies reporting lower stiffness in symptomatic participants, no differences between groups and higher stiffness in symptomatic individuals. Results differed between pain conditions and muscles, and also between studies that examined the same muscle(s) and pathology. The methods of the application of SWE were inconsistent and the reporting was often incomplete. CONCLUSIONS Existing evidence regarding the objective stiffness of muscles in musculoskeletal pain conditions is conflicting. Methodological differences may explain most of the inconsistencies between findings. Methodological standards for SWE measurements of muscles are urgently required.
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Affiliation(s)
- Andreas Haueise
- Faculty of Health, Security, Society, Furtwangen University, Furtwangen, Germany
| | - Guillaume Le Sant
- CHU Nantes, Movement-Interactions-Performance, MIP, Nantes Université, Nantes, France
- School of Physiotherapy, IFM3R, St-Sebastien/Loire, France
| | - Angelika Eisele-Metzger
- Institute for Evidence in Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - Angela V Dieterich
- Faculty of Health, Security, Society, Furtwangen University, Furtwangen, Germany
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Gagnon P, Dunning J, Bliton P, Charlebois C, Henry N, Gorby P, Mourad F. Dry needling in the management of chronic tension-type headache associated with levator scapulae syndrome: A case report. Clin Case Rep 2024; 12:e8858. [PMID: 38689684 PMCID: PMC11060885 DOI: 10.1002/ccr3.8858] [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: 11/22/2023] [Revised: 03/08/2024] [Accepted: 04/04/2024] [Indexed: 05/02/2024] Open
Abstract
Key Clinical Message The use of DN to the muscular trigger points and distal periosteal enthesis of the levator scapulae may be a useful adjunct intervention within a multi-modal plan of care for the management of work-related chronic tension-type headaches associated with LSS. Abstract Chronic tension-type headaches (CTTH) have a lifetime prevalence of 42% and account for more lost workdays than migraine headaches. Dry needling (DN) is being increasingly used by physical therapists in the management of CTTH; however, to date, the supporting evidence is limited. The purpose of this case report was to describe how three sessions of DN targeting myofascial trigger points in the levator scapulae (LS) muscle and its distal enthesis was used to treat a 63-year-old male patient who presented with work-related CTTH associated with levator scapulae syndrome (LSS). The patient was treated for five visits over the course of 2 months. At discharge and 6-month follow-up, the patient reported full resolution of symptoms. Self-report outcomes included the numeric pain rating scale and the Neck Disability Index. The use of DN to the LS muscle and its distal enthesis may be a valuable addition to a multi-modal plan of care in the treatment of work-related CTTH associated with LSS.
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Affiliation(s)
- Peter Gagnon
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical TherapyMontgomeryAlabamaUSA
- Physical Therapy of BoulderBoulderColoradoUSA
| | - James Dunning
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical TherapyMontgomeryAlabamaUSA
- Montgomery Osteopractic Physical Therapy & AcupunctureMontgomeryAlabamaUSA
| | - Paul Bliton
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical TherapyMontgomeryAlabamaUSA
- William S. Middleton VA HospitalMadisonWisconsinUSA
| | - Casey Charlebois
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical TherapyMontgomeryAlabamaUSA
- Arcadia UniversityGlensidePennsylvaniaUSA
| | - Nathan Henry
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical TherapyMontgomeryAlabamaUSA
- Physio RoomColorado SpringsColoradoUSA
| | - Patrick Gorby
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical TherapyMontgomeryAlabamaUSA
- Gorby Osteopractic Physiotherapy, Colorado Springs, COColorado SpringsColoradoUSA
| | - Firas Mourad
- Department of PhysiotherapyLUNEX International University of Health, Exercise and SportsDifferdangeLuxembourg
- Luxembourg Health & Sport Sciences Research Institute ASBLDifferdangeLuxembourg
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Wolff WL, Heinemann CM, Kartes JM, Ashton-Miller JA, Lipps DB. The influence of chair recline and head and neck position on upper trapezius activity and stiffness during seated computer work. APPLIED ERGONOMICS 2024; 117:104227. [PMID: 38290318 DOI: 10.1016/j.apergo.2024.104227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 12/06/2023] [Accepted: 01/05/2024] [Indexed: 02/01/2024]
Abstract
Increasing chair recline during seated computer work may reduce the load placed on the upper trapezius (UT), a common location of pain for those with idiopathic chronic neck pain. This study determined the effect of increasing chair recline on UT stiffness and muscle activity during computer work in people with and without idiopathic chronic neck pain. Surface electromyography and ultrasound shear wave elastography were collected from three subdivisions of the UT in 15 individuals with idiopathic chronic neck pain and 15 sex-matched healthy controls. Participants sat in a standardized computer-work setup while chair recline (0°, 25°, 45°) and head and neck position (self-selected, neutral, flexed) were systematically adjusted and maintained for 2.5-min intervals. Repeated-measures ANOVAs were completed for each sex, muscle, and data type, with group (chronic neck pain, control), chair recline (0°,25°,45°), head and neck position (self-selected, flexed, neutral), and side of collected data (dominant, non-dominant) as fixed factors. Men with idiopathic chronic neck pain demonstrated greater UT stiffness in the cranial subdivision when compared to healthy men. Additionally, the 25° and 45° recline levels increased the stiffness of men's dominant UT compared to men's non-dominant UT. Women's UT was more affected by head and neck position, and a neutral head and neck position resulted in lower UT activation, but higher UT stiffness for the cranial subdivision and midway between C-7 and the acromion process. Overall, our findings suggest that the commonly suggested neutral position may not be a beneficial prompt when positioning someone during seated computer work.
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Affiliation(s)
- Whitney L Wolff
- Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, IL, USA.
| | | | - Jordan M Kartes
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - James A Ashton-Miller
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - David B Lipps
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
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Taş S, Kaynak BA, Salkin Y, Karakoç ZB, Dağ F. An investigation of the changes in mechanical properties of the orofacial and neck muscles between patients with myogenous and mixed temporomandibular disorders. Cranio 2024; 42:150-159. [PMID: 34061722 DOI: 10.1080/08869634.2021.1934795] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To investigate the possible changes in the mechanical properties of the orofacial and neck muscles in patients with temporomandibular disorders (TMD). METHODS The study included a total of 98 females. Females were divided into three groups as myogenous TMD, mixed TMD, and healthy controls. The frequency (indicator of muscle tone), stiffness, and decrement (related to muscle elasticity) values of the sternocleidomastoid, upper trapezius, cervical extensor, and masseter muscles were measured using a portable myotonometer. RESULTS The frequency, stiffness, and decrement values of the masseter muscle were higher in the mixed and myogenous TMD groups than those of the control group (p < 0.017). The mixed TMD group had higher frequency and stiffness values in the upper trapezius muscle compared with the control group (p < 0.017). DISCUSSION The results suggest that the mechanical properties of the oral and neck muscles may be affected in patients with TMD.
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Affiliation(s)
- Serkan Taş
- School of Health Science, Alanya Alaaddin Keykubat University, Department of Physical Therapy and Rehabilitation, Antalya, Turkey
| | - Besime Ahu Kaynak
- Department of Physiotherapy and Rehabilitation, Toros University, School of Health Sciences, Mersin, Turkey
| | - Yasemin Salkin
- Vocational School of Medical Services, Department of Health Care Services, Mersin University, Mersin, Turkey
| | - Zehra Betül Karakoç
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Marmara University, Istanbul, Turkey
| | - Figen Dağ
- School of Medicine, Department of Physical Medicine and Rehabilitation, Mersin University, Mersin, Turkey
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Melo AS, Montóia B, Cruz EB, Vilas-Boas JP, Sousa AS. Scapular muscle dynamic stiffness of asymptomatic subjects and subjects with chronic shoulder pain, at rest and isometric contraction conditions. Proc Inst Mech Eng H 2024; 238:288-300. [PMID: 38403635 DOI: 10.1177/09544119241228082] [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] [Indexed: 02/27/2024]
Abstract
Muscle stiffness had a crucial role in joint stability, particularly, at the shoulder complex. Although changes in upper trapezius muscle stiffness have been described for shoulder pain, contradictory findings have been obtained. Also, existing data regarding scapular muscles are, majorly, about trapezius. Myotonometry is a method used to assess stiffness; however, the reliability values of scapular muscle stiffness through this method have not been assessed in shoulder pain conditions. The present study aims to compare scapular muscles' stiffness (trapezius, serratus anterior, and levator scapulae) between subjects with and without chronic shoulder pain and to evaluate the related test-retest reliability. Twenty-two symptomatic and twenty-two asymptomatic subjects participated in a cross-sectional study. The dynamic muscular stiffness of scapular muscles, at rest and during an isometric contraction, was measured bilaterally with myotonometry, in two moments. The differences in bilateral averaged values between symptomatic and asymptomatic subjects and the effect of the group (group presenting pain in the dominant or non-dominant side, and asymptomatic group) and of the limb (unilateral painful or asymptomatic limb, and bilateral asymptomatic limbs) were investigated. Test-retest intra-rater reliability was determined. An effect of the group was observed at rest, for middle trapezius stiffness, and during contraction, for middle and lower trapezius stiffness. For middle trapezius, increased values were observed in the group presenting pain in non-dominant side comparing to both groups or to group presenting pain in dominant side. The intraclass correlation coefficient, majorly, ranged between 0.775 and 0.989. Participants with pain in the non-dominant side presented an increased middle trapezius' stiffness. Globally, high reliability was observed for scapular muscles dynamic stiffness.
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Affiliation(s)
- Ana Sc Melo
- Centro de Investigação em Reabilitação (CIR), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
- Centro de Investigação em Actividade Física, Saúde e Lazer (CIAFEL), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
- Laboratório de Biomecânica do Porto (LABIOMEP), Universidade do Porto, Porto, Portugal
- Centro Interdisciplinar de Investigação Aplicada em Saúde (CIIAS), Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - Bárbara Montóia
- Escola Superior de Saúde, Politécnico do Porto, Porto, Portugal
| | - Eduardo B Cruz
- Departamento de Fisioterapia, Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
- Centro de Investigação Integrada em Saúde (CHRC), Universidade Nova de Lisboa, Lisboa, Portugal
| | - J Paulo Vilas-Boas
- Laboratório de Biomecânica do Porto (LABIOMEP), Universidade do Porto, Porto, Portugal
- Centro de Investigação, Formação, Inovação e Intervenção em Desporto (CIFI2D), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Andreia Sp Sousa
- Centro de Investigação em Reabilitação (CIR), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
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Wendt M, Waszak M. Assessment of the stiffness of the upper trapezius muscle in a group of asymptomatic people with cervical spine rotation asymmetry. PLoS One 2024; 19:e0298544. [PMID: 38386652 PMCID: PMC10883562 DOI: 10.1371/journal.pone.0298544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
This study investigated the relationship between the stiffness of the upper trapezius muscle and the range of rotational movement of the cervical spine. A total of 60 right-handed asymptomatic students participated in the study. Participants (N = 22) characterised by asymmetry in rotational movements were selected for the experimental group. A difference of ≥10° between right and left rotation of the cervical spine was considered asymmetrical. The control group (N = 38) included participants whose rotation difference was < 10°. Belonging to the experimental or control group did not significantly differentiate trapezius muscle stiffness. The rotation side differentiated the stiffness of the right and left trapezius muscles only in the group of people with rotational movement asymmetry. There were high correlation coefficients between right cervical rotation and the stiffness of the muscle on the right side, and between rotation to the left and the stiffness of the muscle on the left side. There is a relationship between the stiffness of the right and left upper trapezius muscles and the range of right and left rotational motion of the cervical spine. Stiffness of the upper trapezius correlates more strongly with rotation to the side on which the muscle lies than to the opposite side. Increased stiffness of the upper trapezius muscle on the side of limited cervical spine rotation is likely to be determined by the muscle fibre stretching mechanism.
