1
|
Colonna S, Mazzanti M. Pelvic Palpatory Tests in Manual Therapy and Osteopathy: A Critical Review of the Literature and Suggestions for New Research. Cureus 2024; 16:e64066. [PMID: 39114222 PMCID: PMC11304509 DOI: 10.7759/cureus.64066] [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] [Accepted: 07/07/2024] [Indexed: 08/10/2024] Open
Abstract
Manual therapists apply physical interventions to the entire structure of the body to promote healing, prevent pathologies, and improve patient health. In osteopathic practice, palpatory evaluation is considered a fundamental clinical practice requirement for identifying somatic dysfunction. Most of the articles published in this area have failed to demonstrate a level of reproducibility that supports palpation in evidence-based clinical practice. When considering the poor reliability of the palpatory tests highlighted in the literature, a discrepancy is noted with what is known about the tactile sensitivity of human hands. For static touch, the minimum size that can be detected, in the absence of applied movement or vibration, is approximately 0.2 mm. Yet, it seems that this high level of precision is insufficient to ensure reliability in the tests used to evaluate osteopathic somatic dysfunction. The purpose that underscores this article is to determine how these two contradictory elements, high sensitivity and low reliability, can be present in palpatory tests. The article reports the literature findings regarding palpatory tests of pelvic, which is an important structure for clinical purposes. Additionally, a critical review of how these studies were conducted is provided to identify any elements that may justify the obtained results. Following recent accredited guidelines present in the literature, we propose suggestions on vision training methods, manual perception refinement training, the search for anatomical markers, and the position of the examiner in relation to the examinee that may be useful for future studies on the topic covered by the article.
Collapse
Affiliation(s)
- Saverio Colonna
- Orthopedic Surgery, Spine Center, Bologna, ITA
- Education, Osteopathic Spine Center Education, Bologna, ITA
| | - Marco Mazzanti
- Education, Osteopathic Spine Center Education, Bologna, ITA
| |
Collapse
|
2
|
Leonardi G, Alito A, Portaro S, Di Matteo B, Respizzi S, Kon E, Massazza G, Sconza C. Intramuscular injections of botulinum toxin for the treatment of upper back myofascial pain syndrome: A systematic review of randomized controlled trials. Eur J Pain 2024; 28:369-381. [PMID: 37950343 DOI: 10.1002/ejp.2198] [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: 04/19/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND AND OBJECTIVE Myofascial pain syndrome (MPS) is a chronic musculoskeletal disorder characterized by the presence of trigger points. Among the treatment options, botulinum toxin injections have been investigated. The aim of this paper was to provide a synthesis of the evidence on intramuscular botulinum toxin injections for upper back MPS. DATABASES AND DATA TREATMENT A systematic review of the literature was performed on the PubMed, Scopus and Cochrane Library, using the following formula: ("botulinum") AND ("musculoskeletal") AND ("upper back pain") OR ("myofascial pain"). RESULTS Ten studies involving 651 patients were included. Patients in the control groups received placebo (saline solution) injections, anaesthetic injections + dry needling or anaesthetic injections. The analysis of the trials revealed modest methodological quality: one "Good quality" study, one "Fair" and the other "Poor". No major complications or serious adverse events were reported. Results provided conflicting evidence and did not demonstrate the superiority of botulinum toxin over comparators. Most of the included trials were characterized by a small sample size, weak power analysis, different clinical scores used and non-comparable follow-up periods. Even if there is no conclusive evidence, the favourable safety profile and the positive results of some secondary endpoints suggest a potentially beneficial action in pain control and quality of life. CONCLUSION The currently available studies show conflicting results. Their overall low methodological quality does not allow for solid evidence of superiority over other comparison treatments. Further insights are needed to properly profile patients who could benefit more from this peculiar injective approach. SIGNIFICANCE The randomized controlled trials included in this review compared using botulinum toxin to treat upper back MPS with placebo or active treatments (e.g., dry needling or anaesthetics) showing mixed results overall. Despite the lack of clear evidence of superiority, our study suggests that the use of botulinum toxin should not be discouraged. Its safety profile and encouraging results in pain control, motor recovery and disability reduction make it an interesting treatment, particularly in the subset of patients with moderate to severe chronic pain and active trigger points. To support the safety and efficacy of botulinum toxin, further high-quality studies are needed.
Collapse
Affiliation(s)
- G Leonardi
- Department of Physical and Rehabilitation Medicine, University Hospital "G. Martino", Messina, Italy
| | - A Alito
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - S Portaro
- Department of Physical and Rehabilitation Medicine, University Hospital "G. Martino", Messina, Italy
| | - B Di Matteo
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
| | - S Respizzi
- IRCCS Humanitas Research Hospital, Milan, Italy
| | - E Kon
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
| | - G Massazza
- Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - C Sconza
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
| |
Collapse
|
3
|
Uysal Ö, Demirci S, Kara D, Yıldız Tİ, Sevinç C, Eraslan LS, Turgut E, Huri G, Turhan E, Atay ÖA, Düzgün İ. Tender point examination with palpation in different shoulder pathologies: A retrospective study. J Orthop Sci 2022; 27:366-371. [PMID: 33431256 DOI: 10.1016/j.jos.2020.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/06/2020] [Accepted: 12/09/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Shoulder pain is a common symptom for non-traumatic shoulder pathologies and affects 4.7-66.7% of entire population. Even with the latest technological advantages, palpation still is a cost and time efficient tool to evaluate the shoulder pathologies. Our aim was to investigate and compare palpation findings in different shoulder pathologies. METHOD We used first assessments of impingement syndrome (IS) (n = 205), rotator cuff tear (RCT) (n = 185) and frozen shoulder (FS) (n = 210) patients who received treatment between 2010 and 2019 years. Two experienced physiotherapists palpated predefined points: long head of biceps brachii, pectoralis minor, lateral intermuscular septum, proximal tendons of extensor group. These points categorized into "proximal", "mid-proximal", "mid-distal", "distal", "irregular". We also grouped patients by their BMIs. RESULTS We found RCT patients had higher BMI than IS and FS patients (p < 0.001, p = 0.001); more tender intermuscular septum points and night pain than IS patients (p = 0.001, p = 0.003) and more extensor group proximal tendon points than IS and FS patients (p < 0.001, p = 0.001). "No tenderness" group had lesser resting pain than distal group (p < 0.001) and lesser activity and night pain than middle-proximal, middle-distal, and distal groups (all ps < 0.002). Distal group had higher night pain than middle-proximal group (p = 0.003). Morbidly obese patients had higher night pain than normal and overweight patients (p = 0.003 and p = 0.009). CONCLUSIONS Tender point distribution varies depending on the pathology with biceps brachii being the most common. RCT patients had higher night pain related to more distal tender points. Patients with higher night pain had increased tenderness in septum intermuscular and extensor muscles' proximal tendons.
Collapse
Affiliation(s)
- Özgün Uysal
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Serdar Demirci
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Dilara Kara
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Taha İbrahim Yıldız
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ceyda Sevinç
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Leyla Sümeyye Eraslan
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Elif Turgut
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Gazi Huri
- Orthopedics and Traumatology Department, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Egemen Turhan
- Orthopedics and Traumatology Department, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Özgür Ahmet Atay
- Orthopedics and Traumatology Department, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - İrem Düzgün
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| |
Collapse
|
4
|
Dry needling in active or latent trigger point in patients with neck pain: a randomized clinical trial. Sci Rep 2022; 12:3188. [PMID: 35210467 PMCID: PMC8873236 DOI: 10.1038/s41598-022-07063-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 02/03/2022] [Indexed: 12/26/2022] Open
Abstract
The purpose was to determine the efficacy of deep dry needling (DDN) applied on an active myofascial trigger point (MTrP) versus a latent-MTrP versus a non-MTrP location, on pain reduction and cervical disability, in patients with chronic neck pain. A randomized, double-blind clinical trial design was used. A sample of 65 patients was divided into non-MTrP-DDN, active-MTrP-DDN and latent-MTrP-DDN groups. The visual analog scale (VAS), reproduction of the patient's pain, number of local twitch responses, pressure pain threshold (PPT) and Neck Disability Index (NDI) were assessed before, during and after the intervention and up to 1 month post-intervention. The active-MTrP-DDN-group reduced pain intensity more than non-MTrP-DDN-group after a week and a month (P < 0.01), as well as showing the greatest improvement in tibialis muscle PPT. The treatment of both Active and Latent MTrPs was associated with the reproduction of the patient's pain. The application of DDN on an active-MTrP in the upper trapezius muscle shows greater improvements in pain intensity after 1 week and 1 month post-intervention, compared to DDN applied in latent-MTrPs or outside of MTrPs in patients with neck pain.
Collapse
|
5
|
De Meulemeester K, Calders P, Cagnie B. Exploring the Underlying Mechanisms of Action of Dry Needling: What Is the Immediate Effect on Muscle Electrophysiology? An Experimental Randomized Controlled Trial. Am J Phys Med Rehabil 2022; 101:18-25. [PMID: 34915542 DOI: 10.1097/phm.0000000000001732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Dry needling is a commonly used treatment technique for myofascial pain syndromes, such as trapezius myalgia. Despite the shown positive clinical effects on pain, the underlying mechanisms of action, such as the effect on muscle electrophysiology, remain unclear. The aim of this study was to investigate the effect of dry needling, compared with sham needling, in the upper trapezius muscle on surface electromyography activity and the relation with pain in office workers with trapezius myalgia. DESIGN For this experimental randomized controlled trial, 43 office workers with work-related trapezius myalgia were included. Surface electromyography activity was measured before and after a pain-provoking computer task and immediately after, 15, and 30 mins after treatment with dry or sham needling. Pain scores were evaluated at the same time points as well as 1, 2, and 7 days after treatment. RESULTS No significant differences in surface electromyography activity between dry needling and sham needling were found. Significant positive low to moderate Spearman correlations were found between surface electromyography activity and pain levels after dry needling treatment. CONCLUSIONS This study shows no immediate effects of dry needling on the electrophysiology of the upper trapezius muscle, compared with sham needling.
Collapse
|
6
|
Lázaro-Navas I, Lorenzo-Sánchez-Aguilera C, Pecos-Martín D, Jiménez-Rejano JJ, Navarro-Santana MJ, Fernández-Carnero J, Gallego-Izquierdo T. Immediate Effects of Dry Needling on the Autonomic Nervous System and Mechanical Hyperalgesia: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116018. [PMID: 34205103 PMCID: PMC8199958 DOI: 10.3390/ijerph18116018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/05/2021] [Accepted: 05/28/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dry needling (DN) is often used for the treatment of muscle pain among physiotherapists. However, little is known about the mechanisms of action by which its effects are generated. The aim of this randomized controlled trial was to determine if the use of DN in healthy subjects activates the sympathetic nervous system, thus resulting in a decrease in pain caused by stress. METHODS Sixty-five healthy volunteer subjects were recruited from the University of Alcala, Madrid, Spain, with an age of 27.78 (SD = 8.41) years. The participants were randomly assigned to participate in a group with deep DN in the adductor pollicis muscle or a placebo needling group. The autonomic nervous system was evaluated, in addition to local and remote mechanical hyperalgesia. RESULTS In a comparison of the moment at which the needling intervention was carried out with the baseline, the heart rate of the dry needling group significantly increased by 20.60% (SE = 2.88), whereas that of the placebo group increased by 5.33% (SE = 2.32) (p = 0.001, d = 1.02). The pressure pain threshold showed significant differences between both groups, being significantly higher in the needling group (adductor muscle p = 0.001; d = 0.85; anterior tibialis muscle p = 0.022, d = 0.58). CONCLUSIONS This work appears to indicate that dry needling produces an immediate activation in the sympathetic nervous system, improving local and distant mechanical hyperalgesia.
