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Delano EH, Kushartanti W, Arovah NI, Shafi SHA, Nugroho WA. A Comparison Between the Effectiveness of Tepurak Therapy Versus Deep Tissue Massage Stretching on Low Back Function in Nonspecific Low Back Pain. Int J Ther Massage Bodywork 2024; 17:12-19. [PMID: 38873187 PMCID: PMC11131942 DOI: 10.3822/ijtmb.v17i2.927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024] Open
Abstract
Introduction The research carried out is a large research project that examined two different massage methods on many variables so that they can determine their effect on variables on a wider scale, namely pain, range of movement (ROM), and low back function. Pain and ROM variables have been published in different journals, and their acute effects are only known after treatment and the results are effective. This study examined the low back function variable 24, 48, and 72 hours after treatment. Objective This study aimed to determine the effectiveness of Tepurak and deep tissue massaging with stretching (DTMS) on low back function in nonspecific low back pain (NSLBP) and conduct a comparison of the effectiveness of Tepurak versus DTMS for low back function in NSLBP. Methods This research is a quasi-experiment using a pre-test/post-test design to determine the difference in scores before and after treatment. The variable measured involved the low back function using the Oswestry Disability Index. Measurements were carried out four times at pre-test, 24, 48, and 72 hours after the treatments. This study used two different sample groups. The research sample consisted of 42 NSLBP sufferers who were randomly divided into two groups, A and B. Group A received Tepurak treatment, while Group B received DTMS treatment. These treatments were carried out in one treatment session. Results The results of the different treatments for the low back function variables in the Tepurak treatment have a p-value of 0.000. The results of the low back function variables in the DTMS treatment have a p-value of 0.000. The results of the comparison test of Tepurak versus DTMS therapy for the low back function variable had a p-value of 0.771. Conclusion Both Tepurak and DTMS are effective in improving low back function in NSLBP cases. In comparison between Tepurak and DTMS, there was no significant difference in the effectiveness in improving low back function in NSLBP cases.
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Affiliation(s)
- Enggista Hendriko Delano
- Department of Sports Science, Faculty of Sports and Health Sciences, Yogyakarta State University, Yogyakarta, Indonesia
| | - Wara Kushartanti
- Department of Sports Science, Faculty of Sports and Health Sciences, Yogyakarta State University, Yogyakarta, Indonesia
| | - Novita Intan Arovah
- Department of Sports Science, Faculty of Sports and Health Sciences, Yogyakarta State University, Yogyakarta, Indonesia
| | - Sabda Hussain As Shafi
- Department of Sports Science, Faculty of Sports and Health Sciences, Yogyakarta State University, Yogyakarta, Indonesia
| | - Wahyu Aji Nugroho
- Department of Sports Science, Faculty of Sports and Health Sciences, Yogyakarta State University, Yogyakarta, Indonesia
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Sadeghnia M, Shadmehr A, Mir SM, Hadian Rasanani MR, Jalaei S, Fereydounnia S. The immediate effects of deep transverse friction massage, high- power pain threshold ultrasound and whole body vibration on active myofascial trigger points. J Bodyw Mov Ther 2023; 36:165-170. [PMID: 37949555 DOI: 10.1016/j.jbmt.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 06/08/2023] [Accepted: 07/04/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND The most important clinical problem in myofascial pain syndrome (MPS) is trigger points (TrPs). The aim of the present study was to investigate the comparison of immediate effect of deep transverse friction massage (DTFM), high-power pain threshold ultrasound (HPPTUS), and whole body vibration (WBV) on treatment of active myofascial trigger points (MTrPs). MATERIALS AND METHODS sixty six men with active TrPs of upper trapezius muscle were randomly divided into three equal groups: DTFM, HPPT US, and WBV. Pain intensity based on the Visual Analogue Scale (VAS), pressure pain threshold (PPT) and active contralateral lateral flexion range of motion (CLF ROM) of the neck were evaluated before and immediately after the interventions. RESULTS The VAS, PPT and the active CLF ROM were substantially improved after intervention in all groups (P < 0.01). When the three groups were compared regarding VAS, participants in the WBV group reported significantly more reduction in pain (P < 0.01). On comparing the interventions, there were no significant differences in PPT values (P > 0.05). The CLF ROM value in HPPTUS and WBV groups have significant increase in comparison to the DTFM group. CONCLUSION All three interventions can improve neck pain, PPT and ROM in participants with active TrPs in upper trapezius muscle, but due to the fact that the DTFM has more pressure on therapist fingers, and the HPPTUS technique requires proper interaction with the participants, WBV can be used as one of the effective intervention on active MTrPs of upper trapezius. CLINICAL TRIAL REGISTRATION NUMBER IRCT20200518047498N1.