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Affiliation(s)
- Michał Wendt
- Department of Medical Biology, Poznan University of Physical Education, Poznań, Poland
| | - Małgorzata Waszak
- Department of Medical Biology, Poznan University of Physical Education, Poznań, Poland
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Varol U, Valera-Calero JA, Sánchez-Jiménez E, Fernández-de-las-Peñas C, Ortega-Santiago R, Kobylarz MD, Navarro-Santana MJ. Levator Scapulae Stiffness Measurement Reliability in Individuals with and without Chronic Neck Pain by Experienced and Novel Examiners. SENSORS (BASEL, SWITZERLAND) 2024; 24:277. [PMID: 38203140 PMCID: PMC10781297 DOI: 10.3390/s24010277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/19/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024]
Abstract
The levator scapulae muscle is a key structure in the etiopathology of neck and shoulder musculoskeletal pain. Although previous studies used shear-wave elastography (SWE) for characterizing this muscle elasticity, limited evidence assessed the inter-examiner reliability of this procedure. This study aimed to analyze the inter-examiner reliability for calculating Young's modulus and shear wave speed in a cohort of participants with and without chronic neck pain. A diagnostic accuracy study was conducted, acquiring a set of SWE images at the C5 level in participants with and without neck pain (n = 34 and 33, respectively) by two examiners (one experienced and one novel). After blinding the participants' identity, examiner involved, and side, the stiffness indicators were calculated by an independent rater in a randomized order. Intra-class correlation coefficients (ICC), standard error of measurement, minimal detectable changes, and coefficient of variation were calculated. Both cohorts had comparable sociodemographic characteristics (p > 0.05). No significant levator scapulae elasticity differences were found between genders, sides, or cohorts (all, p > 0.05). Inter-examiner reliability for calculating Young's modulus and shear wave speed was moderate-to-good for assessing asymptomatic individuals (ICC = 0.714 and 0.779, respectively), while poor-to-moderate in patients with neck pain (ICC = 0.461 and 0.546, respectively). The results obtained in this study support the use of this procedure for assessing asymptomatic individuals. However, reliability estimates were unacceptable to support its use for assessing elasticity in patients with chronic neck pain. Future studies might consider that the shear wave speed is more sensitive to detect real changes in comparison with Young's modulus.
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Affiliation(s)
- Umut Varol
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 29222 Alcorcón, Spain; (U.V.); (M.D.K.)
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.V.-C.); (M.J.N.-S.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | | | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Mateusz D. Kobylarz
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 29222 Alcorcón, Spain; (U.V.); (M.D.K.)
- Akademia Terapii Manualnej i Igłoterapii Suchej (ATMIS), 34-400 Nowy Targ, Poland
| | - Marcos José Navarro-Santana
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.V.-C.); (M.J.N.-S.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Nagai T, Schilaty ND, Wong H, Keller VC, Stiennon ST, Chang RW, Stuart MJ, Krause DA. Acute effects of an isometric neck warm-up programme on neck performance characteristics and ultrasound-based morphology. Ann Med 2023; 55:2295402. [PMID: 38142049 PMCID: PMC10763903 DOI: 10.1080/07853890.2023.2295402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/11/2023] [Indexed: 12/25/2023] Open
Abstract
OBJECTIVE Athletic performance can be enhanced immediately after an isometric warm-up, a phenomenon termed post-activation performance enhancement (PAPE). While isometric warm-ups can improve lower extremity sprint and jump performance, neck-specific isometric warm-ups need development and validation for mild traumatic brain disorders and neck pain. This study examined acute effects of isometric warm-ups on neck performance and morphology. METHODS Arm 1: Twenty-six adults (13 M:13F) completed neck performance testing before and after a 10-minute neck isometric warm-up or stationary bike (sham) between two visits. Testing included visual-motor reaction time, peak force, rate of force development, force steadiness, and force replication/proprioception measured by a 6-axis load cell. An inclinometer assessed range-of-motion. Paired t-tests and two-way ANOVA examined effects of neck/bike warm-up and interaction effects, respectively. Arm 2: 24 adults (11 M:13F) completed ultrasound scans of cervical muscles: before 20-minute rest (sham), and before/after a 5-min neck isometric warm-up. Longus colli cross-sectional area and sternocleidomastoid/upper trapezius thickness and stiffness, and cervical extensors thickness was assessed. One-way ANOVA compared morphological values at sham, before, and after warm-up. Significance was set at p < 0.05. RESULTS Isometric neck warm-up increased rate of force development in flexion (p = 0.022), extension (p = 0.001-0.003), right lateral flexion (p = 0.004-0.032), left lateral flexion (p = 0.005-0.014), while peak force improved only in left lateral flexion (p = 0.032). Lateral flexion range-of-motion increased after neck warm-up (p = 0.003-0.026). Similarly, longus colli cross-sectional area (p = 0.016) and sternocleidomastoid thickness (p = 0.004) increased. CONCLUSIONS Increased neck performance characteristics and morphology are likely due to PAPE effects of isometric neck warm-up. For coaches and athletes, simple isometric contractions could be added to existing warm-ups to reduce prevalence, incidence, and severity of mild traumatic brain injuries and neck pain.
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Affiliation(s)
- Takashi Nagai
- United States Army Research Institute and Environmental Medicine, Natick, MA, USA
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Nathan D. Schilaty
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Neurosurgery and Brain Repair, University of South FL, Tampa, FL, USA
- Department of Medical Engineering, University of South Florida, Tampa, FL, USA
- Center for Neuromusculoskeletal Research, University of South Florida, Tampa, FL, USA
| | - Hanwen Wong
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Valerie C. Keller
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Sean T. Stiennon
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Ryan W.B Chang
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | | | - David A. Krause
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN, USA
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Seidel A, Brandl A, Egner C, Schleip R. Examination of Myofascial Stiffness and Elasticity in the Upper Trapezius Region in Patients with Unilateral Neck Pain: A Cross-Sectional Study. J Clin Med 2023; 12:6339. [PMID: 37834984 PMCID: PMC10573173 DOI: 10.3390/jcm12196339] [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: 09/15/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: Globally, neck pain is prevalent, affecting around thirty percent of the population annually. To better understand the influence of pain on the myofascial layers, the present study investigated these on the upper trapezius muscle in unilateral, more severe neck pain. (2) Methods: This study was a cross-sectional study. Forty patients (42.2 ± 14.7) with a confirmed diagnosis of unilateral neck pain were examined using durometry and indentometry. This study evaluated the stiffness, elasticity, and pressure pain threshold of both sides of the neck (symptomatic side: SS; healthy side: HS). Furthermore, the range of motion of the cervical spine (lateral flexion, rotation) was quantified using a digital goniometer. (3) Results: A significant lateral discrepancy was observed in stiffness between groups (durometry: SS-33.76 ± 7.78, HS-29.75 ± 7.45, p < 0.001; indentometry: SS-59.73 ± 33.93, HS-4.18 ± 12.69, p = 0.024). In contrast, no differences were found between the comparison sides of the upper trapezius for the parameter's elasticity (SS-0.101 ± 1.09, HS--0.006 ± 0.29, p = 0.416), cervical spine mobility (lateral flexion: SS-37.08 ± 8.15, HS-37.73 ± 7.61, p = 0.559; rotation: SS-73.55 ± 12.37, HS-72.85 ± 11.10, p = 0.660), and algometry (SS-36.41 ± 17.53, HS-37.22 ± 17.00, p = 0.657). (4) Conclusion: Overall, it can be concluded that more severe neck pain unilaterally shows differences in stiffness on the same side. Future research is needed to investigate the links.
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Affiliation(s)
- Anika Seidel
- Department of Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany
| | - Andreas Brandl
- Department of Sports Medicine, Institute for Human Movement Science, Faculty for Psychology and Human Movement Science, University of Hamburg, 20148 Hamburg, Germany
- Conservative and Rehabilitative Orthopedics, Department of Sport and Health Sciences, Technical University of Munich, 80333 Munich, Germany
| | - Christoph Egner
- Department of Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany
| | - Robert Schleip
- Department of Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany
- Conservative and Rehabilitative Orthopedics, Department of Sport and Health Sciences, Technical University of Munich, 80333 Munich, Germany
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Opara M, Kozinc Ž. Which muscles exhibit increased stiffness in people with chronic neck pain? A systematic review with meta-analysis. Front Sports Act Living 2023; 5:1172514. [PMID: 37712006 PMCID: PMC10498279 DOI: 10.3389/fspor.2023.1172514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/18/2023] [Indexed: 09/16/2023] Open
Abstract
Introduction Chronic neck pain (CNP) substantially impacts quality of life, posing both personal challenges and economic strains. This systematic review sought to discern muscle-specific stiffness differences between CNP patients and individuals without CNP. Methods We searched the PubMed, Scopus, and PEDro databases for studies using ultrasound elastography or myotonometry to compare muscle stiffness between CNP patients and asymptomatic controls. Using a meta-analysis with a random-effects model, we derived the pooled effect as standardized mean difference (SMD). Results Out of the six studies selected, the adjusted Newcastle-Ottawa rating scale for cross-sectional studies denoted three as moderate-quality and three as high-quality. Our findings indicate that the upper trapezius (UT) stiffness was elevated in CNP patients compared to their counterparts without CNP (SMD = 0.39, 95% CI = 0.05 to 0.74; p = 0.03; small effect size). The data for other muscles remained inconclusive. Discussion Given the case-control design of all reviewed studies, a direct causative link between UT stiffness and CNP is yet to be confirmed. As such, recommending a reduction in trapezius muscle stiffness as a primary rehabilitation strategy for CNP patients is still inconclusive and further research is needed.