Collapse
Affiliation(s)
- Irene Lázaro-Navas
- Department of Physical Therapy, University Hospital Ramón y Cajal, 28034 Madrid, Spain;
- University of Alcalá, Instituto de Fisioterapia y Dolor, 28805 Madrid, Spain; (C.L.-S.-A.); (D.P.-M.); (T.G.-I.)
| | | | - Daniel Pecos-Martín
- University of Alcalá, Instituto de Fisioterapia y Dolor, 28805 Madrid, Spain; (C.L.-S.-A.); (D.P.-M.); (T.G.-I.)
- Department of Physical Therapy, University of Alcalá, 28805 Alcalá de Henares, Spain
| | - Jose Jesús Jiménez-Rejano
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podology, University of Sevilla, 41009 Sevilla, Spain;
| | | | - Josué Fernández-Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28922 Madrid, Spain
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, Universidad Rey Juan Carlos, 28032 Madrid, Spain
- Paz Hospital Institute for Health Research, IdiPAZ, 28029 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Correspondence: ; Tel.: +34-914-888-949
| | - Tomás Gallego-Izquierdo
- University of Alcalá, Instituto de Fisioterapia y Dolor, 28805 Madrid, Spain; (C.L.-S.-A.); (D.P.-M.); (T.G.-I.)
- Department of Physical Therapy, University of Alcalá, 28805 Alcalá de Henares, Spain
| |
Collapse
|
7
|
Rozenfeld E, Strinkovsky A, Finestone AS, Kalichman L. Reliability of trigger points evaluation in the lower leg muscles. PAIN MEDICINE 2021; 22:2283-2289. [PMID: 34048586 DOI: 10.1093/pm/pnab148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Myofascial trigger point diagnosis is a clinical palpatory skill dependent on the patient's subjective response. The inter- and intra-rater reliability of trigger point physical evaluation in the lower leg muscles has rarely been reported. Previous reliability studies suffered from the Kappa paradox. OBJECTIVE To evaluate the inter- and intra-rater reliability of trigger point recognition in the lower leg muscles implying a specific method to overcome the 1st Kappa paradox. DESIGN A reliability study with pre-second examiner exclusion to correct prevalence index. SETTING Physical therapy outpatient clinic, Beer-Sheva, Israel. SUBJECTS 86 soldiers aged 18-30 referred for physical therapy with a diagnosis of musculoskeletal pain consented to take part in this study. 26 were excluded for lacking trigger points, leaving 60 subjects for analysis (31 women, 29 men). METHODS Both legs were evaluated, and the results were analyzed separately for symptomatic (N = 87) and asymptomatic legs (N = 31).Each subject was evaluated three times, twice by one examiner, and once by a second examiner. Dichotomous findings including palpable taut-band, tenderness, referred pain, and relevance of referred pain were recorded. RESULTS Inter-rater reliability for active trigger points ranged from 0.49 to 0.75 (median: 0.52) and intra-rater reliability ranged from 0.41 to 0.84 (median: 0.65) and. For total trigger points intra-rater reliability ranged from 0.52 to 0.79 (median: 0.67), and inter-rater reliability ranged from 0.44 to 0.77 (median: 0.66). CONCLUSIONS Physical examination is a reliable method of trigger point evaluation in lower leg muscles, and it can be used as a diagnostic method for trigger point evaluation.
Collapse
Affiliation(s)
- Evgeni Rozenfeld
- Israel Defense Force, Medical Corps, Israel.,Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Asia Strinkovsky
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Aharon S Finestone
- Israel Defense Force, Medical Corps, Israel.,Shamir Medical Center, Zerifin, Affiliated to the Faculty of Medicine, Tel Aviv University, Israel
| | - Leonid Kalichman
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| |
Collapse
|
8
|
Lorenzo-Sánchez-Aguilera C, Rodríguez-Sanz D, Gallego-Izquierdo T, Lázaro-Navas I, Plaza-Rodríguez J, Navarro-Santana M, Pecos-Martín D. Neuromuscular Mechanosensitivity in Subjects with Chronic Ankle Sprain: A Cross-Sectional Study. PAIN MEDICINE 2021; 21:1991-1998. [PMID: 30649506 DOI: 10.1093/pm/pny299] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Ankle sprain is one of the most common musculoskeletal injuries in sports, at work, and at home. Subjects who suffer from this injury may develop ankle instability. Functional instability has been associated with a high rate of resprain and impaired neuromuscular control in patients with ankle instability. OBJECTIVE Measurement of neural and muscular mechanosensitivity after ankle sprain injury and establishment of the relationship between these variables. METHODS A cross-sectional case-control study was performed with a sample of 58 students from Alcalá de Henares University (21 males and 37 females, mean age ± SD = 21 ± 3.7 years). Subjects were divided into two groups: a case group (N = 29, subjects with unstable ankle) and a control group (N = 29, healthy subjects). The pressure pain threshold (PPT) of the tibialis anterior, peroneus longus, and peroneus brevis muscles and mechanosensitivity of the common peroneus and tibial nerves were evaluated in all subjects through a manual mechanical algometer. RESULTS Neuromuscular PPTs showed significant differences (P < 0.05) between both groups, such that, compared with the control group, the case group exhibited significantly lower PPT levels. In the case group, a strong positive correlation was observed between neural and muscular homolateral mechanosensitivity in both lower limbs. CONCLUSIONS Participants with chronic ankle instability showed higher neuromuscular mechanosensitivity in muscles and nerves surrounding the ankle joint than healthy subjects. These findings indicate that low PPT values may be associated with symptoms that characterize this disease.
Collapse
|
9
|
Kang BH, Tang CT. Acupuncture to abdominal trigger points as treatment for idiopathic dyspnea: A case study. J Bodyw Mov Ther 2021; 27:436-439. [PMID: 34391268 DOI: 10.1016/j.jbmt.2021.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/19/2021] [Accepted: 02/28/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Brian H Kang
- Washington University in St. Louis, Department of Neurology, Division of Neurorehabilitation, 4444 Forest Park Avenue, St. Louis, MO, 63108, USA
| | - Chi-Tsai Tang
- Washington University in St. Louis, Department of Orthopedic Surgery, Division of Physical Medicine and Rehabilitation, 14532 S. Outer Forty Drive, Chesterfield, MO, 63107, USA.
| |
Collapse
|
10
|
Dones VC, Tangcuangco LPD, Regino JM. The reliability in determining the deep fascia displacement of the upper trapezius during cervical movement: A pilot study. J Bodyw Mov Ther 2021; 27:239-246. [PMID: 34391240 DOI: 10.1016/j.jbmt.2021.02.016] [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: 07/09/2020] [Revised: 02/19/2021] [Accepted: 02/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Restricted shoulder fascia displacement may be an etiological factor for myofascial pain syndrome. A diagnostic ultrasound video can follow deep fascia displacement during active cervical movements. Trackers can be applied to videos to convert deep fascia displacement into data points. This study reports on assessors' reliability in evaluating direction and quantifying upper trapezius' deep fascia displacement during active cervical movements. METHODS PT-Sonographer 1 recorded deep fascia displacement of upper trapezius for three sets using HS1 Konica Minolta diagnostic ultrasound. The recording sequence used was cervical flexion, extension, right lateral flexion, left lateral flexion, right rotation, and left rotation. The three assessors used the tracker to determine direction of deep fascia displacement. PT-Sonographer 1 used the tracker three times in quantifying deep fascia displacement. Intraclass correlation coefficient and Kappa determined the assessors' intra-tester and inter-tester reliability. RESULTS Ten participants were included in the study with a mean±(SD) age of 37±(6). All the assessors had acceptable intra-tester reliability in determining deep fascia displacement on tracker (ICC≥0.40). All assessors had clinically unacceptable inter-tester reliability in determining deep fascia displacement when tracking right rotation (ICC < 0.40). PT-Sonographer 1 had clinically unacceptable intra-tester reliability in determining deep fascia displacement when tracking left rotation (ICC<0.40). CONCLUSION We report clinically acceptable assessors' reliability in determining direction and total deep fascia displacement when tracking diagnostic ultrasound videos of cervical flexion, extension, and lateral flexion. Checking for reliable deep fascia displacements may distinguish MPS from non-MPS individuals increasing the utility of diagnostic ultrasound machine and tracker in clinical practice.
Collapse
Affiliation(s)
- Valentin C Dones
- Center for Health Research and Movement Science, College of Rehabilitation Sciences, University of Santo Tomas, Philippines.
| | - Lyle Patrick D Tangcuangco
- Center for Health Research and Movement Science, College of Rehabilitation Sciences, University of Santo Tomas, Philippines
| | - Jocel M Regino
- Center for Health Research and Movement Science, College of Rehabilitation Sciences, University of Santo Tomas, Philippines
| |
Collapse
|
11
|
Benito-de-Pedro M, Becerro-de-Bengoa-Vallejo R, Elena Losa-Iglesias M, Rodríguez-Sanz D, López-López D, Palomo-López P, Mazoteras-Pardo V, Calvo-Lobo AC. Effectiveness of Deep Dry Needling vs Ischemic Compression in the Latent Myofascial Trigger Points of the Shortened Triceps Surae from Triathletes on Ankle Dorsiflexion, Dynamic, and Static Plantar Pressure Distribution: A Clinical Trial. PAIN MEDICINE 2021; 21:e172-e181. [PMID: 31502640 DOI: 10.1093/pm/pnz222] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine the immediate efficacy of a single session of deep dry needling (DDN) vs ischemic compression (ICT) in a latent myofascial trigger point (MTrP) of the shortened triceps surae from triathletes for ankle dorsiflexion and redistribution of plantar pressures and stability. DESIGN A randomized simple blind clinical trial (NCT03273985). SETTING An outpatient clinic. SUBJECTS Thirty-four triathletes with a latent MTrP in the shortened gastrocnemius. METHODS Triathletes were randomized to receive a single session of DDN (N = 17) or ICT (N = 17) in a latent MTrP of the shortened triceps surae. The primary outcome was ankle dorsiflexion range of motion (ROM) by a universal goniometer. Secondary objectives were distribution of dynamic and static plantar pressures by T-Plate platform pressure, with measurements both before and after five, 10, 15, 20, and 25 minutes of treatment. RESULTS There were no statistically significant differences (P > 0.05) for ankle dorsiflexion ROM or dynamic and static plantar pressures between the experimental group treated with DDN and the control group treated with ICT before and after treatment. CONCLUSIONS DDN vs ICT carried out in latent MTrPs of the shortened gastrocnemius of triathletes did not present differences in terms of dorsiflexion ROM of the tibiofibular-talar joint or in static and dynamic plantar pressure changes before and immediately after treatment.