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Affiliation(s)
- Mehrdad Sadeghnia
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Shadmehr
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | - Seyed Mohsen Mir
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shohreh Jalaei
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Fereydounnia
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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Xu A, Huang Q, Rong J, Wu X, Deng M, Ji L. Effectiveness of ischemic compression on myofascial trigger points in relieving neck pain: A systematic review and meta-analysis. J Back Musculoskelet Rehabil 2023:BMR220045. [PMID: 36872769 DOI: 10.3233/bmr-220045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
BACKGROUND Ischemic compression is widely used to clinically treat neck pain. However, no meta-analysis has been conducted to evaluate the effects of this process on neck pain. OBJECTIVE This study aimed to evaluate the effects of ischemic compression on the myofascial trigger points for improving neck pain-related symptoms (mainly pain, joint mobility limitation and function limitation) and to compare ischemic compression with other therapies. METHODS Electronic searches were conducted in PubMed, OVID, Web of Science, EBSCO, SCOUPS, Cochrane Library, PEDro, Wanfang, CNKI and Chinese VIP Database in June 2021. Only randomised controlled trials on the effects of ischemic compression on neck pain were included. The major outcomes were pain intensity, pressure pain threshold, pain-related disability and range of motion. RESULTS Fifteen studies involving 725 participants were included. Significant differences were observed between ischemic compression and sham/no treatment group in pain intensity, pressure pain threshold and range of motion immediately and in the short term. Significant effect sizes of dry needling were observed over ischemic compression in terms of improving pain intensity (SMD = 0.62; 95% CI: 0.08 to 1.16; P= 0.02), pain-related disability (SMD = 0.68; 95% CI: 0.19 to 1.17; P= 0.007) and range of motion (MD =-2.12; 95% CI: -2.59 to -1.65; P< 0.001) immediately after treatment. Dry needling also showed a significant small effect size for the short-term reduction of pain (SMD = 0.44; 95% CI: 0.04 to 0.85; P= 0.03). CONCLUSION Ischemic compression can be recommended in the immediate and short-term pain relief and increase in the pressure pain threshold and range of motion. Dry needling is superior to ischemic compression in relieving pain and improving pain-related disability and range of motion immediately after treatment.