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Affiliation(s)
- Manca Opara
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- Department of Health Studies, Andrej Marušič Institute, University of Primorska, Koper, Slovenia
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12
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Xu W, Zheng Y, Jiang Y, Zhang Z, Ma S, Cao Y. Shear wave imaging the active constitutive parameters of living muscles. Acta Biomater 2023; 166:400-408. [PMID: 37230437 DOI: 10.1016/j.actbio.2023.05.035] [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: 11/28/2022] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
Shear wave elastography (SWE) of human skeletal muscles allows for measurement of muscle elastic properties in vivo and has important applications in sports medicine and for the diagnosis and treatment of muscle-related diseases. Existing methods of SWE for skeletal muscles rely on the passive constitutive theory and have so far been unable to provide constitutive parameters describing muscle active behavior. In the present paper, we overcome this limitation by proposing a SWE method for quantitative inference of active constitutive parameters of skeletal muscles in vivo. To this end, we investigate the wave motion in a skeletal muscle described by a constitutive model in which muscle active behavior has been defined by an active parameter. An analytical solution relating shear wave velocities to both passive and active material parameters of muscles is derived, based upon which an inverse approach has been developed to evaluate these parameters. To demonstrate the usefulness of the reported method, in vivo experiments were carried out on 10 volunteers to obtain constitutive parameters, particularly those describing active deformation behaviors of living muscles. The results reveal that the active material parameter of skeletal muscles varies with warm-up, fatigue and rest. STATEMENT OF SIGNIFICANCE: Existing shear wave elastography methods are limited to imaging the passive parameters of muscles. This limitation is addressed in the present paper by developing a method to image the active constitutive parameter of living muscles using shear waves. We derived an analytical solution demonstrating the relationship between constitutive parameters of living muscles and shear waves. Relying on the analytical solution, we proposed an inverse method to infer active parameter of skeletal muscles. We performed in vivo experiments to demonstrate the usefulness of the theory and method; the quantitative variation of the active parameter with muscle states such as warm-up, fatigue and rest has been reported for the first time.
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Affiliation(s)
- Weiqiang Xu
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, 100084, PR China
| | - Yang Zheng
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, 100084, PR China
| | - Yuxuan Jiang
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, 100084, PR China
| | - Zhaoyi Zhang
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, 100084, PR China
| | - Shiyu Ma
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, 100084, PR China
| | - Yanping Cao
- Institute of Biomechanics and Medical Engineering, AML, Department of Engineering Mechanics, Tsinghua University, Beijing, 100084, PR China.
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13
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Karaağaç A, Arslan SA, Keskin ED. Assessment of pain, scapulothoracic muscle strength, endurance and scapular dyskinesis in individuals with and without nonspecific chronic neck pain: A cross-sectional study. J Bodyw Mov Ther 2023; 35:261-267. [PMID: 37330779 DOI: 10.1016/j.jbmt.2023.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 10/03/2022] [Accepted: 04/10/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION This study is aimed to evaluate pain, muscle strength, scapular muscular endurance and scapular kinesis in individuals with Nonspecific Chronic Neck Pain and to compare them with asymptomatic individuals. In addition, to investigate the effect of mechanical changes in the scapular region on neck pain. METHOD 40 individuals who applied to Kırıkkale University Faculty of Medicine Hospital Physical Therapy and Rehabilitation Center and diagnosed with NSCNP and 40 asymptomatic individuals for the control group were included the study. Pain was evaluated with Visual Analogue Scale, pain threshold and pain tolerance with algometer, cervical deep flexor group muscle strength with Stabilizer Pressure Biofeedback device, and neck and scapulothoracic muscle strength with Hand Held Dynamometer. Scapular Dyskinesia Test, Scapular Depression Test and Lateral Scapular Slide Test were used to evaluate scapular kinesis. A timer was used to evaluate scapular muscular endurance. RESULT Pain threshold and pain tolerance values of the NSCNP group were lower (p < 0.05). Muscle strength around neck and scapulothoracic region of the NSCNP group were lower than the asymptomatic individuals (p < 0.05). NSCNP group had more scapular dyskinesia (p < 0.05). Scapular muscular endurance values of the NSCNP group were lower (p < 0.05). CONCLUSION As a result, pain threshold and pain tolerance decreased, muscle strength of the neck region and the scapular region decreased, scapular endurance values decreased and the incidence of scapular dyskinesia increased in the individuals with NSCNP compared to the asymptomatic individuals. It is thought that our study will provide a different perspective in the evaluation of neck pain and including the scapular region to the evaluations.
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Affiliation(s)
- Ali Karaağaç
- İstanbul Gelisim University, Vocational School of Health Services, İstanbul, Turkey.
| | - Saniye Aydoğan Arslan
- Department of Physiotherapy and Rehabilitation, Kırıkkale University Faculty of Health Sciences, Kırıkkale, Turkey
| | - Esra Dilek Keskin
- Kırıkkale University, Faculty of Medical Sciences, Department of Physical Medicine and Rehabilitation, Kırıkkale, Turkey
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14
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Stiver ML, Mirjalili SA, Agur AMR. Measuring Shear Wave Velocity in Adult Skeletal Muscle with Ultrasound 2-D Shear Wave Elastography: A Scoping Review. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1353-1362. [PMID: 36958957 DOI: 10.1016/j.ultrasmedbio.2023.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 05/11/2023]
Abstract
Ultrasound 2-D shear wave elastography (US 2D-SWE) is a non-invasive, cost-effective tool for quantifying tissue stiffness. Amidst growing interest in US 2D-SWE for musculoskeletal research, it has been recommended that shear wave velocity (SWV) should be reported instead of elastic moduli to avoid introducing unwanted error into the data. This scoping review examined the evolving use of US 2D-SWE to measure SWV in skeletal muscle and identified strengths and weaknesses to guide future research. We searched electronic databases and key review reference lists to identify articles published between January 2000 and May 2021. Two reviewers assessed the eligibility of records during title/abstract and full-text screening, and one reviewer extracted and coded the data. Sixty-six studies met the eligibility criteria, of which 58 were published in 2017 or later. We found a striking lack of consensus regarding the effects of age and sex on skeletal muscle SWV, and widely variable reliability values. Substantial differences in methodology between studies suggest a pressing need for developing standardized, validated scanning protocols. This scoping review illustrates the breadth of application for US 2D-SWE in musculoskeletal research, and the data synthesis exposed several notable inconsistencies and gaps in current literature that warrant consideration in future studies.
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Affiliation(s)
- Mikaela L Stiver
- Division of Anatomy, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Anatomical Sciences, Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
| | - Seyed Ali Mirjalili
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Anne M R Agur
- Division of Anatomy, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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15
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Xie Y, Thomas L, Johnston V, Coombes BK. Cervical and axioscapular muscle stiffness measured with shear wave elastography: A comparison between different levels of work-related neck disability. J Electromyogr Kinesiol 2023; 69:102754. [PMID: 36773478 DOI: 10.1016/j.jelekin.2023.102754] [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: 11/01/2022] [Revised: 12/21/2022] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Assessing muscle mechanical properties in terms of stiffness may provide important insights into mechanisms underlying work-related neck pain. This study compared stiffness of cervical and axioscapular muscles between 92 participants (sonographers) with no (n = 31), mild (n = 43) or moderate/severe (n = 18) neck disability. It was hypothesized that participants with more severe neck pain and disability would present with altered distribution of stiffness in cervical and axioscapular muscles than those with no disability. Using shear wave elastography, the shear modulus (kPa) of five cervical and six axioscapular muscles or muscle segments were measured in a relaxed seated upright or side-lying position. Muscle activity was measured simultaneously using surface electromyography during the elastography measurements and scapular depression was measured using a measurement tape and inclinometer before the elastography measurements to evaluate their potential confounding influences on shear modulus. Increased shear modulus was found in deeper than superficial cervical muscles and more cranial than caudal axioscapular muscles. However, no differences in shear modulus of the cervical or axioscapular muscles were found between sonographers with varying levels of disability. This study suggests no alterations in stiffness of cervical and axioscapular muscles were associated with work-related neck pain and disability.
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Affiliation(s)
- Yanfei Xie
- RECOVER Injury Research Centre, The University of Queensland, Australia.
| | - Lucy Thomas
- School of Health and Rehabilitation Science, The University of Queensland, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Science, The University of Queensland, Australia; School of Health and Medical Sciences, University of Southern Queensland, Australia
| | - Brooke K Coombes
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia; Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
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16
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Preliminary investigation of the effects of sitting with and without short active breaks on muscle stiffness assessed with shear-wave elastography. SPORT SCIENCES FOR HEALTH 2023. [DOI: 10.1007/s11332-023-01051-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Abstract
Purpose
The purpose of this preliminary study was to compare the effects of 1-h sitting with and without short active breaks on muscle stiffness as measured by shear-wave elastography (SWE).
Methods
The participants (7 females, 3 males; age: 24.9 ± 1.2 years) completed two (with and without active breaks) 1-h sitting exposures on separate days. Active breaks (2–3 min) were performed at 20 min and 40 min time marks and comprised simple stretching and activation exercises. Before, during (30 min) and after (1 h) of sitting, shear modulus of upper trapezius, lumbar region of erector spinae and rectus femoris muscles was measured with SWE.
Results
Statistically significant effects of sitting exposure in erector spinae muscle stiffness were noted (p = 0.041; η2 = 0.38). There were no other statistically significant effects of sitting exposure or condition (with/without breaks).
Conclusions
Although few statistically significant effects were detected, the trends in this preliminary trial suggest that prolonged sitting increases muscle stiffness and warrants further investigation of short active breaks with larger sample sizes.
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Hao CJ, Xiao WL, Zhang QB, Tan XM. Viscoelasticity in trapezius myofascial pain syndrome: quantitative assessment using Real-Time Shear-Wave Elastography. Ann Med 2023; 55:2252442. [PMID: 37676997 PMCID: PMC10486288 DOI: 10.1080/07853890.2023.2252442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/19/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVE To investigate the differences in the viscoelastic properties between normal trapezius muscles and those in patients with trapezius myofascial pain syndrome (MPS) using real-time shear-wave elastography (SWE). MATERIALS AND METHODS This study included 31 patients with trapezius MPS and 31 volunteers. Sixty-one trapezius muscles (41 and 20 on the affected and non-affected side, respectively) of patients with MPS and 62 normal trapezius muscles in volunteers were assessed. Conventional ultrasonic parameters, including skeletal muscle thickness, resistance index (RI), and mean shear wave velocity (SWVmean) of trapezius muscles, were obtained in the seated position with the shoulders and neck relaxed. The daily neck leaning time (unit:hours) of all participants was obtained using a questionnaire. RESULTS Ultrasound showed no statistically significant differences in thickness or RI of the trapezius muscles of the affected and non-affected sides in MPS patients versus normal trapezius muscles (p = 0.976 and 0.106, respectively). In contrast, the SWVmean of trapezius muscles in patients with MPS was significantly higher than that of normal trapezius muscles in both the affected and non-affected sides (4.41 ± 1.02 m/s vs. 3.35 ± 0.79 m/s, p < 0.001; 4.05 ± 0.63 m/s vs. 3.35 ± 0.79 m/s, p = 0.002). There was no significant difference between the SWVmean of the trapezius muscles on the affected and non-affected sides in patients with MPS (4.41 ± 1.02 m/s vs. 4.05 ± 0.63 m/s, p = 0.225). Correlation analysis showed that daily neck forward time was positively correlated with the SWVmean of the trapezius muscles on the affected and non-affected sides in patients with MPS (r = 0.635, p < 0.001; r = 0.576, p = 0.008). CONCLUSION SWE can quantitatively evaluate stiffness of trapezius muscles in patients with trapezius MPS. The stiffness of both affected and non-affected trapezius muscles increased in patients with trapezius MPS, and the degree of increase positively correlated with the time of cervical forward leaning.