Collapse
Affiliation(s)
- María Benito-de-Pedro
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | - David Rodríguez-Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | - Daniel López-López
- Research, Health and Podiatry Unit, Department of Health Sciences. Faculty of Nursing and Podiatry, Universidade da Coruña, Coruña, Spain
| | - Patricia Palomo-López
- Department of Nursing, University Center of Plasencia, University of Extremadura, Extremadura, Spain
| | - Victoria Mazoteras-Pardo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | - And César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| |
Collapse
|
12
|
San-Antolín M, Rodríguez-Sanz D, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Martínez-Jiménez EM, López-López D, Calvo-Lobo C. Neuroticism Traits and Anxiety Symptoms are Exhibited in Athletes With Chronic Gastrocnemius Myofascial Pain Syndrome. J Strength Cond Res 2020; 34:3377-3385. [PMID: 33065704 DOI: 10.1519/jsc.0000000000003838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
San-Antolín, M, Rodríguez-Sanz, D, Becerro-de-Bengoa-Vallejo, R, Losa-Iglesias, ME, Martínez-Jiménez, EM, López-López, D, and Calvo-Lobo, C. Neuroticism traits and anxiety symptoms are exhibited in athletes with chronic gastrocnemius myofascial pain syndrome. J Strength Cond Res 34(12): 3377-3385, 2020-Common psychological factors, such as anxiety or neurotic personality traits, seem to be associated with pain suffered by athletes. Gastrocnemius muscles present a high prevalence for injury in athletes. These muscles are a region in which myofascial pain syndrome (MPS) frequently develops. Myofascial pain syndrome is characterized by the presence of active myofascial trigger points (MTrPs). This study compared different personality and anxiety symptoms between athletes with and without active MTrPs in the gastrocnemius. A case-control study was conducted in an outpatient clinic. Athletes who performed moderate or vigorous physical activity according to the International Physical Activity Questionnaire were included. Fifty paired-matched athletes with and without active MTrPs in their gastrocnemius muscles (n = 25 in each group) were recruited. Different personality traits (neuroticism, extraversion, psychoticism, and sincerity) and anxiety (state and trait) were evaluated by the Eysenck Personality Questionnaire and State-Trait Anxiety Inventory, respectively. Statistically significant differences (p < 0.01) with an effect size from moderate to large (d = 0.75-1.29) were found for greater neuroticism and sincerity traits in addition to state and trait anxiety in athletes with gastrocnemius MPS compared with healthy controls. In conclusion, athletes with gastrocnemius active MTrPs exhibited higher neuroticism and anxiety symptoms compared with healthy athletes. Mental health may play a key role in athletes with myofascial pain, and future studies should be performed to determine whether neuroticism-related and anxiety-related psychological care could be a key intervention in athletes with gastrocnemius active MTrPs to improve athletic performance and rehabilitation or prevent injuries.
Collapse
Affiliation(s)
- Marta San-Antolín
- Department of Psychology, European University of Madrid, Villaviciosa de Odón, Madrid, Spain
| | - David Rodríguez-Sanz
- Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Madrid, Spain
| | | | | | | | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, University of A Coruña, Ferrol, Spain
| | - César Calvo-Lobo
- Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
13
|
Middlebrook N, Rushton AB, Abichandani D, Kuithan P, Heneghan NR, Falla D. Measures of central sensitization and their measurement properties in musculoskeletal trauma: A systematic review. Eur J Pain 2020; 25:71-87. [PMID: 33034137 DOI: 10.1002/ejp.1670] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/01/2020] [Accepted: 10/05/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND OBJECTIVE Chronic pain following musculoskeletal trauma is common, which may partially be attributed to the early presence of central sensitization (CS). Multiple measures are suggested to assess clinical features of CS, yet no systematic review has evaluated the measurement properties of these measures in a musculoskeletal trauma population. DATABASES AND DATA TREATMENT This systematic review, which followed a published and PROSPERO registered protocol (CRD42018091531), aimed to establish the scope of CS measures used within a musculoskeletal trauma population and evaluate their measurement properties. Searches were conducted in two stages by two independent reviewers. The Consensus-based Standards for the selection of Health Measurement Instruments (COSMIN) checklist was used to evaluate risk of bias and overall quality was assessed using the modified Grading of Recommendations Assessment, Development and Evaluation. RESULTS From 86 studies, 30 different CS outcome measures were identified. Nine studies evaluated measurement properties of nine outcome measures; eight evaluated reliability and one evaluated construct validity. Measures included seven quantitative sensory testing methods (pressure, cold and electrical pain thresholds; warm, cold and vibration detection thresholds; vibration perception thresholds), pain drawings and a pinwheel. Risk of bias was assessed as doubtful/inadequate for all but one study, overall quality of evidence was low/very low for all measures. Reliability of measures ranged from poor to excellent. CONCLUSIONS Many measures are used to evaluate CS but with limited established measurement properties in musculoskeletal trauma. High quality research to establish measurement properties of CS outcome measures is required.
Collapse
Affiliation(s)
- Nicola Middlebrook
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.,NIHR Surgical Reconstruction & Microbiology Research Centre, University of Birmingham, Birmingham, UK
| | - Alison B Rushton
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.,NIHR Surgical Reconstruction & Microbiology Research Centre, University of Birmingham, Birmingham, UK
| | - Deepa Abichandani
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.,NIHR Surgical Reconstruction & Microbiology Research Centre, University of Birmingham, Birmingham, UK
| | - Pauline Kuithan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.,NIHR Surgical Reconstruction & Microbiology Research Centre, University of Birmingham, Birmingham, UK
| |
Collapse
|
14
|
San-Antolín M, Rodríguez-Sanz D, Vicente-Campos D, Palomo-López P, Romero-Morales C, Benito-de-Pedro M, López-López D, Calvo-Lobo C. Fear Avoidance Beliefs and Kinesiophobia Are Presented in Athletes who Suffer from Gastrocnemius Chronic Myofascial Pain. PAIN MEDICINE 2020; 21:1626-1635. [PMID: 32003802 DOI: 10.1093/pm/pnz362] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To compare and predict kinesiophobia and fear avoidance beliefs between athletes with gastrocnemius myofascial pain syndrome (MPS) and healthy athletes. DESIGN Case-control. SETTING Outpatient clinic. SUBJECTS Fifty athletes were divided into athletes with chronic gastrocnemius MPS (N = 25) and healthy athletes (N = 25). METHODS Kinesiophobia symptoms total and domain scores (harm and activity avoidance) and levels were determined by the Tampa Scale of Kinesiophobia (TSK-11). Fear avoidance beliefs total and domain scores (physical and working activities) were measured by the Fear Avoidance Beliefs Questionnaire (FABQ). RESULTS Significant differences (P < 0.05) with a large effect size (d = 0.81-4.22) were found between both groups, with greater kinesiophobia symptom scores for the TSK-11 activity avoidance domain and total scores, and greater fear avoidance beliefs scores for the FABQ physical and working activities domains and total scores of athletes with gastrocnemius MPS with respect to healthy athletes. TSK-11 total score showed a prediction model (R2 = 0.256) based on the FABQ total score. The FABQ total score showed a prediction model (R2 = 0.741) based on gastrocnemius MPS presence (R2 = 0.665), levels of kinesiophobia (R2 = 0.052), and height (R2 = 0.025). CONCLUSIONS Greater kinesiophobia levels, greater total and activity avoidance domain scores (but not for the harm domain), and greater fear avoidance beliefs total and domain scores (work and physical activity) were shown for athletes with gastrocnemius MPS vs healthy athletes. Higher kinesiophobia symptoms were predicted by greater fear avoidance beliefs in athletes. Greater fear avoidance beliefs were predicted by the presence of gastrocnemius MPS, higher levels of kinesiophobia, and lower height in athletes.
Collapse
Affiliation(s)
- Marta San-Antolín
- Department of Psychology, Universidad Europea de Madrid, Villaviciosa, de Odón, Madrid, Spain
| | - David Rodríguez-Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | - Davinia Vicente-Campos
- Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | | | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa, de Odón, Madrid, Spain
| | - María Benito-de-Pedro
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | - Daniel López-López
- Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain
| | - César Calvo-Lobo
- Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain
| |
Collapse
|
15
|
Behrangrad S, Abbaszadeh-Amirdehi M, Kordi Yoosefinejad A, Esmaeilnejadganji SM. Comparison of dry needling and ischaemic compression techniques on pain and function in patients with patellofemoral pain syndrome: a randomised clinical trial. Acupunct Med 2020; 38:371-379. [PMID: 32338532 DOI: 10.1177/0964528420912253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND To compare the effectiveness of ischaemic compression (IC) applied directly to the knee versus dry needling (DN) with respect to pain, functional status and sensitivity to mechanical stimulation of vastus medialis obliquus (VMO) myofascial trigger points (MTrPs) in patients with patellofemoral pain syndrome (PFPS). METHODS A total of 54 patients with unilateral PFPS aged 20-30 years were selected randomly from patients referred to physical therapy clinics of Babol University of Medical Sciences in Iran. Twenty-seven patients were allocated to either IC or DN groups. Three sessions of treatment were applied over 1 week with follow-up at 1 week, 1 month and 3 months. Primary outcome measures comprised the Kujala questionnaire score for functional status, numerical pain rating scale (NPRS) for pain intensity and pressure pain threshold (PPT) for sensitivity to mechanical stimulation; these were measured and recorded before treatment and 1 week, 1 month and 3 months after the last treatment session. RESULTS There were no statistically significant differences in the between-group comparisons of any variables at the various follow-up points. Both groups (n = 27 participants each) had significant improvements (p < 0.05) in pain, functional status and PPT values at follow-up. CONCLUSIONS There were no differences in markers of pain, function or pressure sensitivity over a 3-month follow-up period between patients with PFPS treated with DN and IC. Temporal improvements in both groups suggested that the two techniques may be similarly effective for the treatment of PFPS.
Collapse
Affiliation(s)
- Shabnam Behrangrad
- Department of Physical Therapy, Monash University, Melbourne, VIC, Australia
| | - Maryam Abbaszadeh-Amirdehi
- Mobility Impairment Research Center, Department of Physiotherapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, Iran
| | - Amin Kordi Yoosefinejad
- Rehabilitation Research Center, Department of Physical therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | | |
Collapse
|
16
|
San-Antolín M, Rodríguez-Sanz D, López-López D, Romero-Morales C, Carbajales-Lopez J, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Calvo-Lobo C. Depression levels and symptoms in athletes with chronic gastrocnemius myofascial pain: A case-control study. Phys Ther Sport 2020; 43:166-172. [PMID: 32179495 DOI: 10.1016/j.ptsp.2020.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine the influence of depression symptoms and levels in athletes with gastrocnemius myofascial pain with respect to healthy athletes. In addition, to determine a prediction model for kinesiophobia symptoms based on descriptive data and gastrocnemius myofascial pain presence. DESIGN Secondary case-control. SETTING Outpatient clinic. PARTICIPANTS A sample of 50 athletes was recruited and divided into athletes with chronic gastrocnemius myofascial pain (n = 25) and healthy athletes (n = 25). MAIN OUTCOME MEASUREMENTS Depression symptoms scores and levels were self-reported by athletes using the Beck Depression Inventory - II (BDI-II). RESULTS Statistically significant differences for depression symptoms scores (P = 0.011) with a moderate effect size (d = 0.77) and depression levels (P = 0.036) were found between both groups showing greater depression symptoms and levels in athletes with gastrocnemius myofascial pain (13.00 ± 13.50 points; range from 0 to 28 points) versus healthy athletes (4.00 ± 7.00 points; range from 0 to 19 points). Higher depression symptoms scores of BDI-II were only predicted by the presence of gastrocnemius myofascial pain in athletes (R2 = 0.134; β = +5.360; F[1,48] = 7.428; P = 0.009). CONCLUSIONS Greater depression symptoms and levels were exhibited for athletes with gastrocnemius myofascial pain compared to healthy athletes. In addition, depression score of athletes was only predicted by the presence of gastrocnemius myofascial pain.
Collapse
Affiliation(s)
- Marta San-Antolín
- Department of Psychology, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain.
| | - David Rodríguez-Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain.