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Affiliation(s)
- Anle Xu
- Center of Rehabilitation Therapy, The First Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Qiangmin Huang
- Department of Sport Rehabilitation, School of Kinesiology, Shanghai University of Sport, Shanghai, China.,Shanghai Ciyuan Rehabilitation Hospital, Sinopharm Healthcare, Shanghai, China
| | - Jifeng Rong
- Center of Rehabilitation Therapy, The First Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Xuejiao Wu
- Center of Rehabilitation Therapy, The First Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Meikui Deng
- Center of Rehabilitation Therapy, The First Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Lijuan Ji
- Department of Sport Rehabilitation, School of Kinesiology, Shanghai University of Sport, Shanghai, China
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Jo HR, Noh EJ, Oh SH, Choi SK, Sung WS, Choi SJ, Kim DI, Hong SU, Kim EJ. Comparative effectiveness of different acupuncture therapies for neck pain. Medicine (Baltimore) 2022; 101:e29656. [PMID: 35984173 PMCID: PMC9387950 DOI: 10.1097/md.0000000000029656] [Citation(s) in RCA: 4] [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: 01/05/2023] Open
Abstract
BACKGROUND Neck pain is a common musculoskeletal symptom that has negative effects on quality of life and work productivity. Acupuncture has been widely used for neck pain, and a number of randomized controlled trials (RCTs) and systematic reviews (SRs) have evaluated its effectiveness. However, previous studies have obtained inconsistent results regarding the effects of acupuncture for neck pain, and there is no SR for the comparative efficacy and safety of various types of acupuncture. Therefore, we herein conducted a SR and network meta-analysis to compare and rank different types of acupuncture with respect to their effectiveness in treating neck pain. METHODS We searched 9 electronic databases for relevant RCTs published from their inception to July 1, 2021. Pairwise meta-analyses and network meta-analysis were performed with R software using the frequentist framework. Change of pain intensity was assessed as the primary outcome, and change of pain-related disability and efficacy rate were assessed as secondary outcomes. The Cochrane risk of bias tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) instrument were used to evaluate the quality of the included RCTs and the certainty of the evidence. RESULTS A total of 65 RCTs involving 5266 participants and 9 interventions were included. Three network meta-analyses were constructed for the following: pain intensity (42 RCTs, 3158 participants), pain-related disability (21 RCTs, 1581 participants), and efficacy rate (40 RCTs, 3512 participants). The results indicated that fire acupuncture, electroacupuncture, and warm acupuncture were more effective than manual acupuncture in terms of pain intensity reduction and efficacy rate, and that electroacupuncture decreased pain-related disability more effectively than manual acupuncture. Fire acupuncture ranked first among the 9 interventions. The overall q of evidence was very low according to the GRADE assessment. The reported adverse events were not serious. CONCLUSION Fire acupuncture, warm acupuncture, acupoint catgut embedding, and electroacupuncture ranked higher than other interventions (usual care, sham acupuncture, no treatment) in reducing the pain and disability index scores and the efficacy rate. However, the included trials were evaluated as being of low quality; thus, we recommend additional well-designed RCTs with larger sample sizes to confirm these findings. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42021235274.
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Affiliation(s)
- Hyo-Rim Jo
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Dongguk University Graduate School, Seoul, Republic of Korea
| | - Eun-Ji Noh
- Department of Obstetrics & Gynecology, College of Korean Medicine, Dongguk University Graduate School, Seoul, Republic of Korea
| | - Se-Hee Oh
- Department of Ophthalmology, Otolaryngology and Dermatology, Dongguk University Ilsan Oriental Hospital, Gyeonggi-do, Republic of Korea
| | - Seong-Kyeong Choi
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Won-Suk Sung
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Su-Ji Choi
- Department of Obstetrics & Gynecology, Dongguk University Ilsan Oriental Hospital, Gyeonggi-do, Republic of Korea
| | - Dong-Il Kim
- Department of Obstetrics & Gynecology, Dongguk University Ilsan Oriental Hospital, Gyeonggi-do, Republic of Korea
| | - Seung-Ug Hong
- Department of Ophthalmology, Otolaryngology and Dermatology, Dongguk University Ilsan Oriental Hospital, Gyeonggi-do, Republic of Korea
| | - Eun-Jung Kim
- Department of Acupuncture & Moxibustion, Dongguk University, Seoul, Republic of Korea
- *Correspondence: Eun-Jung Kim, KMD, PhD, Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, 268, Buljeong-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea (e-mail: )