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Affiliation(s)
- Chang-Juan Hao
- Department of Ultrasound, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Shanxi Tongji Hospital, Taiyuan, China
| | - Wen-Li Xiao
- Department of Ultrasound, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Shanxi Tongji Hospital, Taiyuan, China
| | - Quan-Bin Zhang
- Department of Ultrasound, Sixth Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiao-Mei Tan
- Device management and maintenance center, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Shanxi Tongji Hospital, Taiyuan, China
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Paskali F, Simantzik J, Dieterich A, Kohl M. Specification of Neck Muscle Dysfunction through Digital Image Analysis Using Machine Learning. Diagnostics (Basel) 2022; 13:diagnostics13010007. [PMID: 36611299 PMCID: PMC9818408 DOI: 10.3390/diagnostics13010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/17/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
Everyone has or will have experienced some degree of neck pain. Typically, neck pain is associated with the sensation of tense, tight, or stiff neck muscles. However, it is unclear whether the neck muscles are objectively stiffer with neck pain. This study used 1099 ultrasound elastography images (elastograms) obtained from 38 adult women, 20 with chronic neck pain and 18 asymptomatic. For training machine learning algorithms, 28 numerical characteristics were extracted from both the original and transformed shear wave velocity color-coded images as well as from respective image segments. Overall, a total number of 323 distinct features were generated from the data. A supervised binary classification was performed, using six machine-learning algorithms. The random forest algorithm produced the most accurate model to distinguish the elastograms of women with chronic neck pain from asymptomatic women with an AUC of 0.898. When evaluating features that can be used as biomarkers for muscle dysfunction in neck pain, the region of the deepest neck muscles (M. multifidus) provided the most features to support the correct classification of elastograms. By constructing summary images and associated Hotelling's T2 maps, we enabled the visualization of group differences and their statistical confirmation.
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Affiliation(s)
- Filip Paskali
- Institute of Precision Medicine, Medical and Life Sciences, Hochschule Furtwangen, 78054 Villingen-Schwenningen, Germany
| | - Jonathan Simantzik
- Institute of Precision Medicine, Medical and Life Sciences, Hochschule Furtwangen, 78054 Villingen-Schwenningen, Germany
| | - Angela Dieterich
- Physiotherapie, Fakultät Gesundheit, Sicherheit, Gesellschaft, Hochschule Furtwangen, Studienzentrum Freiburg, 79110 Freiburg, Germany
| | - Matthias Kohl
- Institute of Precision Medicine, Medical and Life Sciences, Hochschule Furtwangen, 78054 Villingen-Schwenningen, Germany
- Correspondence:
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Thomas E, Ficarra S, Nakamura M, Paoli A, Bellafiore M, Palma A, Bianco A. Effects of Different Long-Term Exercise Modalities on Tissue Stiffness. SPORTS MEDICINE - OPEN 2022; 8:71. [PMID: 35657537 PMCID: PMC9166919 DOI: 10.1186/s40798-022-00462-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 05/13/2022] [Indexed: 11/10/2022]
Abstract
AbstractStiffness is a fundamental property of living tissues, which may be modified by pathologies or traumatic events but also by nutritional, pharmacological and exercise interventions. This review aimed to understand if specific forms of exercise are able to determine specific forms of tissue stiffness adaptations. A literature search was performed on PubMed, Scopus and Web of Science databases to identify manuscripts addressing adaptations of tissue stiffness as a consequence of long-term exercise. Muscular, connective, peripheral nerve and arterial stiffness were considered for the purpose of this review. Resistance training, aerobic training, plyometric training and stretching were retrieved as exercise modalities responsible for tissue stiffness adaptations. Differences were observed related to each specific modality. When exercise was applied to pathological cohorts (i.e. tendinopathy or hypertension), stiffness changed towards a physiological condition. Exercise interventions are able to determine tissue stiffness adaptations. These should be considered for specific exercise prescriptions. Future studies should concentrate on identifying the effects of exercise on the stiffness of specific tissues in a broader spectrum of pathological populations, in which a tendency for increased stiffness is observed.
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Yan ZW, Yang Z, Zhao FL, Gao Y, Wu ZK, Wang JL, Zhou M. Effect of sling exercise therapy on surface electromyography and muscle thickness of superficial cervical muscle groups in female patients with chronic neck pain. J Back Musculoskelet Rehabil 2022; 36:387-397. [PMID: 36278336 DOI: 10.3233/bmr-220030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The persistence of symptoms in patients with chronic neck pain is considered to be associated with variation in the neck muscle structure and associated neuromuscular control. Sling exercise therapy (SET) has been demonstrated to relieve the symptoms of chronic neck pain, whereas it is controversial whether this benefit is correlated to altered neck muscle structure and associated neuromuscular control in the patients. OBJECTIVE To investigate the effect of SET on cervical muscle structure (thickness) and associated neuromuscular control in patients with chronic neck pain. METHODS Twenty-five patients with chronic neck pain were randomly assigned to the SET group (n= 12) or the control group (n= 13). The SET group received the SET intervention for 4 weeks, while the control group maintained normal activities of daily living. At baseline and after 4 weeks of intervention, Visual analogue scale and neck disability index were measured in both groups, and changes in the thickness of the superficial cervical muscles were assessed using musculoskeletal ultrasound. Surface electromyography (EMG) was adapted to assess the neuromuscular control of the neck while the participant was performing the cranio-cervical flexion test. RESULTS At 4 weeks, the SET group had a significant reduction of RMS in both UT and SCM of EMG compared to the control group (p< 0.05). Regarding ultrasound, the SET group had significantly lower muscle thickness compared to the control group in both the rest position and the MVIC position (p< 0.05). There were no within-group differences in the control group (p> 0.05), while the SET group showed significant reductions in both RMS and muscle thickness (p< 0.05). CONCLUSION 4-week SET was effective in reducing pain and dysfunction in patients with chronic neck pain, which may be related to improved neck muscle thickness and neuromuscular control of the neck.
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Affiliation(s)
- Zhi-Wei Yan
- Department of Sports Rehabilitation, College of Human Kinesiology, Shenyang Sport University, Liaoning, China.,Department of Sports Rehabilitation, College of Human Kinesiology, Shenyang Sport University, Liaoning, China
| | - Zhen Yang
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK.,Department of Sports Rehabilitation, College of Human Kinesiology, Shenyang Sport University, Liaoning, China
| | - Feng-Long Zhao
- Institute of Ultrasonic Engineering in Medicine, Chongqing Key Laboratory of Ultrasound Medical Engineering, Department of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Yan Gao
- Department of Sports Rehabilitation, College of Human Kinesiology, Shenyang Sport University, Liaoning, China
| | - Zhen-Kun Wu
- Department of Sports Rehabilitation, College of Human Kinesiology, Shenyang Sport University, Liaoning, China
| | - Jie-Long Wang
- School of Physical Education and Sports Science, Soochow University, Suzhou, China
| | - Mei Zhou
- Laboratory Management Center, Shenyang Sport University, Liaoning, China
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21
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Effects of cervicothoracic postures on the stiffness of trapezius muscles. Med Biol Eng Comput 2022; 60:3009-3017. [DOI: 10.1007/s11517-022-02655-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/09/2022] [Indexed: 10/14/2022]
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22
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Dağ F, Taş S, Çimen ÖB. Pulmonary Functions in Patients With Chronic Neck Pain: A Case-Control Study. J Manipulative Physiol Ther 2022; 45:290-297. [DOI: 10.1016/j.jmpt.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 06/08/2021] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
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23
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The influence of idiopathic chronic neck pain on upper trapezius and sternocleidomastoid muscle activity and elasticity during functional reaching: A cross-sectional study. J Biomech 2022; 141:111223. [DOI: 10.1016/j.jbiomech.2022.111223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/24/2022] [Accepted: 07/15/2022] [Indexed: 11/20/2022]
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Sawada T, Okawara H, Nakashima D, Iwabuchi S, Matsumoto M, Nakamura M, Nagura T. Effects of alternating heat and cold stimulation at different cooling rates using a wearable thermo device on shoulder muscle stiffness: a cross-over study. BMC Musculoskelet Disord 2022; 23:669. [PMID: 35831832 PMCID: PMC9281090 DOI: 10.1186/s12891-022-05623-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background A small, wearable thermo device that uses Peltier elements for programmed heat and cold stimulation has been developed recently and is expected to be applied in conventional contrast bath therapy. This study was aimed to examine improvements in trapezius muscle hardness and subjective symptoms resulting from alternating heat and cold stimulation, with different rates of cooling. Methods This cross-over study included four conditions. Twenty healthy young male individuals (age, 22.3 ± 4.5 years) participated in this study. These four interventions targeted the unilateral trapezius muscle of the dominant arm after a 15-min typing task. Specifically, heat and cold stimulations were applied at different ratios (the heating/cooling rate of 3:1, 3:2, and 3:3) or not applied. Each intervention was separated by at least one week. Skin temperature at the stimulation area was recorded using a data logger. Outcome measures included muscle hardness (measured using a portable tester) and subjective symptoms (muscle stiffness and fatigue). Each item was assessed at three time points: baseline, after typing, and after the intervention. Results Two-way analysis of variance with repeated measures found an interaction effect for muscle hardness between four conditions (3:1, 3:2, 3:3, and no) and three time points (p < 0.05). Only in the 3:1 condition were the post-intervention values lower than those after typing (p < 0.01). There was also an interaction effect for subjective muscle stiffness (p < 0.05); the values after the intervention in the 3:1 condition were lower than those after intervention in the no stimulation condition (p < 0.01). There was no significant relationship between changes in muscle hardness and changes in subjective symptoms in the 3:1 condition. Conclusions Our results demonstrate that alternating heat and cold stimulations with a different cooling rate could affect the degree of improvement in muscle hardness and subjective symptoms. In particular, the 3:1 condition has the possibility to improved muscle hardness within the condition and subjective muscle stiffness between conditions. Trial registration UMIN000040620. Registered 1 June 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046359 Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05623-z.