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain.
| | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain.
| | | | | | | | - César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain.
| |
Collapse
|
17
|
Arias-Buría JL, Franco-Hidalgo-Chacón MM, Cleland JA, Palacios-Ceña M, Fuensalida-Novo S, Fernández-de-Las-Peñas C. Effects of Kinesio Taping on Post-Needling Induced Pain After Dry Needling of Active Trigger Point in Individuals With Mechanical Neck Pain. J Manipulative Physiol Ther 2020; 43:32-42. [PMID: 32061417 DOI: 10.1016/j.jmpt.2019.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/17/2019] [Accepted: 02/26/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the effectiveness of the application of kinesio taping in reducing induced pain after dry needling of active trigger points (TrPs) to the upper trapezius muscle. METHODS Consecutive patients had mechanical neck pain (n = 34, 44% female) with active TrPs in the upper trapezius muscle. All participants received dry needling into upper trapezius active TrPs. Then, they were randomly divided into a kinesio taping group, which received an adhesive tape (Kinesio Tex), and a control group, which did not receive the taping. The numeric pain rating scale was assessed (0-10) at post-needling; immediately after; and 24 hours, 48 hours, and 72 hours after needling. Neck- and shoulder-related disability was assessed before and 72 hours after needling with the Neck Disability Index (NDI) and the Shoulder Pain and Disability Index, respectively. The pressure pain threshold (PPT) over the TrP was also assessed post-needling, immediately post-intervention, and 72 hours after needling. RESULTS The analysis of covariance did not find a significant group × time interaction (P = .26) for post-needling soreness: both groups exhibited similar changes in post-needling induced pain (P < .001). No significant group × time interactions were observed for changes in NDI (P = .62), SPADI (P = .41), or PPTs (P = .52): similar improvements were found after the needling procedure for the NDI (P < .001), Shoulder Pain and Disability Index (P < .001), and PPT (P < .001). The number of local twitch responses and sex (all, P > .30) did not influence the effect for any outcome. CONCLUSION The application of kinesio taping after dry needling of active TrPs in the upper trapezius muscle was not effective for reducing post-needling induced pain in people with mechanical neck pain. Further, the application of kinesio taping as a post-needling intervention did not influence short-term changes in disability.
Collapse
Affiliation(s)
- Jose Luis Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | | | - Joshua A Cleland
- Department of Physical Therapy, Franklin Pierce University, Manchester, New Hampshire
| | - María Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Stella Fuensalida-Novo
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain.
| |
Collapse
|
18
|
Holm-Jensen A, Kjaer P, Schiøttz-Christensen B, Ziegler DS, Andersen S, Myburgh C. The Interexaminer Reproducibility and Prevalence of Lumbar and Gluteal Myofascial Trigger Points in Patients With Radiating Low Back Pain. Arch Rehabil Res Clin Transl 2020; 2:100044. [PMID: 33543073 PMCID: PMC7853331 DOI: 10.1016/j.arrct.2020.100044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective To determine the interexaminer reproducibility for judging the presence, number, and location of leg-pain referring myofascial trigger points, and their prevalence in patients with low back pain with and without concomitant leg pain referral. Design An interexaminer reproducibility study. Setting An outpatient public Hospital Spine Centre in Southern Denmark. Participants Examiners: experienced examiners (N=2), a chiropractor and a physiotherapist, respectively. Subjects: a case mix of patients with low back pain (N=32) with and without leg pain referral. Interventions A standardized palpation examination protocol of 4 bilateral lumbosacral muscles performed by each examiner. Main Outcome Measures Reproducibility on presence (measured in Cohen’s κ), number (difference and limits of agreement), location (distance between matching marks placed by examiners), and prevalence of myofascial trigger points. Results Kappa values of the examined muscles were as follows: quadratus lumborum (κ=0.42), gluteus medius (κ=0.83), gluteus minimus (κ=0.74), and piriformis (κ=0.62), with a mean of all examined muscles of kappa=0.66, assessed as substantial agreement. The mean difference in number of trigger points was 0.8, with limits of agreement ranging from −6.4 to 4.9. Mean distance between trigger point locations was 12.9 mm, with 57% only being identified by a single examiner. The prevalence of trigger points was 82.7%, highest in the gluteal region of the painful side. Conclusions Inadequate standardization and multiple trigger point sites complicate interexaminer reproducibility on location and number of patients with low back pain and leg pain referral. Nevertheless, substantial interexaminer reproducibility for the trigger point presence appears achievable. Implemented routinely, this relatively simple clinical evaluation procedure could meaningfully enhance diagnostic triage and eventual management.
Collapse
Affiliation(s)
- Aske Holm-Jensen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Per Kjaer
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Berit Schiøttz-Christensen
- Medical Research Department, Spine Centre of Southern Denmark, Hospital Lillebælt, Middelfart, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Dorthe Schøler Ziegler
- Medical Research Department, Spine Centre of Southern Denmark, Hospital Lillebælt, Middelfart, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark.,Spine Surgery and Research, Spine Center of Southern Denmark-part of Lillebaelt Hospital, Middelfart, Denmark
| | - Stina Andersen
- Medical Research Department, Spine Centre of Southern Denmark, Hospital Lillebælt, Middelfart, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Corrie Myburgh
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
19
|
San-Antolín M, Rodríguez-Sanz D, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Casado-Hernández I, López-López D, Calvo-Lobo C. Central Sensitization and Catastrophism Symptoms Are Associated with Chronic Myofascial Pain in the Gastrocnemius of Athletes. PAIN MEDICINE 2019; 21:1616-1625. [DOI: 10.1093/pm/pnz296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Abstract
Objective
To compare central sensitization symptoms, presence of central sensitivity syndrome (CSS), catastrophism, rumination, magnification, and helplessness symptoms between athletes with gastrocnemius myofascial pain and healthy athletes. Furthermore, to predict central sensitization symptoms based on sociodemographic and descriptive data, catastrophism features, and presence of gastrocnemius myofascial pain in athletes.
Design
Case–control study.
Setting
Outpatient clinic.
Subjects
Fifty matched paired athletes were recruited and divided into patients with chronic (more than three months) gastrocnemius myofascial pain (N = 25) and healthy subjects (N = 25).
Methods
Central sensitization symptoms and CSS presence (≥40 points) were determined by the Central Sensitization Questionnaire (CSQ). Catastrophism symptoms and rumination, magnification, and helplessness domains were measured by the Pain Catastrophizing Scale (PCS). Statistical significance was set at P < 0.01 for a 99% confidence interval.
Results
Statistically significant differences (P ≤ 0.001) with a large effect size (d = 1.05–1.19) were shown for higher CSQ scores and PCS total and domain scores in athletes with gastrocnemius myofascial pain vs healthy athletes. Nevertheless, CSS presence (CSQ ≥ 40 points) did not show statistically significant differences (P = 0.050) between groups. A linear regression model (R2 = 0.560, P < 0.01) predicted higher CSQ scores based on PCS total score (R2 = 0.390), female sex (R2 = 0.095), and myofascial pain presence (R2 = 0.075).
Conclusions
Greater symptoms of central sensitization, catastrophism, rumination, magnification, and helplessness were shown in athletes with gastrocnemius myofascial pain compared with healthy athletes. Nevertheless, there was not a statistically significant presence of CSS comparing both groups. Greater central sensitization symptoms were predicted by catastrophism symptoms, female sex, and presence of gastrocnemius myofascial pain in athletes.
Collapse
Affiliation(s)
- Marta San-Antolín
- Department of Psychology, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - David Rodríguez-Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | | | - Daniel López-López
- Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, Spain
| | - César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| |
Collapse
|
20
|
Abstract
Hip pathology is common amongst athletes and the general population. The mechanics of cycling have the potential to exacerbate symptomatic hip pathology and progress articular pathology in patients with morphologic risk factors such as femoroacetabular impingement. A professional fit of the bicycle to the individual which aims to optimize hip joint function can allow patients with hip pathology to exercise in comfort when alternative high impact exercise such as running may not be possible. Conversely improper fit of the bicycle can lead to hip symptoms in otherwise healthy individuals who present with risk factors for hip pain. Accordingly a bike fit can form part of the overall management strategy in a cyclist with hip symptoms. The purpose of this clinical commentary is to discuss hip pathomechanics with respect to cycling, bicycle fitting methodology and the options available to a physical therapist to optimize hip mechanics during the pedaling action.
Collapse
|
21
|
Pecos-Martin D, Ponce-Castro MJ, Jiménez-Rejano JJ, Nunez-Nagy S, Calvo-Lobo C, Gallego-Izquierdo T. Immediate effects of variable durations of pressure release technique on latent myofascial trigger points of the levator scapulae: a double-blinded randomised clinical trial. Acupunct Med 2019; 37:141-150. [PMID: 31060367 DOI: 10.1136/acupmed-2018-011738] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Latent myofascial trigger points (MTrPs) of the levator scapulae have a high prevalence and may influenceconditions of the neck and shoulder. The pressure release technique is one of the most recommended manual therapy techniques. The aim of this study was to determine the effect of varying durations of the pressure release technique application on latent MTrPs of the levator scapulae. METHODS In a three-arm (1:1:1 ratio), double-blinded, parallel, randomised clinical trial, 60 healthy university students (23 men, 37 women) with a mean±SD age of 20.0±2.67 years were recruited. Subjects were assigned to receive pressure release in one latent MTrP of the levator scapulae lasting 30s (T30s; n=17), 60s (T60s; n=22) or 90s (T90s; n=21). Active cervical range of movement (CROM), strength, pressure pain threshold (PPT) and neck pain intensity at full stretch were measured immediately before and after treatment. RESULTS Mixed-model analyses of variance showed statistically significant differences for PPT (P=0.045; partial Eta2=0.103), comparing T60s versus T30s (P=0.009; Cohen's d=1.044) and T90s versus T30s groups (P=0.001; Cohen's d=1.253), and for left side bending strength (P=0.043; partial Eta2=0.105), comparing T90s versus T30s (P=0.023; Cohen's d=0.907). The rest of the comparisons did not present any significant differences (P⩾0.05). CONCLUSIONS The 60 s and 90 s applications of the pressure release technique may be recommended to increase PPT and strength, respectively, in latent MTrPs of the levator scapulae in the short term. TRIAL REGISTRATION NUMBER NCT03006822.
Collapse
Affiliation(s)
- Daniel Pecos-Martin
- 1 Physiotherapy and Pain Group, Department of Physiotherapy and Nursing, Alcalá University, Alcalá de Henares, Spain
| | - Manuel José Ponce-Castro
- 2 Faculty of Physical Therapy, Nursing and Podiatry, University of Sevilla, Sevilla, Sevilla, Spain
| | | | - Susana Nunez-Nagy
- 4 Physiotherapy and Nursing Departament, Alcalá University, Alcalá de Henares, Spain
| | - César Calvo-Lobo
- 5 Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), Universidad de León, Ponferrada, Spain
| | - Tomás Gallego-Izquierdo
- 1 Physiotherapy and Pain Group, Department of Physiotherapy and Nursing, Alcalá University, Alcalá de Henares, Spain
| |
Collapse
|
22
|
Martín-Rodríguez A, Sáez-Olmo E, Pecos-Martín D, Calvo-Lobo C. Effects of dry needling in the sternocleidomastoid muscle on cervical motor control in patients with neck pain: a randomised clinical trial. Acupunct Med 2019; 37:151-163. [DOI: 10.1177/0964528419843913] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: To determine the changes produced by trigger point dry needling (TrP-DN) of sternocleidomastoid in patients with neck pain, and to observe how it might modify cervical motor control (CMC). Design: Single-centre, randomised, double-blinded clinical trial. Setting: Participants were recruited through advertising. The duration of the study was 6 months. Subjects: Thirty-four subjects with non-specific neck pain, aged over 18 years with an active myofascial trigger point in sternocleidomastoid, participated in the study. They were randomly assigned to treatment or control groups. Methods: TrP-DN inside or (1.5 cm) outside of the active myofascial trigger point of sternocleidomastoid. Main outcome measures: CMC, visual analogue scale and cervical range of motion were assessed before treatment, immediately post treatment, and 24 h, 1 week and 1 month after the intervention; the neck disability index was evaluated before treatment and 1 month later. Results: With a confidence interval of 99%, TrP-DN of sternocleidomastoid was associated with a decrease in pain after 1 week and CMC improved 1 month after the intervention (p < 0.001), when compared with baseline measurements, within the experimental group; there were no statistically significant differences between experimental and control groups. Conclusion: The effects of TrP-DN inside and outside of active myofascial trigger points did not differ in this study. Both interventions were associated with a similar temporal effect, specifically a reduction in neck pain at 1 week and an increase CMC at 1 month. However, these findings should be interpreted with caution due to the lack of a contemporaneous untreated control group.
Collapse
Affiliation(s)
| | - Esther Sáez-Olmo
- Physical Therapy Department, Alcalá de Henares University, Alcalá de Henares, Spain
| | - Daniel Pecos-Martín
- Physical Therapy Department, Alcalá de Henares University, Alcalá de Henares, Spain
- Physiotherapy and Pain Group, Madrid, Spain
| | - César Calvo-Lobo
- Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), Universidad de León, León, Spain
| |
Collapse
|
23
|
Diego IMA, Fernández-Carnero J, Val SL, Cano-de-la-Cuerda R, Calvo-Lobo C, Piédrola RM, Oliva LCL, Rueda FM. Analgesic effects of a capacitive-resistive monopolar radiofrequency in patients with myofascial chronic neck pain: a pilot randomized controlled trial. ACTA ACUST UNITED AC 2019; 65:156-164. [PMID: 30892438 DOI: 10.1590/1806-9282.65.2.156] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 04/22/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND To date, there is a lack of prior studies on the use of capacitive resistive monopolar radiofrequency (RF) to treat neck pain. The objective of this study was to investigate the immediate effect of capacitive resistive monopolar radiofrequency (RF=448 kHz), in comparison with a placebo, on (1) reducing neck pain intensity at myofascial trigger points (MTrP), (2) decreasing neck disability and (3) improving cervical range of motion (CROM). METHODS A randomized, double-blind, placebo-controlled trial (NCT02353195) was carried out. Patients with myofascial chronic neck pain (N=24) with active MTrP in one upper trapezius muscle were randomly divided into two groups: a radio-frequency group, which received eight sessions of a monopolar capacitive resistive radio-frequency application over the upper trapezius muscle, and a placebo group (PG), which received eight sessions of placebo radio-frequency over the same muscle. Visual analog scale (VAS), CROM and Neck Disability Index (NDI) were evaluated after the first session and after the eight sessions. RESULTS The Wilcoxon test for VAS showed statistically significant differences between baseline, immediately after the first session and after eight sessions (p<.001). No significant differences for PG were found. No differences were observed between groups. NDI improved in both groups after eight sessions, but no differences were found between groups (p<.05). ANOVA for time factor showed statistically significant changes in the right cervical rotation in both groups (F=4.112; p=.026) after eight sessions. CONCLUSIONS Even though there were no differences between both groups, the monopolar capacitive, resistive RF could have a potential effect on pain intensity.
Collapse
Affiliation(s)
- Isabel Maria Alguacil Diego
- Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine. Rey Juan Carlos University, Madrid, Spain
| | - Josue Fernández-Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine. Rey Juan Carlos University, Madrid, Spain.,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain
| | - Sofía Laguarta Val
- Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine. Rey Juan Carlos University, Madrid, Spain
| | - Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine. Rey Juan Carlos University, Madrid, Spain
| | - César Calvo-Lobo
- Nursing and Physical Therapy Department, Faculty of Health Sciences, Universidad de León, Ponferrada, León, Spain
| | - Rosa Martínez Piédrola
- Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine. Rey Juan Carlos University, Madrid, Spain
| | - Laura Cristina Luna Oliva
- Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine. Rey Juan Carlos University, Madrid, Spain
| | - Francisco Molina Rueda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine. Rey Juan Carlos University, Madrid, Spain
| |
Collapse
|
24
|
Bourgaize S, Janjua I, Murnaghan K, Mior S, Srbely J, Newton G. Fibromyalgia and myofascial pain syndrome: Two sides of the same coin? A scoping review to determine the lexicon of the current diagnostic criteria. Musculoskeletal Care 2019; 17:3-12. [PMID: 30350334 DOI: 10.1002/msc.1366] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 09/03/2018] [Accepted: 09/05/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Consistent terminology to describe the diagnostic criteria for fibromyalgia (FM) and myofascial pain syndrome (MPS) is required to address the reported inadequacies in diagnosis. The present review investigated intervention studies in FM and MPS populations to determine the lexicon of the current diagnostic criteria used to identify chronic musculoskeletal pain patients. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a scoping review to review systematically the literature obtained from five scientific databases between 1997 and February 2017. Included studies consisted of intervention studies that involved symptomatic musculoskeletal pain patients, of any age or gender, presenting with FM or MPS. Included studies were evaluated for musculoskeletal condition and the diagnostic criteria used to identify patient conditions. Extraction of study criteria focused on whether diagnostic criteria were explicitly stated, the diagnostic criteria used, physical findings, symptomatic duration and the profession of the healthcare provider who confirmed diagnosis. RESULTS We identified 493 interventions, of which 410 were related to FM and 83 to MPS. The lexicon of the diagnostic criteria used for MPS tended to be less consistent in comparison to FM criteria, with notable differences in all comparative categories. CONCLUSIONS The current review identified inconsistencies associated with the lexicon of the diagnostic criteria used to diagnose FM and MPS, and showed that there is wide variability in the terminology currently being used. These findings may have important implications for future development of consistent criteria to diagnose FM and MPS patients accurately.
Collapse
Affiliation(s)
- Sheryl Bourgaize
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Imtisal Janjua
- College of Biological Sciences, University of Guelph, Guelph, ON, Canada
| | - Kent Murnaghan
- Department of Library Services, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Silvano Mior
- Department of Graduate Education & Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - John Srbely
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Genevieve Newton
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| |
Collapse
|
25
|
Morphological Differences in the Upper Trapezius Muscle Between Female Office Workers With and Without Trapezius Myalgia: Facts or Fiction? Am J Phys Med Rehabil 2019; 98:117-124. [DOI: 10.1097/phm.0000000000001029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
26
|
Fernández-de-Las-Peñas C, Dommerholt J. International Consensus on Diagnostic Criteria and Clinical Considerations of Myofascial Trigger Points: A Delphi Study. PAIN MEDICINE 2019; 19:142-150. [PMID: 29025044 DOI: 10.1093/pm/pnx207] [Citation(s) in RCA: 148] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective There is no consensus on the essential diagnostic criteria for diagnosing a trigger point (TrP). In fact, a variety of diagnostic criteria are currently being used. Our aim was to conduct a Delphi panel to achieve an international consensus on the cluster of criteria needed for the TrP diagnosis to reach a consensus on the definition of active and latent TrPs and to clarify different clinical considerations about TrPs. Methods Following international guidelines, an international three-round Delphi survey was conducted. Questions were created based on a systematic literature search of the diagnostic criteria for TrPs. Results Sixty experts from 12 countries completed all rounds of the survey. A cluster of three diagnostic criteria was proposed as essential for the TrP diagnosis: a taut band, a hypersensitive spot, and referred pain. Eighty percent of the experts agreed that the referred pain elicited by a TrP can include different sensory sensations and not just pain, that is, pain spreading to a distant area, deep pain, dull ache, tingling, or burning pain. Eighty-four percent of the international experts consistently answered that the main clinical differences between active and latent TrPs are the reproduction of any of the symptoms experienced by a patient and the recognition of pain. No specific location of the pain referral area and TrP location should be expected. Conclusions This Delphi panel has produced an expert-based standardized definition of a TrP with a discussion of the clinical components, including the definition of referred pain and the difference between active and latent TrPs, thereby providing a foundation for future research in MPS.
Collapse
Affiliation(s)
- César Fernández-de-Las-Peñas
- Department Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.,Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Jan Dommerholt
- Myopain Seminars, LLC, Bethesda Physiocare Inc., Bethesda, Maryland, USA.,Universidad CEU Cardenal Herrera, Valencia, Spain
| |
Collapse
|
27
|
García-Muntión A, Godefroy L, Robert H, Muñoz-García D, Calvo-Lobo C, López-de-Uralde-Villanueva I. Study of the mechanisms of action of the hypoalgesic effect of pressure under shock waves application: A randomised controlled trial. Complement Ther Med 2018; 42:332-339. [PMID: 30670263 DOI: 10.1016/j.ctim.2018.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/29/2018] [Accepted: 12/17/2018] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To determine if the perceived pain intensity during the application of shock waves (SWs) is a determinant mechanism in producing hypoalgesic changes in pressure pain thresholds (PPTs) in asymptomatic individuals. DESIGN A randomised, single-blind controlled trial [NCT03455933]. SETTING University. PARTICIPANTS Sixty-three asymptomatic individuals. INTERVENTIONS Participants were randomised into three groups: 1-SWs causing mild pain (SW-DP); 2-SWs generating moderate pain (SW-MP); and 3-cold pressor test (CPT). MAIN OUTCOME MEASUREMENTS Before and after the intervention, the PPT was evaluated bilaterally at the following points: lateral epicondyle, median nerve in the flexure of the elbow, and tibia. RESULTS The results showed differences between various groups over time for all PPTs assessments, due to the existence of statistically significant differences in the interaction group x times (dominant arm lateral epicondyle [P < 0.001; η2p = 0.255]; dominant arm median nerve [P = 0.001; η2p = 0.212]; nondominant arm lateral epicondyle [P < 0.001; η2p = 0.275]; nondominant arm median nerve [P < 0.001; η2p = 0.268]; tibia [P = 0.012, η2p = 0.138]). The SW-MP group obtained a significant increase in all the PPT evaluations compared with the SW-DP group (d > 0.80). The CPT group only showed significantly higher results, and of high magnitude (d > 0.80), regarding the SW-DP group for the PPT evaluation in the dominant member. The SW-MP group showed differences compared with the CPT only for the PPT obtained in the nondominant arm. CONCLUSIONS The findings show that SW treatment generates a hypoalgesic effect on the application point, with moderate pain. Further studies are necessary in order to link these hypoalgesic changes to the activation of the descending inhibitory systems.
Collapse
Affiliation(s)
- Alberto García-Muntión
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain; Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Loris Godefroy
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Hugo Robert
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Daniel Muñoz-García
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain; Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - César Calvo-Lobo
- Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), Universidad de León, Av. Astorga, s/n, Ponferrada, 24401, León, Spain.
| | - Ibai López-de-Uralde-Villanueva
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain; Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain; Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain
| |
Collapse
|
28
|
Lemeunier N, Jeoun EB, Suri M, Tuff T, Shearer H, Mior S, Wong JJ, da Silva-Oolup S, Torres P, D'Silva C, Stern P, Yu H, Millan M, Sutton D, Murnaghan K, Cȏté P. Reliability and validity of clinical tests to assess posture, pain location, and cervical spine mobility in adults with neck pain and its associated disorders: Part 4. A systematic review from the cervical assessment and diagnosis research evaluation (CADRE) collaboration. Musculoskelet Sci Pract 2018; 38:128-147. [PMID: 30455032 DOI: 10.1016/j.msksp.2018.09.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/21/2018] [Accepted: 09/25/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the reliability and validity of clinical tests to assess posture, pain location, and cervical spine mobility in adults with grades I-IV neck pain and associated disorders (NAD). METHODS We systematically searched electronic databases to update the systematic review of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Eligible reliability and validity studies were critically appraised using modified versions of the QAREL and QUADAS-2 instruments, respectively. Evidence from low risk of bias studies were synthesized following best evidence synthesis principles. RESULTS We screened 14302 articles, critically appraised 46 studies, and found 32 low risk of bias articles (14 reliability and 18 validity studies). We found preliminary evidence of: 1) reliability of visual inspection, aided with devices (CROM and digital caliper) to assess head posture; 2) reliability and validity of soft tissue palpation to locate tender/trigger points in muscles; 3) reliability and validity of joint motion palpation to assess stiffness and pain provocation in combination; and 4) range of motion tests using visual estimation (in cervical extension only) or devices (digital caliper, goniometer, inclinometer) to assess cervical mobility. CONCLUSIONS We found little evidence to support the reliability and validity of clinical tests to assess head posture, pain location and cervical mobility in adults with NAD grades I-III. More advanced validity studies are needed to inform the clinical utility of tests used to evaluate patients with NAD.