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Affiliation(s)
- Tomonori Sawada
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Hiroki Okawara
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Daisuke Nakashima
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan. .,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
| | - Shuhei Iwabuchi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Takeo Nagura
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.,Department of Clinical Biomechanics, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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Onda A, Onozato K, Kimura M. Clinical features of neck and shoulder pain (Katakori) in Japanese hospital workers. Fukushima J Med Sci 2022; 68:79-87. [PMID: 35660659 PMCID: PMC9493333 DOI: 10.5387/fms.2022-02] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Non-specific pain or discomfort in the neck and shoulder girdle, called katakori in Japanese, is a common, chronic musculoskeletal condition worldwide. However, its various clinical features are incompletely characterized, even among medical professionals. We aimed to clarify factors affecting katakori and to investigate objectively the associated neck muscle stiffness and skeletal muscle volume. Methods: All staff members at our private hospital were surveyed about their lifestyle, physical and mental status, and katakori symptoms, using a self-administered questionnaire. Multiple logistic regression analysis was used to explore possible katakori risk factors. On secondary assessment, ultrasound elastography of the trapezius muscle as well as limb/trunk muscle mass were compared between subjects with severe symptoms and subjects without katakori, using propensity score matching. Results: Of 359 participants enrolled, nearly 75% had katakori to some degree. Spending time on a computer during work (adjusted odds ratio [aOR]: 1.82 for 3-6 hours, aOR: 2.48 for > 6 hours), being female (aOR: 3.75), and having unsatisfactory sleep (aOR: 2.92) were potential risk factors for katakori. Comparison of 13 matched pairs showed a significantly stiffer trapezius in subjects with severe katakori symptoms, but no apparent differences in limb/trunk muscle mass. Conclusions: Katakori was particularly prevalent in our hospital staff. Possible risk factors for disabling katakori were doing long-term computer work, being female, and having unsatisfactory sleep. Symptoms seem to be associated with elevated neck muscle stiffness. These findings could guide working condition improvements to mitigate katakori.
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Affiliation(s)
- Akira Onda
- Department of Orthopedic Surgery, Zenshukai Hospital.,Department of Rehabilitation, Zenshukai Hospital
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Shen S, Lam WK, Teng J, Jia SW, Baker JS, Ugbolue UC, Fekete G, Gu Y. Gender and leg-dominance differences in shoe properties and foot injuries in badminton: a cross-sectional survey. J Foot Ankle Res 2022; 15:26. [PMID: 35369886 PMCID: PMC8978418 DOI: 10.1186/s13047-022-00531-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
While the roles of injury prevention and performance enhancement have increasingly been investigated for badminton footwear, there is a lack of research on gender-specific badminton footwear. The purpose of this study was to examine the gender differences in footwear demands and foot injuries in badminton.
Methods
The study was a cross-sectional survey, in which 326 recreational badminton players were recruited. The questionnaire was divided into four sections enquiring about the characteristics of (1) participant profiles, (2) importance of shoe properties (3) shoe complaints (4) and pain or discomfort in different foot regions. The Mann-Whitney U test and Wilcoxon Signed Ranks test were performed to determine the differences between genders and the differences between leg dominance, respectively. The significance level was set at 0.05.
Results
Both males and females rated shoe fit as the most important features, followed by the overall comfort and injury protection. Females considered the shoe forefoot cushioning, comfort, breathability and colour as more important compared with the other properties, which showed distinct pattern differences from males. The shoe problem results indicated that plantar pain of the non-dominant foot was considered the most commonly reported footwear problem by both males and females. The problem of excessive arch-support on the dominant and non-dominant sides of male participants was significantly higher than females (p < 0.05). Occasional pain or frequent pain were mainly distributed in the forefoot, followed by the rearfoot and midfoot regions.
Conclusion
There were small differences in footwear demand between the dominant and non-dominant sides, but several differences existed between females and males. The results from gender differences suggested that female shoes prefer a specific shoe last for better fit, rather than a modified version of male shoes. In the future, the design of badminton shoes should consider footwear demands and foot discomfort profiles in respective male and female badminton players.
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Melo ASC, Cruz EB, Vilas-Boas JP, Sousa ASP. Scapular Dynamic Muscular Stiffness Assessed through Myotonometry: A Narrative Review. SENSORS 2022; 22:s22072565. [PMID: 35408180 PMCID: PMC9002787 DOI: 10.3390/s22072565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 02/04/2023]
Abstract
Several tools have been used to assess muscular stiffness. Myotonometry stands out as an accessible, handheld, and easy to use tool. The purpose of this review was to summarize the psychometric properties and methodological considerations of myotonometry and its applicability in assessing scapular muscles. Myotonometry seems to be a reliable method to assess several muscles stiffness, as trapezius. This method has been demonstrated fair to moderate correlation with passive stiffness measured by shear wave elastography for several muscles, as well as with level of muscle contraction, pinch and muscle strength, Action Research Arm Test score and muscle or subcutaneous thickness. Myotonometry can detect scapular muscles stiffness differences between pre- and post-intervention in painful conditions and, sometimes, between symptomatic and asymptomatic subjects.
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Affiliation(s)
- Ana S. C. Melo
- Center for Rehabilitation Research—Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal;
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP-UP), University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal;
- Center for Interdisciplinary Applied Research in Health, School of Health, Setubal Polytechnic Institute, Campus do IPS Estefanilha, 2914-503 Setubal, Portugal
| | - Eduardo B. Cruz
- Department of Physiotherapy, School of Health, Setubal Polytechnic Institute, Campus do IPS Estefanilha, 2914-503 Setubal, Portugal;
- Comprehensive Health Research Center (CHRC), Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal
| | - João Paulo Vilas-Boas
- Porto Biomechanics Laboratory (LABIOMEP-UP), University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal;
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal
| | - Andreia S. P. Sousa
- Center for Rehabilitation Research—Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal;
- Correspondence: or
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Ahn SH, Jung SH, Kim HA, Kim JH, Weon YS, Kwon OY. Differences in neck muscle activity according to lying positions using a smartphone. J Back Musculoskelet Rehabil 2022; 35:383-391. [PMID: 34334376 DOI: 10.3233/bmr-200315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Due to the extended use of smartphones, people spend a lot of time on these devices while lying down. OBJECTIVE The purpose of the present study was to compare the differences in neck muscle activity of participants while they watched videos on a smartphone in four different lying positions (supine (SUP), prone on elbows (PE), side lying (SIDE), and 45∘ head turn while side lying (45-SIDE)). METHODS Twenty-three healthy volunteers (22.4 ± 1.7 years) were enrolled in this study. We assessed the activities of their right and left sternocleidomastoid (SCM), anterior scalene, cervical erector spinae (CES), and upper trapezius (UT) muscles while they watched videos on a smartphone in four different lying positions. RESULTS The right and left SCM and CES had significantly different muscle activities depending on the lying positions. The SCM activity had a significantly greater asymmetry in the 45-SIDE position, while the CES activity had a significantly greater asymmetry in the SIDE and 45-SIDE positions. Moreover, the UT activity had a significantly greater asymmetry in the SUP, PE, and SIDE positions. CONCLUSIONS Neck muscle activity and asymmetry were the lowest in the SUP position relative to the other positions. Therefore, lying down in the SUP position may minimize neck muscle activation while using a smartphone.
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Affiliation(s)
- Sun-Hee Ahn
- Department of Rehabilitation Therapy, Graduate School, Yonsei University, Wonju, Korea
| | - Sung-Hoon Jung
- Department of Rehabilitation Therapy, Graduate School, Yonsei University, Wonju, Korea
| | - Hyun-A Kim
- Department of Physical Therapy, Graduate School of Medicine, Nagoya University, Aichi, Japan
| | - Jun-Hee Kim
- Department of Rehabilitation Therapy, Graduate School, Yonsei University, Wonju, Korea
| | - Young-Soo Weon
- Department of Rehabilitation Therapy, Graduate School, Yonsei University, Wonju, Korea
| | - Oh-Yun Kwon
- Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University, Wonju, Korea
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Ceballos-Laita L, Medrano-de-la-Fuente R, Mingo-Gómez MT, Hernando-Garijo I, Estébanez-de-Miguel E, Jiménez-Del-Barrio S. Effects of dry needling on pain, disability, kinesiophobia, pain catastrophizing and psychological distress in patients with chronic neck pain: A randomized controlled pilot study. J Back Musculoskelet Rehabil 2022; 35:393-401. [PMID: 34334377 DOI: 10.3233/bmr-200322] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Myofascial trigger points (MTrPs) in neck muscles seem to be related to the main symptoms of patients with chronic neck pain. OBJECTIVE The objective was to investigate the effects of dry needling (DN) on pain, disability, kinesiophobia, pain catastrophizing and psychological distress in patients with chronic neck pain. METHODS A double blind randomized controlled pilot trial was designed. Twenty-one patients with chronic neck pain were randomly allocated to the DN group (n= 7), Sham-DN group (n= 7) or Control group (n= 7). All groups received a Transcutaneous Electrical Nerve Stimulation and Therapeutic Ultrasound (TENS/US) protocol with patient education. The DN and Sham-DN groups received two sessions of DN and sham DN, respectively. The primary outcome was pain intensity. Secondary outcomes were disability, kinesiophobia, pain catastrophizing, psychological distress, self-reported improvement and success of blinding. RESULTS The DN group showed a greater decrease in pain intensity, disability and pain catastrophizing compared to the Sham-DN group (p< 0.05) and the Control group (p< 0.05). The DN group showed the highest self-reported improvement. CONCLUSION Adding two sessions of DN in active MTrPs in upper trapezius, levator scapulae and sternocleidomastoid muscles to a TENS/US protocol with patient education decreased pain intensity, disability and pain catastrophizing in patients with chronic neck pain.
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Affiliation(s)
- Luis Ceballos-Laita
- Department of Surgery, Ophtalmology and Physiotherapy, University of Valladolid, Soria, Spain
| | | | | | - Ignacio Hernando-Garijo
- Department of Surgery, Ophtalmology and Physiotherapy, University of Valladolid, Soria, Spain
| | - Elena Estébanez-de-Miguel
- Department of Physiatrist and Nursey, Faculty of Health Sciencies, University of Zaragoza, Zaragoza, Spain
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Dieterich AV, Haueise A, Gizzi L. [Feeling stiff…but what does it mean objectively? : Can you measure muscle tension?]. Schmerz 2022; 36:242-247. [PMID: 35301591 PMCID: PMC9300510 DOI: 10.1007/s00482-022-00636-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: 09/03/2021] [Revised: 12/22/2021] [Accepted: 01/17/2022] [Indexed: 10/27/2022]
Abstract
Almost everyone is familiar with "tense muscles", but what is muscle tension physiologically behind? Are tense muscles more active; do they have problems relaxing? Are they harder or stiffer than asymptomatic muscles? In this work, current evidence regarding the activity and stiffness of tense neck muscles is presented. Further, measurement methods and their limitations are explained. These limitations reveal the shortcomings of the current knowledge and the need for further research. Finally, a recently funded research project on the measurement of tense muscles is presented.