Collapse
Affiliation(s)
- N Lemeunier
- Institut Franco-Européen de Chiropraxie, 72 chemin de la Flambère, 31300, Toulouse, France; UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada.
| | - E B Jeoun
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - M Suri
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - T Tuff
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - H Shearer
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - S Mior
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - J J Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - S da Silva-Oolup
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - P Torres
- Rehabilitation Centre, San Cristobal Clinic, Santiago Spine Group, Santiago, Chile
| | - C D'Silva
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, L1H 7K4, Canada
| | - P Stern
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - H Yu
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada
| | - M Millan
- Cabinet d'expertise médicale, Castres, France
| | - D Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada
| | - K Murnaghan
- Librarian, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - P Cȏté
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, L1H 7K4, Canada
| |
Collapse
|
29
|
Kumbhare D, Shaw S, Ahmed S, Noseworthy MD. Quantitative ultrasound of trapezius muscle involvement in myofascial pain: comparison of clinical and healthy population using texture analysis. J Ultrasound 2018; 23:23-30. [PMID: 30414083 DOI: 10.1007/s40477-018-0330-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 10/10/2018] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Ultrasound is a non-invasive quantitative method to characterize sonographic textures of skeletal muscles. To date, there is no information available on the trapezius muscle. This study assessed the trapezius muscles of patients with myofascial pain compared with normal healthy participants. METHODS The trapezius muscles of 15 healthy and 17 myofascial pain participants were assessed using B-mode ultrasound to obtain 120 images for healthy and 162 images from myofascial pain participants. Texture features such as blob area, count and local binary patterns (LBP) were calculated. Multi-feature classification and analysis were performed using principal component analysis (PCA) and MANOVA to determine whether there were statistical differences. RESULTS We demonstrate the two principal components composed of a combination of LBP and blob parameters which explain 92.55% of the cumulative variance of our data set. In addition, blob characteristics were significantly different between healthy and myofascial pain participants. CONCLUSION Our study provides evidence that texture analysis techniques can differentiate between healthy and myofascial pain affected trapezius muscles. Further research is necessary to evaluate the nature of these differences.
Collapse
Affiliation(s)
- Dinesh Kumbhare
- Department of Medicine, Division of Physical Medicine and Rehabilitation, Toronto Rehabilitation Institute, 550 University Ave, Suite 7-131, Toronto, ON, M5G 2A2, Canada.
| | - Saurabh Shaw
- Department of Psychology, McMaster University, Hamilton, Canada
| | | | - Michael D Noseworthy
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, Canada
| |
Collapse
|
30
|
Calvo-Lobo C, Pacheco-da-Costa S, Martínez-Martínez J, Rodríguez-Sanz D, Cuesta-Álvaro P, López-López D. Dry Needling on the Infraspinatus Latent and Active Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized Clinical Trial. J Geriatr Phys Ther 2018; 41:1-13. [PMID: 26760574 PMCID: PMC5728593 DOI: 10.1519/jpt.0000000000000079] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Shoulder pain is a prevalent condition in older adults. Some authors associate nonspecific shoulder pain with myofascial trigger points (MTrPs) in the infraspinatus muscle. Dry needling is recommended to relieve the MTrP pain of shoulders in the short term (<9 days). Active MTrPs dry needling improves shoulder pain and the irritability of the satellite MTrPs in the referred pain area. Nociceptive activity at a latent MTrP may influence motor activity and the sensitivity of MTrPs in distant muscles at a similar segmental level. Therefore, this study aimed to evaluate dry needling on 1 latent MTrP, in conjunction with 1 active MTrP, in the infraspinatus muscle of older adults with nonspecific shoulder pain. METHODS A single-center, randomized, single-blinded, controlled study (NCT02032602) was carried out. Sixty-six patients aged 65 years and older with trigger points in the ipsilateral infraspinatus of the painful shoulder were randomly assigned to (1) of (2) treatment groups. A session of dry needling on the infraspinatus was performed in (1) the most hyperalgesic active and latent MTrP or (2) only the most hyperalgesic active MTrP. The Numeric Rating Scale, the pressure pain threshold (primary outcome) on the anterior deltoid and extensor carpi radialis brevis latent MTrPs, and grip strength were assessed before, after, and 1 week after the intervention. RESULTS Statistically significant differences in the reduction of pain intensity (P ≤ .001; η = 0.159-0.269; d = 1.017-1.219) and the increase of pressure pain threshold (P < .001; η = 0.206-0.481; d = 0.870-1.924) were found for the (1) treatment group immediately and 1 week postintervention. Nevertheless, no statistical significant differences were found in grip strength (P >. 05; η = 0.006-0.033; d = 0.158-0.368). CONCLUSIONS One dry needling intervention of the latent MTrP associated with the key active MTrP of the infraspinatus reduces pain intensity and the irritability of the satellite MTrPs located in the referred pain area in the short term in older adults with nonspecific shoulder pain.
Collapse
Affiliation(s)
- César Calvo-Lobo
- Physiotherapy Department, Faculty of Health, Exercise and Sport, European University of Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Soraya Pacheco-da-Costa
- Nursing and Physiotherapy Department, Physiotherapy Teaching Unit, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | | | - David Rodríguez-Sanz
- Physiotherapy Department, Faculty of Health, Exercise and Sport, European University of Madrid, Villaviciosa de Odón, Madrid, Spain
| | | | - Daniel López-López
- Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, Coruña, Spain
| |
Collapse
|
31
|
Kalichman L, Levin I, Bachar I, Vered E. Short-term effects of kinesio taping on trigger points in upper trapezius and gastrocnemius muscles. J Bodyw Mov Ther 2018; 22:700-706. [DOI: 10.1016/j.jbmt.2017.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 11/06/2017] [Accepted: 11/12/2017] [Indexed: 11/30/2022]
|
32
|
Dommerholt J, Finnegan M, Hooks T, Chou LW. A critical overview of the current myofascial pain literature - July 2018. J Bodyw Mov Ther 2018; 22:673-684. [PMID: 30100296 DOI: 10.1016/j.jbmt.2018.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 06/25/2018] [Indexed: 01/09/2023]
Abstract
In the current issue of this clinical overview, we are pleased to include several basic research studies ranging from the differentiation of radicular and non-radicular low back pain based on the presence of trigger points (TrPs) to the role of TrPs in patients with osteoarthritis, the diagnostic criteria of TrP, the accurate placement of needles in the piriformis muscle with dry needling (DN), and the reliability of TrP identification, among others. As usual, there are many new DN studies, but also several review papers, and manual TrP research. Contributing authors come from as many as 15 different countries!
Collapse
Affiliation(s)
- Jan Dommerholt
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA.
| | - Michelle Finnegan
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA.
| | - Todd Hooks
- New Orleans Pelicans, New Orleans, LA, USA.
| | | |
Collapse
|
33
|
Dommerholt J, Chou LW, Finnegan M, Hooks T. A critical overview of the current myofascial pain literature - April 2018. J Bodyw Mov Ther 2018; 22:402-410. [PMID: 29861242 DOI: 10.1016/j.jbmt.2018.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Twenty-four basic and clinical studies and case reports are included in this quarterly review of the myofascial pain literature. The majority of publications focus on invasive techniques, especially dry needling. We hope, that this not suggest that clinicians and researchers are slowly moving away from manual trigger point (TrP) approaches. While some physiotherapists have bought into the notion that hands-on approaches are a thing of the past, since "pain is in the brain" and "the issues are not in the tissues," there is also a body of research that aims to combine so-called top-down and bottom-up therapies. Combining manual therapy and dry needling with pain neuroscience education is likely the preferred method using a multimodal approach (Puentedura and Flynn, 2016; Lluch Girbes et al., 2015).
Collapse
Affiliation(s)
- Jan Dommerholt
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA.
| | | | - Michelle Finnegan
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA.
| | - Todd Hooks
- New Orleans Pelicans, New Orleans, LA, USA.
| |
Collapse
|
34
|
Nascimento JDSD, Alburquerque-Sendín F, Vigolvino LP, Oliveira WFD, Sousa CDO. Inter- and Intraexaminer Reliability in Identifying and Classifying Myofascial Trigger Points in Shoulder Muscles. Arch Phys Med Rehabil 2018; 99:49-56. [DOI: 10.1016/j.apmr.2017.06.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/18/2017] [Accepted: 06/20/2017] [Indexed: 01/02/2023]
|
35
|
Surface Electromyographic Activity of the Upper Trapezius Before and After a Single Dry Needling Session in Female Office Workers With Trapezius Myalgia. Am J Phys Med Rehabil 2017. [DOI: 10.1097/phm.0000000000000761] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
36
|
Walsh R, Kinsella S, McEvoy J. The intra-rater reliability of locating and measuring the severity of latent trigger points in the quadriceps. J Bodyw Mov Ther 2017; 21:926-932. [DOI: 10.1016/j.jbmt.2016.11.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 10/22/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
|
37
|
Interrater Agreement of Manual Palpation for Identification of Myofascial Trigger Points. Clin J Pain 2017; 33:715-729. [DOI: 10.1097/ajp.0000000000000459] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
38
|
Dommerholt J, Chou LW, Finnegan M, Hooks T. A critical overview of the current myofascial pain literature - June 2017. J Bodyw Mov Ther 2017; 21:673-683. [PMID: 28750983 DOI: 10.1016/j.jbmt.2017.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We would like to welcome Dr. Li-Wei Chou, MD, PhD as our newly appointed contributing author. Dr. Chou is Assistant Professor at China Medical University in Taichung, Taiwan and he has an impressive publication record with many research studies and book chapters. The current overview includes several articles comparing dry needling (DN) to acupuncture with sharply contrasting points of view. Several basic studies shed further light on the nature of myofascial pain, myalgia, fascia and examination techniques, such as sonoelastography. Neuroimaging studies demonstrated microstructural abnormalities in brain gray matter of chronic myofascial pain patients, which is an important new finding. As usual, many manual TrP papers and DN papers were published in the past several months.
Collapse
Affiliation(s)
- Jan Dommerholt
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA.
| | | | - Michelle Finnegan
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA.
| | - Todd Hooks
- Myopain Seminars, Bethesda, MD, USA; New Orleans Pelicans, New Orleans, LA, USA.
| |
Collapse
|
39
|
Segura-Pérez M, Hernández-Criado MT, Calvo-Lobo C, Vega-Piris L, Fernández-Martín R, Rodríguez-Sanz D. A Multimodal Approach for Myofascial Pain Syndrome: A Prospective Study. J Manipulative Physiol Ther 2017; 40:397-403. [PMID: 28739020 DOI: 10.1016/j.jmpt.2017.06.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 06/07/2017] [Accepted: 06/15/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The purpose of this study was to analyze pain intensity in patients with myofascial pain syndrome (MPS) following a multimodal rehabilitation protocol. METHODS A prospective study was carried out following the Template for Intervention Description and Replication criteria. Patients were recruited from the rehabilitation unit of a university hospital in Spain between 2009 and 2013. Patients were included if they had a medical diagnosis of MPS in any of the following regions: cervicobrachial (n = 102), lumbosacral (n = 30), elbow (n = 14), ankle and foot (n = 10), and temporomandibular jaw (n = 1). The multimodal rehabilitation protocol included myofascial trigger point dry needling, spray and stretching, Kinesio taping, eccentric exercise, and patient education. The protocol was applied for 4 weeks (5 sessions) for the active and/or latent myofascial trigger points in each body region. Pain intensity was measured by using the visual analog scale (VAS) immediately before beginning of the study and 1 week after completion of the protocol. RESULTS The study sample comprised 150 patients (mean ± standard deviation age, 51.5 ± 1.19 years). Statistically significant differences were obtained for reduction in pain intensity (4 ± 2.03; P = .002). Clinically relevant reductions (VAS ≥30 mm; P < .001) were obtained in 78.7% of the interventions. Four treatment sessions reduced the VAS score by 10 mm in 83.55% of the sample. There were no statistically significant differences (P = .064) for reduction in pain intensity in the different body regions. CONCLUSIONS A multimodal rehabilitation protocol showed clinically relevant differences in the reduction in pain intensity in different body regions in patients with MPS.
Collapse
Affiliation(s)
| | | | - César Calvo-Lobo
- Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), Faculty of Health Sciences, University of León, León, Spain..
| | - Lorena Vega-Piris
- Health Research Institute, University Hospital la Princesa, Madrid, Spain
| | | | - David Rodríguez-Sanz
- Physical Therapy & Health Sciences Research Group, Physiotherapy Department, Faculty of Health, Exercise and Sport, European University, Madrid, Spain
| |
Collapse
|
40
|
Kearns G, Gilbert KK, Allen B, Sizer PS, Brismée JM, Pendergrass T, Lierly M, York D. Accuracy and safety of dry needle placement in the piriformis muscle in cadavers. J Man Manip Ther 2017; 26:89-96. [PMID: 29686482 DOI: 10.1080/10669817.2017.1346745] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Objectives The purpose of this anatomic investigation is to (1) establish accuracy of dry needle placement into the medial third of the piriformis muscle as it exits the pelvis from the greater sciatic notch in unembalmed cadaveric specimens, while avoiding puncture of the sciatic nerve, and (2) establish guidelines for dry needle length selection. Methods Dry needles were placed in nineteen unembalmed cadaveric posterior hips. Dissection of the posterior hip musculature was performed to confirm location of the needle. A binary decision (yes/no) was made to determine whether the needle reached the piriformis muscle, went through the piriformis muscle, and/or pierced the sciatic nerve. Additionally, mean adipose tissue thickness, gluteus maximus muscle thickness, and perpendicular distance from the needle to the exiting sciatic nerve were recorded. Results The needle reached the medial third of the piriformis in 16 out of 19 hips (84.2% accuracy) and never punctured the sciatic nerve. There was a fair (r = 0.493) and good (r = 0.759) correlation between the needle length and the mean fat thickness for the left and right hips, respectively. Discussion A physical therapist was able to use bony landmark palpation to locate the piriformis muscle and use estimated adipose tissue thickness to choose a sufficient needle length to reach the medial third of the piriformis muscle. While the needle placement technique was safe and no sciatic nerve puncture occurred, the proximity of the piriformis muscle to the sciatic nerve warrants caution during needle placement. Level of Evidence 2c.
Collapse
Affiliation(s)
- Gary Kearns
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Kerry K Gilbert
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA.,Clinical Anatomy Research Laboratory, Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Brad Allen
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Phillip S Sizer
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA.,Clinical Musculoskeletal Research Laboratory, Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Jean-Michel Brismée
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA.,Clinical Musculoskeletal Research Laboratory, Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Timothy Pendergrass
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Micah Lierly
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Deborah York
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| |
Collapse
|
41
|
Dommerholt J, Grieve R, Hooks T, Finnegan M. A critical overview of the current myofascial pain literature - March 2017. J Bodyw Mov Ther 2017; 21:378-385. [PMID: 28532883 DOI: 10.1016/j.jbmt.2017.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
After two years of having contributed to this overview series of articles, we sadly say goodbye to Dr. Rob Grieve. We would like to thank Dr. Grieve for his insightful contributions and analyses of the myofascial pain literature. Dr. Grieve would have preferred to continue, but his many university and research responsibilities had to take priority. We are looking forward to reviewing his future research endeavors in this article. We are pleased that Dr. Li-Wei Chou, MD, PhD has agreed to replace Dr. Grieve and join our team. Dr. Chou is Assistant Professor at China Medical University in Taichung, Taiwan and he has an impressive publication record with many research studies and book chapters. In this edition of the overview article, we once again have included articles from around the world with a combination of basic research and clinical studies and case reports. The majority of papers deal with dry needling, but there are also several more basic research studies and manual therapy papers.
Collapse
Affiliation(s)
- Jan Dommerholt
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA.
| | - Rob Grieve
- Department of Allied Health Professions, Faculty of Health and Applied Sciences, University of the West of England, Blackberry Hill, Bristol, United Kingdom.
| | - Todd Hooks
- New Orleans Pelicans, New Orleans, LA, USA.
| | - Michelle Finnegan
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA.
| |
Collapse
|
42
|
Velázquez-Saornil J, Ruíz-Ruíz B, Rodríguez-Sanz D, Romero-Morales C, López-López D, Calvo-Lobo C. Efficacy of quadriceps vastus medialis dry needling in a rehabilitation protocol after surgical reconstruction of complete anterior cruciate ligament rupture. Medicine (Baltimore) 2017; 96:e6726. [PMID: 28445290 PMCID: PMC5413255 DOI: 10.1097/md.0000000000006726] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Several new rehabilitation modalities have been proposed after anterior cruciate ligament (ACL) reconstruction. Among these, trigger point dry needling (TrP-DN) might be useful in the treatment of myofascial pain syndrome associated with ACL reconstruction to reduce pain intensity, increase knee flexion range and modify the mechanical properties of the quadriceps muscle during late-stage rehabilitation. To date, this is the first randomized clinical trial to support the use of TrP-DN in the early rehabilitation process after ACL reconstruction. The aim of this study was to determine the pain intensity, range of motion (ROM), stability, and functionality improvements by adding quadriceps vastus medialis TrP-DN to the rehabilitation protocol (Rh) provided to subacute ACL reconstructed patients. METHODS This randomized, single-blinded, clinical trial (NCT02699411) included 44 subacute patients with surgical reconstruction of complete ACL rupture. The patients were randomized into 2 intervention groups: Rh (n = 22) or Rh + TrP-DN (n = 22). Pain intensity, ROM, stability, and functionality were measured at baseline (A0) and immediately (A1), 24 hours (A2), 1 week (A3), and 5 weeks (A4) after the first treatment. RESULTS Comparing statistically significant differences (P ≤ .001; Eta = 0.198-0.360) between both groups, pain intensity (at A1), ROM (at A1, A2, and A3), and functionality (at A2, A3, and A4) were increased. Nevertheless, the rest of measurements did not show significant differences (P > .05). CONCLUSION Quadriceps vastus medialis TrP-DN in conjunction with a rehabilitation protocol in subacute patients with surgical reconstruction of complete ACL rupture increases ROM (short-term) and functionality (short- to mid-term). Although there was an increase in pain intensity with the addition of TrP-DN, this was not detected beyond immediately after the first treatment. Furthermore, stability does not seem to be modified after TrP-DN.
Collapse
Affiliation(s)
- Jorge Velázquez-Saornil
- Physiotherapy Department, Physical Therapy and Health Sciences Research Group, Faculty of Health, Exercise and Sport, European University of Madrid, Villaviciosa de Odón, Madrid
| | - Beatriz Ruíz-Ruíz
- Physiotherapy Department, Physical Therapy and Health Sciences Research Group, Faculty of Health, Exercise and Sport, European University of Madrid, Villaviciosa de Odón, Madrid
| | - David Rodríguez-Sanz
- Physiotherapy Department, Physical Therapy and Health Sciences Research Group, Faculty of Health, Exercise and Sport, European University of Madrid, Villaviciosa de Odón, Madrid
| | - Carlos Romero-Morales
- Physiotherapy Department, Physical Therapy and Health Sciences Research Group, Faculty of Health, Exercise and Sport, European University of Madrid, Villaviciosa de Odón, Madrid
| | - Daniel López-López
- Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol
| | - Cesar Calvo-Lobo
- Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), University of León, León, Spain
| |
Collapse
|
43
|
Calvo-Lobo C, Diez-Vega I, Martínez-Pascual B, Fernández-Martínez S, de la Cueva-Reguera M, Garrosa-Martín G, Rodríguez-Sanz D. Tensiomyography, sonoelastography, and mechanosensitivity differences between active, latent, and control low back myofascial trigger points: A cross-sectional study. Medicine (Baltimore) 2017; 96:e6287. [PMID: 28272251 PMCID: PMC5348199 DOI: 10.1097/md.0000000000006287] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The myofascial pain syndrome (MPS) is considered the most common musculoskeletal condition. The lumbopelvic pain (LPP) is established as one of the most prevalent musculoskeletal disorders. Nevertheless, previous research has not yet studied the contractibility changes by tensiomyography between myofascial trigger point (MTrP) types and normal tissue. Therefore, the aim of this study was to determine the tensiomyography, sonoelastography, and pressure pain threshold (PPT) differences between the palpation area of active and latent MTrPs with regards to control points in the lumbar erector spinae muscles of subjects with LPP. A cross-sectional descriptive study was performed. A convenience sample of 60 points (20 active MTrPs, 20 latent MTrPs, and 20 control points) was registered bilaterally in the lumbar erector spinae muscles from subjects with nonspecific LPP. The palpation order of active MTrPs, latent MTrPs, or control points was randomized for each side. The outcome assessors were blinded to the order or point type. The outcome measurements order for each point was sonoelastography manual strain index, tensiomyography, and PPT, separated by 15 minutes. Five contractile objective parameters were: maximal radial displacement (Dm), contraction time (Tc), sustain time (Ts), delay time (Td), and half-relaxation time (Tr). Tensiomyography parameters did not show any statistically significant difference (P > 0.05) between active MTrPs, latent MTrPs, and control points. Nevertheless, PPT and sonoelastography showed statistically significant differences (P < 0.05) between all point types, except for active and latent MTrPs PPT comparison (P = 0.091). Regarding the active MTrPs, a moderate positive correlation was observed between PPT and Dm (P = 0.047; τB = 0.450). Considering the control points, a moderate positive correlation was shown between sonoelastography and Td (P = 0.044; τB = 0.328). The tensiomyography contractile properties did not seem to show differences, while the sonoelastography and mechanosensitivity presented a higher stiffness and a lower PPT, respectively, between the palpation area of active and latent MTrPs with regards to control points in the lumbar erector spinae muscles of subjects with LPP. Considering the correlations, further research is needed regarding the muscle contractile properties modifications under MPS treatments, especially Dm in active MTrPs and Td in normal sites.