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Affiliation(s)
- A V Dieterich
- Studiengang Physiotherapie, Fakultät Gesundheit, Sicherheit, Gesellschaft, Hochschule Furtwangen, Studienzentrum Freiburg, Konrad-Goldmann-Str. 7, 79100, Freiburg i.B., Deutschland.
| | - A Haueise
- Studiengang Physiotherapie, Fakultät Gesundheit, Sicherheit, Gesellschaft, Hochschule Furtwangen, Studienzentrum Freiburg, Konrad-Goldmann-Str. 7, 79100, Freiburg i.B., Deutschland
| | - L Gizzi
- Institute for Modelling and Simulation of Biomechanical Systems, Universität Stuttgart, Pfaffenwaldring 4f, 70569, Stuttgart, Deutschland
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Plaut S. Scoping review and interpretation of myofascial pain/fibromyalgia syndrome: An attempt to assemble a medical puzzle. PLoS One 2022; 17:e0263087. [PMID: 35171940 PMCID: PMC8849503 DOI: 10.1371/journal.pone.0263087] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 01/11/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Myofascial Pain Syndrome (MPS) is a common, overlooked, and underdiagnosed condition and has significant burden. MPS is often dismissed by clinicians while patients remain in pain for years. MPS can evolve into fibromyalgia, however, effective treatments for both are lacking due to absence of a clear mechanism. Many studies focus on central sensitization. Therefore, the purpose of this scoping review is to systematically search cross-disciplinary empirical studies of MPS, focusing on mechanical aspects, and suggest an organic mechanism explaining how it might evolve into fibromyalgia. Hopefully, it will advance our understanding of this disease. METHODS Systematically searched multiple phrases in MEDLINE, EMBASE, COCHRANE, PEDro, and medRxiv, majority with no time limit. Inclusion/exclusion based on title and abstract, then full text inspection. Additional literature added on relevant side topics. Review follows PRISMA-ScR guidelines. PROSPERO yet to adapt registration for scoping reviews. FINDINGS 799 records included. Fascia can adapt to various states by reversibly changing biomechanical and physical properties. Trigger points, tension, and pain are a hallmark of MPS. Myofibroblasts play a role in sustained myofascial tension. Tension can propagate in fascia, possibly supporting a tensegrity framework. Movement and mechanical interventions treat and prevent MPS, while living sedentarily predisposes to MPS and recurrence. CONCLUSIONS MPS can be seen as a pathological state of imbalance in a natural process; manifesting from the inherent properties of the fascia, triggered by a disrupted biomechanical interplay. MPS might evolve into fibromyalgia through deranged myofibroblasts in connective tissue ("fascial armoring"). Movement is an underemployed requisite in modern lifestyle. Lifestyle is linked to pain and suffering. The mechanism of needling is suggested to be more mechanical than currently thought. A "global percutaneous needle fasciotomy" that respects tensegrity principles may treat MPS/fibromyalgia more effectively. "Functional-somatic syndromes" can be seen as one entity (myofibroblast-generated-tensegrity-tension), sharing a common rheuma-psycho-neurological mechanism.
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Affiliation(s)
- Shiloh Plaut
- School of Medicine, St. George’s University of London, London, United Kingdom
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Is early diagnosis of myofascial pain syndrome possible with the detection of latent trigger points by shear wave elastography? Pol J Radiol 2021; 86:e425-e431. [PMID: 34429789 PMCID: PMC8369817 DOI: 10.5114/pjr.2021.108537] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/02/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose The aim of the study was to investigate the contribution of shear wave elastography to the diagnosis of myo-fascial pain syndrome (MPS) of the upper part of the trapezius. Material and methods Ethical committee approval was obtained for the study. Thirty volunteer women with trigger points in the upper part of the trapezius muscle and 30 healthy women with a similar age distribution were included in the study. The patient group performed a self-stretching exercise program for 4 weeks. No intervention was applied to the control group. Muscle stiffness values of both groups were evaluated with shear wave elastography (SWE), and pain levels of all volunteers were evaluated by the Visual Analogue Scale at the beginning and the end of the study. The statistical analyses were performed using SPSS version 18.0. Results There was a significant decrease after the treatment in terms of upper trapezius muscle stiffness and the pain levels in the patient group (p < 0.001 and p < 0.001). In the patient group, there was a moderate correlation between the decrease in the pain level and the reductions in muscle stiffness (r = 0.595). In control group, there was no significant difference in terms of both muscle stiffness and pain levels before and after treatment (p > 0.05). Conclusions SWE is a reliable method for detecting latent trigger points in MPS, and it can be used for evaluating the response to treatment.
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Ertekin E, Günaydın ÖE. Neck pain in rounded shoulder posture: Clinico-radiologic correlation by shear wave elastography. Int J Clin Pract 2021; 75:e14240. [PMID: 33971068 DOI: 10.1111/ijcp.14240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/10/2021] [Indexed: 11/29/2022] Open
Abstract
AIM The frequency of neck pain increases in adolescents and young adults. Using smart phones and computers for a long time causes posture disorders such as rounded shoulder (RSP) and forward head postures, and these posture disorders cause neck pain. The aim of the study is to analyse the correlation between shoulder and neck angles and the stiffness of the upper trapezius and pectoralis minor muscles in patients with RSP. METHOD Patients with neck pain examined by shear wave elastography were screened retrospectively. Patients with RSP were determined. Of these patients, whose had evaluated for shoulder and neck angles with a smart phone-based photogrammetric method were assigned. Patients with a history of operation/trauma, connective tissue or neurological disease were excluded. A total of 39 female patients were included in the study. Age, height, weight, elastography measurements, cervical and shoulder angles were noted. Obtained data were statistically analysed with SPSS 22.0 program. RESULTS Cervical and shoulder angles of the patients were 52.2 ± 3.8 and 57.91 ± 9.4, respectively. The stiffness of the right and left upper trapezius muscles and right and left pectoralis minor muscles were 42.5 ± 14.1, 47.1 ± 17.1, 20.5 ± 8.0 and 17.9 ± 8.4, respectively. In multiple regression analysis, it was observed that the stiffness of the left upper trapezius muscle was positively correlated with the shoulder angle. CONCLUSION The upper trapezius muscle stiffness increased in RSP. It can reveal the relationship between RSP and neck pain.
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Affiliation(s)
- Ersen Ertekin
- Department of Radiology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Özge E Günaydın
- Department fo Physical Therapy, Faculty of Health Sciences, Aydın Adnan Menderes University, Aydin, Turkey
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Carpintero-Rubio C, Torres-Chica B, Guadrón-Romero MA, Visiers-Jiménez L, Peña-Otero D. Perception of musculoskeletal pain in the state of confinement: associated factors. Rev Lat Am Enfermagem 2021; 29:e3454. [PMID: 34190945 PMCID: PMC8253348 DOI: 10.1590/1518-8345.4894.3454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/06/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to describe the perception of musculoskeletal pain in the population and how the state of confinement (adopted as a measure to control contagion by COVID-19) has interfered with it, as well as identifying the sociodemographic, occupational, physical, and psychosocial factors involved. METHOD an observational, cross-sectional and analytical study, with simple random probabilistic sampling, aimed at residents in Spain over 18 years old during the confinement period. An ad hoc survey was conducted, consisting in 59 items. RESULTS a total of 3,247 surveys were answered. Persistent musculoskeletal pain or significant episodes thereof increased 22.2% during confinement. The main location was the spine (49.5%). The related factors were decreased physical activity, increased seated position, and use of electronic devices. The psychological impact of confinement was also related to the perception of musculoskeletal pain. CONCLUSION the state of confinement causes an increase in the perception of musculoskeletal pain. The identification of a particularly sensitive population profile, as well as that of the related factors, allows establishing multidisciplinary approaches in health promotion.
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Affiliation(s)
| | | | - María Alexandra Guadrón-Romero
- Hospital de Sierrallana, Servicio Cántabro de Salud, Torrelavega,
Cantabria, Spain
- Universidad Cátolica de Ávila, Escuela Técnico Profesional en
Ciencias de la Salud, Clínica Mompía, Cantabria, Spain
- Cómité Ético de Investigación con Medicamentos de Cantabria,
CEI-CEIm, Santander, Cantabria, Spain
| | - Laura Visiers-Jiménez
- Instituto de Investigación-Grupo de Enfermería-Sanitaria Gregorio
Marañón, IiSGM, Madrid, Spain
| | - David Peña-Otero
- Instituto de Investigación-Grupo de Enfermería-Sanitaria Gregorio
Marañón, IiSGM, Madrid, Spain
- Hospital de Sierrallana, Subdirección de Cuidados, Servicio Cántabro
de Salud, Torrelavega, Cantabria, Spain
- Instituto de Investigación-Grupo de Enfermería-Sanitaria Valdecilla,
IDIVAL, Santander, Cantabria, Spain
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Yanase K, Ikezoe T, Nakamura M, Saeki J, Yagi M, Hirono T, Tamezawa T, Motomura Y, Ibuki S, Ichihashi N. Effective muscle elongation positions for the neck extensor muscles: An ultrasonic shear wave elastography study. J Electromyogr Kinesiol 2021; 60:102569. [PMID: 34298283 DOI: 10.1016/j.jelekin.2021.102569] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/01/2021] [Accepted: 06/14/2021] [Indexed: 12/01/2022] Open
Abstract
This study aimed to clarify the effective stretching positions for neck extensor muscles. Fifteen healthy men were measured shear moduli of the right neck extensor muscles using ultrasound shear wave elastography in following positions: rest (Rest), flexion (Flex), contralateral bending (Bend), flexion + contralateral bending (Flex → Bend), flexion + contralateral bending + contralateral rotation (Flex → Bend → ConRot), and flexion + contralateral bending + ipsilateral rotation (Flex → Bend → IpsRot). The increase in the shear modulus indicated a greater muscle elongation. Regarding the upper trapezius and splenius capitis, the shear moduli at Flex → Bend, Flex → Bend → ConRot, and Flex → Bend → IpsRot were significantly higher than those at Rest. The shear moduli at stretching positions, including contralateral bending, were significantly higher than those at Rest and Flex in the levator scapulae. The results indicated that the stretching position with a combination of flexion and contralateral bending could be effective for elongation of the upper trapezius and splenius capitis. Furthermore, the stretching positions including contralateral bending could be effective for the levator scapulae.