Collapse
Affiliation(s)
- César Calvo-Lobo
- Nursing and Physical Therapy Department, Faculty of Health Sciences, University of León, Ponferrada, León, Spain
| | - Ignacio Diez-Vega
- Sport Sciences Department, Assessment and Control of Performance and Sport Learning Research Group, Faculty of Health, Exercise and Sport, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Beatriz Martínez-Pascual
- Physiotherapy Department, Physical Therapy and Health Sciences Research Group, Faculty of Health, Exercise and Sport, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Silvia Fernández-Martínez
- Physiotherapy Department, Physical Therapy and Health Sciences Research Group, Faculty of Health, Exercise and Sport, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Mónica de la Cueva-Reguera
- Physiotherapy Department, Physical Therapy and Health Sciences Research Group, Faculty of Health, Exercise and Sport, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Gerson Garrosa-Martín
- Sport Sciences Department, Assessment and Control of Performance and Sport Learning Research Group, Faculty of Health, Exercise and Sport, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - David Rodríguez-Sanz
- Physiotherapy Department, Physical Therapy and Health Sciences Research Group, Faculty of Health, Exercise and Sport, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| |
Collapse
|
44
|
Palacios-Ceña M, Castaldo M, Wang K, Catena A, Torelli P, Arendt-Nielsen L, Fernández-de-las-Peñas C. Relationship of active trigger points with related disability and anxiety in people with tension-type headache. Medicine (Baltimore) 2017; 96:e6548. [PMID: 28353618 PMCID: PMC5380302 DOI: 10.1097/md.0000000000006548] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
To investigate the differences in the presence of trigger points (TrPs) and their association with headache-related disability and mood disorders in people with frequent episodic tension-type headache (TTH) (FETTH) and chronic TTH (CTTH). One hundred twenty-two individuals with TTH participated. Clinical features of headache (i.e., intensity, duration, and frequency) were recorded on a headache diary. Headache-related disability was assessed with the Headache Disability Inventory, trait and state anxiety levels with State-Trait Anxiety Inventory, and depression with the Hospital Anxiety and Depression Scale. TrPs were bilaterally explored in the temporalis, masseter, suboccipital, upper trapezius, splenius capitis, and sternocleidomastoid muscles. Sixty-two (51%) patients were classified as FETTH, whereas 60 (49%) were classified as CTTH. Individuals with CTTH showed higher burden of headache and depression than FETTH (P < 0.001). Subjects with FETTH showed similar number of TrPs (total number: 5.9 ± 3.1, active TrPs: 4.7 ± 2.5, and latent TrPs: 1.2 ± 1.9) than those with CTTH (total number: 5.7 ± 3.2, active TrPs: 4.2 ± 3.0, and latent TrPs: 1.5 ± 1.8). The number of active TrPs was significantly associated with the burden of headache (r = 0.189; P = 0.037) and trait anxiety (r = 0.273; P = 0.005): the higher the number of active TrPs, the greater the physical burden of headache or the more the trait anxiety level. No association with the depression was observed. The presence of active TrPs in head and neck/shoulder muscles was similar between individuals with FETTH and CTTH and associated with the physical burden of headache and trait anxiety levels independently of the subgroup of TTH.
Collapse
Affiliation(s)
- María Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
- Department of Health Science and Technology, Center for Sensory-Motor Interaction (SMI), School of Medicine, Aalborg University, Aalborg, Denmark
| | - Matteo Castaldo
- Department of Health Science and Technology, Center for Sensory-Motor Interaction (SMI), School of Medicine, Aalborg University, Aalborg, Denmark
- Department of Physical Therapy, University of Siena, Siena
- Poliambulatorio Fisiocenter, Collecchio
| | - Kelun Wang
- Department of Health Science and Technology, Center for Sensory-Motor Interaction (SMI), School of Medicine, Aalborg University, Aalborg, Denmark
| | | | - Paola Torelli
- Department of Experimental Clinical Medicine, Headache Center, University of Parma, Parma, Province of Parma, Italy
| | - Lars Arendt-Nielsen
- Department of Health Science and Technology, Center for Sensory-Motor Interaction (SMI), School of Medicine, Aalborg University, Aalborg, Denmark
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
- Department of Health Science and Technology, Center for Sensory-Motor Interaction (SMI), School of Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|
45
|
Calvo Lobo C, Romero Morales C, Rodríguez Sanz D, Sanz Corbalán I, Sánchez Romero EA, Fernández Carnero J, López López D. Comparison of hand grip strength and upper limb pressure pain threshold between older adults with or without non-specific shoulder pain. PeerJ 2017; 5:e2995. [PMID: 28289561 PMCID: PMC5345821 DOI: 10.7717/peerj.2995] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 01/16/2017] [Indexed: 11/20/2022] Open
Abstract
Background There is a high prevalence of non-specific shoulder pain associated with upper limb functional limitations in older adults. The purpose of this study was to determine the minimal clinically important differences (MCID) of grip strength and pressure pain threshold (PPT) in the upper limb between older adults with or without non-specific shoulder pain. Methods A case-control study was carried out following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria. A sample of 132 shoulders (mean ± SD years) with (n = 66; 76.04 ± 7.58) and without (n = 66; 75.05 ± 6.26) non-specific pain were recruited. The grip strength and PPT of the anterior deltoid and extensor carpi radialis brevis (ECRB) muscles were assessed. Results There were statistically significant differences (mean ± SD; P-value) for anterior deltoid PPT (2.51 ± 0.69 vs 3.68 ± 0.65, kg/cm2; P < .001), ECRB PPT (2.20 ± 0.60 vs 3.35 ± 0.38 kg/cm2; P < .001) and grip strength (20.78 ± 10.94 vs 24.63 ± 9.38 kg; P = .032) between shoulders with and without non-specific pain, respectively. Discussion The MCID of 1.17 kg/cm2, 1.15 kg/cm2 and 3.84 kg were proposed for anterior deltoid PPT, ECRB PPT and grip strength, respectively, to assess the upper limb of older adults with non-specific shoulder pain after treatment. In addition, univariate and multivariate (linear regression and regression trees) analyses may be used to consider age distribution, sex, pain intensity, grip strength and PPT in older adults including clinical and epidemiological studies with non-specific shoulder pain.
Collapse
Affiliation(s)
- Cesar Calvo Lobo
- Physiotherapy Department, Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid , Madrid , Spain
| | - Carlos Romero Morales
- Physical Therapy & Health Sciences Research Group, Physiotherapy Department, Faculty of Health, Exercise and Sport, European University , Madrid , Spain
| | - David Rodríguez Sanz
- Physical Therapy & Health Sciences Research Group, Physiotherapy Department, Faculty of Health, Exercise and Sport, European University , Madrid , Spain
| | - Irene Sanz Corbalán
- School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid , Madrid , Spain
| | - Eleuterio A Sánchez Romero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University , Madrid , Spain
| | - Josué Fernández Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain; Research Group on Movement and Behavioural Science and Study of Pain, The Center for Advanced Studies University La Salle, Autónoma University, Madrid, Spain; La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain
| | - Daniel López López
- Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña , Ferrol , A Coruña , Spain
| |
Collapse
|
46
|
Xie P, Qin B, Song G, Zhang Y, Cao S, Yu J, Wu J, Wang J, Zhang T, Zhang X, Yu T, Zheng H. Microstructural Abnormalities Were Found in Brain Gray Matter from Patients with Chronic Myofascial Pain. Front Neuroanat 2016; 10:122. [PMID: 28066193 PMCID: PMC5167736 DOI: 10.3389/fnana.2016.00122] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 12/02/2016] [Indexed: 11/13/2022] Open
Abstract
Myofascial pain, presented as myofascial trigger points (MTrPs)-related pain, is a common, chronic disease involving skeletal muscle, but its underlying mechanisms have been poorly understood. Previous studies have revealed that chronic pain can induce microstructural abnormalities in the cerebral gray matter. However, it remains unclear whether the brain gray matters of patients with chronic MTrPs-related pain undergo alteration. In this study, we employed the Diffusion Kurtosis Imaging (DKI) technique, which is particularly sensitive to brain microstructural perturbation, to monitor the MTrPs-related microstructural alterations in brain gray matter of patients with chronic pain. Our results revealed that, in comparison with the healthy controls, patients with chronic myofascial pain exhibited microstructural abnormalities in the cerebral gray matter and these lesions were mainly distributed in the limbic system and the brain areas involved in the pain matrix. In addition, we showed that microstructural abnormalities in the right anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC) had a significant negative correlation with the course of disease and pain intensity. The results of this study demonstrated for the first time that there are microstructural abnormalities in the brain gray matter of patients with MTrPs-related chronic pain. Our findings may provide new insights into the future development of appropriate therapeutic strategies to this disease.
Collapse
Affiliation(s)
- Peng Xie
- Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University Urumqi, China
| | - Bangyong Qin
- Department of Anesthesiology, Zunyi Medical University Zunyi, China
| | - Ganjun Song
- Department of Radiology, Zunyi Medical University Zunyi, China
| | - Yi Zhang
- Department of Anesthesiology, Zunyi Medical UniversityZunyi, China; Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical UniversityZunyi, China
| | - Song Cao
- Department of Anesthesiology, Zunyi Medical UniversityZunyi, China; Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical UniversityZunyi, China
| | - Jin Yu
- Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University Urumqi, China
| | - Jianjiang Wu
- Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University Urumqi, China
| | - Jiang Wang
- Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University Urumqi, China
| | - Tijiang Zhang
- Department of Radiology, Zunyi Medical University Zunyi, China
| | - Xiaoming Zhang
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City KS, USA
| | - Tian Yu
- Department of Anesthesiology, Zunyi Medical UniversityZunyi, China; Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical UniversityZunyi, China
| | - Hong Zheng
- Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University Urumqi, China
| |
Collapse
|
47
|
Miles D. Re: "Dry Needling Alters Trigger Points in the Upper Trapezius Muscle and Reduces Pain in Subjects with Chronic Myofascial Pain". PM R 2016; 8:1225-1226. [PMID: 27989419 DOI: 10.1016/j.pmrj.2016.07.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 07/22/2016] [Accepted: 07/30/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Derek Miles
- Sports Medicine, University of Florida, Gainesville, FL(∗)
| |
Collapse
|
48
|
The Location of Peak Upper Trapezius Muscle Activity During Submaximal Contractions is not Associated With the Location of Myofascial Trigger Points. Clin J Pain 2016; 32:1044-1052. [DOI: 10.1097/ajp.0000000000000373] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
49
|
Sanz DR, Lobo CC, López DL, Morales CR, Marín CS, Corbalán IS. Interrater Reliability in the Clinical Evaluation of Myofascial Trigger Points in Three Ankle Muscles. J Manipulative Physiol Ther 2016; 39:623-634. [DOI: 10.1016/j.jmpt.2016.09.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 02/10/2016] [Accepted: 03/30/2016] [Indexed: 12/26/2022]
|
50
|
Dommerholt J, Finnegan M, Hooks T, Grieve R. A critical overview of the current myofascial pain literature - September 2016. J Bodyw Mov Ther 2016; 20:879-892. [PMID: 27814870 DOI: 10.1016/j.jbmt.2016.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This edition of the overview of the current myofascial pain literature includes 24 studies, case reports and systematic and narrative reviews. Surprisingly, five of the 24 papers were difficult to read and interpret mostly because of a poor mastery of the English language. It is somewhat surprising that journal editors and reviewers would accept papers that are needlessly difficult to read and not direct the authors to language services or others who could improve the quality of the writings. Of course, it is exciting that researchers and clinicians from all over the world continue to focus on myofascial pain and attempt to shed new light on the complexity of the problem to improve the clinical decision-making process and eventually clinical approaches and outcomes. There were no new papers on manual therapies, but many focused on dry needling.
Collapse
Affiliation(s)
- Jan Dommerholt
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA.
| | - Michelle Finnegan
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA.
| | - Todd Hooks
- New Orleans Pelicans, New Orleans, LA, USA.
| | - Rob Grieve
- Department of Allied Health Professions, Faculty of Health and Applied Sciences, University of the West of England, Blackberry Hill, Bristol, United Kingdom.
| |
Collapse
|