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Affiliation(s)
- Ko Yanase
- Faculty of Health and Sports Science, Doshisha University, Kyotanabe, Japan; Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Tome Ikezoe
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Masatoshi Nakamura
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Junya Saeki
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masahide Yagi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tetsuya Hirono
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Toru Tamezawa
- Section of Rehabilitation, Kanazawa University Hospital, Ishikawa, Japan
| | - Yoshiki Motomura
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoko Ibuki
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Abe-Takahashi Y, Kitta T, Ouchi M, Chiba H, Higuchi M, Togo M, Shinohara N. Examination of pelvic floor muscle elasticity in patients with interstitial cystitis/bladder pain syndrome using real-time tissue elastography. Int Urogynecol J 2021; 33:619-626. [PMID: 33740121 DOI: 10.1007/s00192-021-04761-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/03/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The aim was to compare pelvic floor muscle (PFM) elasticity between interstitial cystitis/bladder pain syndrome (IC/BPS) patients and healthy women using real-time tissue elastography. METHODS The subjects were 17 IC/BPS female patients (IC/BPS group; age 34-84 years), 10 healthy middle-aged women (middle-aged group; 50-80 years), and 17 healthy young adult women (young group; 23-37 years). The target sites of elastography were the striated urethral sphincter (SUS) and adipose tissue as the reference site; muscle elasticity was calculated as the strain ratio (SR) of the SUS to the reference site. Evaluations were performed at rest and during PFM contraction. The IC/BPS group completed lower urinary tract symptom and pain questionnaires. SUS SR was compared among the three groups. SUS SR at rest and during PFM contraction was compared among the three groups with the t-test and the Wilcoxon test. Associations between questionnaire results and SUS SR were evaluated by correlation analysis. RESULTS There was no significant difference in age between the IC/BPS and middle-aged groups, but the young group was significantly younger than the other groups (p < 0.001). SUS SR at rest was significantly higher in the IC/BPS group than in the middle-aged (p = 0.014) and young groups (p = 0.002). Furthermore, in the IC/BPS group, there was no significant difference in SUS SR between at rest and during PFM contraction. SUS SR was not significantly correlated with questionnaire results for lower urinary tract symptoms. CONCLUSIONS SUS SR at rest was significantly higher in the IC/BPS group than in the young and middle-aged groups.
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Affiliation(s)
- Yui Abe-Takahashi
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
- Department of Physical Therapy, Faculty of Health Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Takeya Kitta
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, 060-8638, Japan.
| | - Mifuka Ouchi
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
- Department of Physical Therapy, School of Rehabilitation Sciences, Health Sciences University of Hokkaido, Tobetsu, Japan
| | - Hiroki Chiba
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
| | - Madoka Higuchi
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
| | - Mio Togo
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
| | - Nobuo Shinohara
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
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Reliability of Trapezius Muscle Hardness Measurement: A Comparison between Portable Muscle Hardness Meter and Ultrasound Strain Elastography. SENSORS 2020; 20:s20247200. [PMID: 33339151 PMCID: PMC7765603 DOI: 10.3390/s20247200] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 12/17/2022]
Abstract
Prolonged computer work and smartphone use can cause stiffness of the neck and shoulder muscles, including the trapezius muscle. Hence, muscle hardness quantification is clinically beneficial. The present study aimed to examine the reliability of trapezius muscle hardness measurement using a portable muscle hardness meter and ultrasound strain elastography. Overall, 20 healthy young men participated in this study. Prior to measurement, the participant’s subjective symptoms, particularly shoulder muscle stiffness, were rated using an 11-point verbal scale. Furthermore, hardness of the right and left upper trapezius muscles was assessed. In the strain elastography assessment, muscle hardness was evaluated using strain ratio. Results showed that, in quantifying upper trapezius muscle hardness, both portable muscle hardness meter and strain elastography had an excellent intra-tester reliability (>0.9). However, the correlation coefficients between muscle hardness values assessed using a muscle hardness meter and those evaluated with strain elastography did not significantly differ, and the scores for subjective shoulder stiffness did not correspond to muscle hardness values. Therefore, the hardness of the trapezius muscle does not directly reflect the subjective shoulder stiffness. Future studies should thoroughly examine the location of the shoulder stiffness, and check whether it is accompanied by local pain or tenderness.
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Taş S, Yaşar Ü, Kaynak BA. Interrater and Intrarater Reliability of a Handheld Myotonometer in Measuring Mechanical Properties of the Neck and Orofacial Muscles. J Manipulative Physiol Ther 2020; 44:42-48. [PMID: 33248749 DOI: 10.1016/j.jmpt.2020.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 02/06/2020] [Accepted: 08/03/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The purpose this study was to investigate the reliability of a handheld myotonometer in measuring the mechanical properties of the neck and orofacial muscles in asymptomatic individuals. METHODS The study included 16 healthy participants. The mechanical properties (frequency, decrement, stiffness, relaxation time, and creep) of the selected muscles were measured with a MyotonPRO myotonometer (Mumeetria Ltd, Tallinn, Estonia). The sternocleidomastoid, upper trapezius, cervical extensor, and masseter muscles were selected to determine the reliability of the device. Measurements were performed by 2 examiners to determine interrater reliability; for intrarater reliability, an examiner repeated the measurements 1 week after the first measurements. RESULTS The results revealed moderate to excellent intrarater and interrater reliability (intraclass correlation coefficients: 0.50-0.95) in measuring muscle mechanic properties. The standard error of measurement in the tested muscles ranged from 0.3 to 0.8 Hz for frequency, from 7.4 to 20.9 N/m for stiffness, from 0.1 to 0.2 for decrement, and from 0.8 to 1.4 ms for relaxation time. The minimum detectable change ranged from 0.8 to 2.2 Hz for frequency, from 20.5 to 57.9 N/m for stiffness, from 0.2 to 0.6 for decrement, from 2.2 to 3.9 ms for relaxation time, and from 0.2 to 0.3 for creep. In addition, the coefficients of variation were below 9.1% for all the assessed parameters. CONCLUSION The obtained results demonstrate that the MyotonPRO device is a reliable and repeatable tool to quantify the frequency, stiffness, decrement, relation time, and creep of the neck and orofacial muscles in asymptomatic individuals.
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Affiliation(s)
- Serkan Taş
- Toros University, School of Health Sciences, Department of Physiotherapy and Rehabilitation, Mersin, Turkey.
| | - Ümit Yaşar
- Ardahan University, Nihat Delibalta Vocational School, Laboratory and Veterinary Health Department, Ardahan, Turkey
| | - Besime Ahu Kaynak
- Toros University, School of Health Sciences, Department of Physiotherapy and Rehabilitation, Mersin, Turkey
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Bastijns S, De Cock AM, Vandewoude M, Perkisas S. Usability and Pitfalls of Shear-Wave Elastography for Evaluation of Muscle Quality and Its Potential in Assessing Sarcopenia: A Review. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:2891-2907. [PMID: 32843232 DOI: 10.1016/j.ultrasmedbio.2020.06.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 06/18/2020] [Accepted: 06/30/2020] [Indexed: 05/08/2023]
Abstract
Sarcopenia is age-related progressive and generalized loss of skeletal muscle mass and strength. Its prevalence is rising, which poses a burden for society because it increases disability and dependency and therefore raises health care costs. Muscle mass quality, however-an essential part of sarcopenia-is not easily diagnosable yet. Recent interest has risen for ultrasonographic evaluation of muscle. This review introduces muscle elastography as a possible, easy and cheap tool to evaluate qualitative muscle parameters. Basic principles of muscle elastography are described, as well as different elastography techniques and some technical considerations. Furthermore, a proposal for practical guidelines is offered and factors influencing muscle stiffness are highlighted.
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Affiliation(s)
- Sophie Bastijns
- Department of Medicine, University of Antwerp, Antwerp, Belgium; Ziekenhuisnetwerk Antwerpen, Antwerp, Belgium.
| | - Anne-Marie De Cock
- Department of Medicine, University of Antwerp, Antwerp, Belgium; Ziekenhuisnetwerk Antwerpen, Antwerp, Belgium
| | - Maurits Vandewoude
- Department of Medicine, University of Antwerp, Antwerp, Belgium; Ziekenhuisnetwerk Antwerpen, Antwerp, Belgium; Belgian Ageing Muscle Society, Liege, Belgium
| | - Stany Perkisas
- Department of Medicine, University of Antwerp, Antwerp, Belgium; Ziekenhuisnetwerk Antwerpen, Antwerp, Belgium; Belgian Ageing Muscle Society, Liege, Belgium
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Wang L, Xiang X, Zhu BH, Qiu L. Determination of reference ranges for normal upper trapezius elasticity during different shoulder abduction using shear wave elastography: a preliminary study. Sci Rep 2020; 10:17104. [PMID: 33051541 PMCID: PMC7555503 DOI: 10.1038/s41598-020-74307-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 09/15/2020] [Indexed: 02/05/2023] Open
Abstract
The purpose of this study was to determine the reference ranges of normal upper trapezius (UT) elasticity during different shoulder abduction using shear wave elastography (SWE). Mean shear wave velocity (SWV) of UT elasticity in eighty healthy participants were measured at left and right shoulder 0° abduction and 90° passive abduction (L0°, R0°, L90°, R90°) with SWE. The effects of potential factors (gender, UT thickness, age, and body mass index) on UT elasticity were analyzed. The reference ranges of normal UT elasticity were calculated by using the normal distribution method. UT elasticity was significantly different among various shoulder abduction (P < 0.0001). UT elasticity was significantly higher in males at both L90° (P < 0.05) and R90° (P < 0.01) than in females. The reference ranges of normal UT elasticity were 2.90-4.01 m/s at L0° and 3.01-4.29 m/s at R0°, and were 4.90-6.40 m/s in males and 4.40-6.20 m/s in females at L90°, 5.20-7.02 m/s in males and 4.71-6.80 m/s in females at R90°. Our results suggest that gender should be considered when determining the reference ranges of normal UT elasticity at L90° and R90° with SWE. These values may provide quantitative baseline measurements for the assessment of UT muscle strain in the future.
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Affiliation(s)
- Lei Wang
- Department of Ultrasound, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China.,Department of Ultrasound, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, Sichuan Province, China
| | - Xi Xiang
- Department of Ultrasound, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China
| | - Bi-Hui Zhu
- Department of Ultrasound, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China
| | - Li Qiu
- Department of Ultrasound, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China.
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Heredia-Rizo AM, Petersen KK, Arendt-Nielsen L, Madeleine P. Eccentric Training Changes the Pressure Pain and Stiffness Maps of the Upper Trapezius in Females with Chronic Neck-Shoulder Pain: A Preliminary Study. PAIN MEDICINE 2020; 21:1936-1946. [PMID: 32011710 DOI: 10.1093/pm/pnz360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Between 50% and 67% of adults suffer from neck-shoulder pain, which may be associated with increased stiffness of neck muscles. We assessed pressure pain sensitivity and muscle stiffness maps of the upper trapezius in female computer users with and without chronic neck-shoulder pain and investigated the effects of eccentric training on females with neck-shoulder pain. DESIGN Cross-sectional (part 1) and open-label (part 2) study. SETTING University. SUBJECTS Twenty females with neck-shoulder pain were compared with 20 controls (part 1). In part 2, neck-shoulder pain participants followed a five-week unilateral upper trapezius eccentric training program. METHODS Topographical maps of pressure pain thresholds (pressure algometer) and muscle stiffness (myotonometer), using a 15-point grid covering myotendinous and muscle belly sites, and shoulder elevation force and range of elevation (dynamometer) were assessed at baseline and after training. RESULTS There were no differences in pressure pain thresholds between sites (P = 0.243) or groups (P = 0.068), and there were significant differences in stiffness between myotendinous and muscle belly sites (P < 0.001) but not groups (P = 0.273). After training, pressure pain thresholds increased, stiffness decreased (P < 0.005), and shoulder elevation force and range of elevation improved (P < 0.001). CONCLUSIONS The lack of differences in upper trapezius pressure pain sensitivity and stiffness between females with or without neck-shoulder pain confirms no clear etiology among computer users reporting neck-shoulder pain. A five-week eccentric training protocol showed positive effects on pressure pain sensitivity, stiffness, shoulder force, and range of motion.
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Affiliation(s)
- Alberto Marcos Heredia-Rizo
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain.,Sport Sciences, Performance and Technology, Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark.,Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark.,SMI, School of Medicine, Aalborg University, Aalborg, Denmark
| | - Kristian Kjær Petersen
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark
| | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark.,SMI, School of Medicine, Aalborg University, Aalborg, Denmark
| | - Pascal Madeleine
- Sport Sciences, Performance and Technology, Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark
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Kozinc Ž, Šarabon N. Shear-wave elastography for assessment of trapezius muscle stiffness: Reliability and association with low-level muscle activity. PLoS One 2020; 15:e0234359. [PMID: 32520959 PMCID: PMC7286494 DOI: 10.1371/journal.pone.0234359] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/22/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose Shear-wave elastography has been recognized a useful tool for quantifying muscle stiffness, commonly reported as shear modulus, however the reports on reliability are often limited to test-retest correlations. In this study, we explored the reliability of shear-wave elastography for assessment of the trapezius muscle stiffness and its relationship with low-level muscle activity. Methods Twenty participants were included in a two-session experiment. Measurements of shear modulus and muscle activity were performed at rest and during low-level activity, induced by shoulder abduction without additional external resistance. Results Good to excellent intra-session repeatability (ICC > 0.80) and moderate inter-rater and inter-session reproducibility (ICC = 0.66–0.74) were observed. Typical errors were acceptable (7.6% of the mean value) only for intra-session measurements in resting conditions, but not acceptable for all conditions with low-level muscle activity (10.2–16.6% of the mean value). Inverse relationships between shear modulus and muscle activity at 40° and 60° of shoulder abduction (r = -0.53 and -0.57) were observed on a group level. We also found higher shear modulus in males compared to females, for the parallel probe position compared to the perpendicular position (in relation to muscle fiber orientation), and for the dominant side of the body compared to the non-dominant side. Conclusions This study showed an inverse relationship between muscle activity in low-level range and shear modulus on a group level, suggesting inherent passive stiffness could account for a larger portion of the variance (compared to muscle activity) in shear modulus when the muscle activity is low. Our results imply that shear-wave elastography can be used in research exploring muscle stiffness, however, caution is needed since only intra-session examination in resting conditions showed acceptable within-participant typical errors. The secondary analyses of the study showed higher shear modulus for males, for the non-dominant side of the body and for the parallel orientation of the ultrasound probe.
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Affiliation(s)
- Žiga Kozinc
- University of Primorska, Faculty of Health Sciences, Polje, Izola, Slovenia
- University of Primorska, Andrej Marušič Institute, Muzejski trg, Koper, Slovenia
| | - Nejc Šarabon
- University of Primorska, Faculty of Health Sciences, Polje, Izola, Slovenia
- S2P, Science to practice, Ltd., Laboratory for Motor Control and Motor Behavior, Tehnološki park, Ljubljana, Slovenia
- InnoRenew CoE, Human Health Department, Livade, Izola, Slovenia
- * E-mail:
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Is cervical region tightness related to vagal function and stomach symptoms? Med Hypotheses 2020; 142:109819. [PMID: 32408072 DOI: 10.1016/j.mehy.2020.109819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/19/2020] [Accepted: 05/05/2020] [Indexed: 11/21/2022]
Abstract
The vagal nerve is a cranial nerve that carries mainly parasympathetic fibers (average 75%) with both sensory and motor functions. The vagal nerve contains a complex neuro-endocrine-immune network. The majority, at least 66%, of the gastric myenteric neurons receive direct cholinergic excitatory stimulation from the pre-enteric vagal nerve. Changes in vagal function may cause stomach problems, although the mechanisms that change the vagal function have not yet been fully illuminated. Considering the course of the vagal nerve in the cervical region, it is thought that conditions such as stiffness, tightness and decreased elasticity in this region may compress the vagal nerve andmay affect vagal function. According to this hypothesis, neuroinflammation and hyperalgesia may occur in the vagal nerve under mechanical pressure, resulting in increased complaints of pain and burning in the stomach increases. However, as the vagal nerve has various effects on the motility of the stomach and vagal dysfunction affects the motor function of the stomach, relaxation techniques applied to the soft tissues of the cervical region will provide mechanical relief in the nerve. Thus, the vagal nerve will be decompressed and be able to function optimally. According to our clinical observations, in patients whose soft tissues in the cervical region are relaxed, gastric symptoms are decreased. Based on research results and clinical experience, cervical region tightness can be considered to cause stomach problems through the vagal nerve, and soft tissue relaxation of the cervical region can be a promising treatment method for stomach symptoms.
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Hvedstrup J, Kolding LT, Ashina M, Schytz HW. Increased neck muscle stiffness in migraine patients with ictal neck pain: A shear wave elastography study. Cephalalgia 2020; 40:565-574. [DOI: 10.1177/0333102420919998] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BackgroundIctal neck pain is a frequent symptom reported by half of migraine patients. It is unknown if neck pain is caused by peripheral or central mechanisms. Neck muscle stiffness can be investigated with ultrasound shear wave elastography.ObjectivesTo determine if migraine patients with ictal neck pain have stiffer neck muscles interictally compared with patients without ictal neck pain and controls.MethodsThis was a cross-sectional study investigating neck muscle stiffness, pressure pain thresholds and neck pain symptoms in 100 migraine patients recruited from a tertiary headache center and 46 controls.ResultsPatients with ictal neck pain had increased mean neck muscle stiffness interictally compared to both migraine patients without ictal neck pain ( p = 0.018) and controls ( p = 0.036). Muscle stiffness was negatively correlated with pressure pain thresholds in the neck in migraine patients with ictal neck pain (r = −0.292, p = 0.042). There were no differences in mean pressure pain thresholds between migraine subgroups.ConclusionsMigraine patients with ictal neck pain have stiffer neck muscles interictally compared with migraine patients without ictal neck pain and controls measured with ultrasound shear wave elastography. The increased stiffness could be due to local alterations in the neck muscles. Trial registration: clinical-trials.gov, identifier: NCT03626805
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Affiliation(s)
- Jeppe Hvedstrup
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Lærke Tørring Kolding
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Henrik Winther Schytz
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
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Neck Muscle Stiffness Measured With Shear Wave Elastography in Women With Chronic Nonspecific Neck Pain. J Orthop Sports Phys Ther 2020; 50:179-188. [PMID: 31905095 DOI: 10.2519/jospt.2020.8821] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Utilizing shear wave elastography, we compared the stiffness of the neck extensor muscles and the stiffness in muscle-specific regions between women with chronic nonspecific neck pain and asymptomatic controls. DESIGN Cross-sectional observational study. METHODS We measured the average muscle stiffness over multiple neck extensor muscles and in regions corresponding approximately to the trapezius, splenius capitis, semispinalis capitis, semispinalis cervicis, and multifidus muscles using ultrasound shear wave elastography in 20 women with chronic nonspecific neck pain and 18 asymptomatic women during multiple tasks. The measurements were automatically quality controlled and computer processed over the complete visible neck region or a large muscle-specific region. RESULTS Pooled over all tasks, neck muscle stiffness was not significantly different between those with neck pain and asymptomatic controls (neck pain median, 11.6 kPa; interquartile range, 8.9 kPa and control median, 13.3 kPa; interquartile range, 8.6 kPa; P = .175). The measure of neck muscle stiffness was not correlated with the intensity of neck pain or perceived disability. CONCLUSION Shear wave elastography revealed similar muscle stiffness in people with and without chronic neck pain, despite the sensation of increased neck stiffness in those with chronic neck pain. Therapeutic interventions aiming to reduce neck muscle tone are often based on the assumption that perceived neck stiffness corresponds to objective muscle stiffness. The current results question this assumption. J Orthop Sports Phys Ther 2020;50(4):179-188. Epub 6 Jan 2020. doi:10.2519/jospt.2020.8821.
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Xie Y, Thomas L, Hug F, Johnston V, Coombes BK. Quantifying cervical and axioscapular muscle stiffness using shear wave elastography. J Electromyogr Kinesiol 2019; 48:94-102. [PMID: 31272075 DOI: 10.1016/j.jelekin.2019.06.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/10/2019] [Accepted: 06/20/2019] [Indexed: 11/26/2022] Open
Abstract
This study aimed to assess intra-rater (intra-session and inter-day) reliability and influence of side dominance and the scapular resting position on the shear modulus (an index of stiffness) of resting cervical and axioscapular muscles. Sixteen healthy participants were recruited. On day one, ultrasound shear wave elastography was used to measure the shear modulus of superficial and deep cervical extensor and axioscapular muscles bilaterally. Clinical assessments of scapular resting position were performed bilaterally. On day two, testing was repeated on the dominant side. Both intra-session and inter-day reliability were good to excellent for shear modulus of superficial muscles, and poor to excellent for deep muscles. Side differences of shear modulus for posterior upper trapezius were statistically significant but clinically irrelevant. The shear modulus of posterior upper trapezius and middle trapezius were significantly correlated with scapular depression. Ultrasound shear wave elastography is a reliable tool for quantitatively assessing stiffness of superficial cervical and axioscapular muscles. The influence of scapular position should be considered in future comparative studies of healthy controls and patients with neck/shoulder pain. This study provides the necessary first step for future studies on assessing and interpreting the stiffness of cervical and axioscapular muscles for neck and shoulder musculoskeletal disorders.
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Affiliation(s)
- Yanfei Xie
- School of Health and Rehabilitation Science, The University of Queensland, Australia.
| | - Lucy Thomas
- School of Health and Rehabilitation Science, The University of Queensland, Australia
| | - François Hug
- Laboratory "Movement, Interactions, Performance" (EA 4334), UFR STAPS, University of Nantes, France; Institut Universitaire de France (IUF), Paris, France; School of Biomedical Sciences, The University of Queensland, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Science, The University of Queensland, Australia; RECOVER Injury Research Centre, The University of Queensland, Australia
| | - Brooke K Coombes
- School of Health and Rehabilitation Science, The University of Queensland, Australia; School of Allied Health Sciences, Griffith University, Australia
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