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Cygańska AK, Tomaszewski P, Cabak A. Pain threshold in selected trigger points of superficial muscles of the back in young adults. PeerJ 2022; 10:e12780. [PMID: 35178293 PMCID: PMC8815375 DOI: 10.7717/peerj.12780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 12/21/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Monitoring of pain threshold is the basis for verification of the effectiveness of therapy or assessment of the patient's condition. This study aimed to determine the pain threshold of selected superficial muscles of the back taking into account trigger point activity in young and healthy males and females, with the evaluation of intrarater reliability of algometric measurements. MATERIAL AND METHODS The study examined 30 young adult participants (15 males and 15 females) aged 26.23 ± 3.21, and BMI of 23.80 ± 3.43. The Pain Test FPX Algometer (Wagner) was used for the study. Trigger points on the levator scapulae and trapezius muscles (superior and inferior portion) on both sides were examined. It was also verified whether the trigger points studied are active or inactive. Furthermore, an author's survey questionnaire was used. RESULTS Within the trigger points of the right (p = 0.04) and left (p = 0.02) superior trapezius muscle and the left (p = 0.04) levator scapulae muscle, the pain threshold values were higher in the male group. There was a statistically significantly higher number of active trigger points in the female group compared to that in the male group (2.49 ± 1.51 vs. 1.07 ± 1.16, respectively), p = 0.01. For all muscles tested, mean pain threshold values were significantly higher for inactive trigger points. A greater number of active trigger points is associated with lower pain thresholds at these points (left: the superior trapezius, r = -0.597, the inferior trapezius, r = -0.609; the levator scapulae, r = -0.746; right: the superior trapezius, r = -0.610, the inferior trapezius, r = -0.604; the levator scapulae, r = -0.747). The evaluation of the intrarater reliability showed excellent agreement between the first and second measurements, ICC > 0.987 for all examined trigger points. CONCLUSIONS (1) Women who reported pain more than once a week in the studied muscles showed a greater number of active trigger points. (2) A greater number of active trigger points in female is related to a lower pain threshold (which is associated with greater pain sensitivity) in female than in male. (3) A sample size of 30 people seems sufficient to detect variations in the pain threshold at active and inactive trigger points of selected back muscles, especially when the frequency of occurrence of both types of points is comparable.
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Affiliation(s)
| | - Paweł Tomaszewski
- Faculty of Physical Education, Józef Piłsudski University of Physical Education, Warsaw, Poland
| | - Anna Cabak
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland
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Pérez-Bellmunt A, Casasayas-Cos O, López-de-Celis C, Rodríguez-Sanz J, Rodríguez-Jiménez J, Ortiz-Miguel S, Meca-Rivera T, Fernández-de-las-Peñas C. Effects of Dry Needling of Latent Trigger Points on Viscoelastic and Muscular Contractile Properties: Preliminary Results of a Randomized Within-Participant Clinical Trial. J Clin Med 2021; 10:jcm10173848. [PMID: 34501299 PMCID: PMC8432234 DOI: 10.3390/jcm10173848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 02/07/2023] Open
Abstract
This study aimed to evaluate changes in neuromuscular function and pain perception in latent trigger points (TrPs) in the gastrocnemius muscle after a single session of dry needling. A randomized within-participant clinical trial was conducted. Fifty volunteers with latent TrPs in the gastrocnemius muscles were explored. Each extremity was randomly assigned to a control or experimental (dry needling) group. Viscoelastic parameters and contractile properties were analyzed by tensiomyography. Ankle dorsiflexion range of motion was assessed with the lunge test. Pressure pain thresholds (PPT) and pain perceived were also analyzed. The results observed that three viscoelastic proprieties (myotonometry) showed significant differences in favor of the experimental extremity in the lateral gastrocnemius: stiffness (p = 0.02), relaxation (p = 0.045), and creep (p = 0.03), but not in the medial gastrocnemius. No changes in tensiomyography outcomes were found. The control extremity showed a higher increase in PPTs (i.e., decrease in pressure pain sensitivity) than the experimental extremity (p = 0.03). No significant effects for range of motion or strength were observed. In general, gender did not influence the effects of dry needling over latent TrPs in the gastrocnemius muscle. In conclusion, a single session of dry needling was able to change some parameters of neuromuscular function, such as muscle tone, relaxation, pressure pain sensitivity, and creep in the lateral (but not medial) gastrocnemius but did not improve strength or range of motion.
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Affiliation(s)
- Albert Pérez-Bellmunt
- Basic Sciences Department, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain; (A.P.-B.); (O.C.-C.); (J.R.-S.); (S.O.-M.); (T.M.-R.)
- ACTIUM Functional Anatomy Group, 08017 Barcelona, Spain
| | - Oriol Casasayas-Cos
- Basic Sciences Department, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain; (A.P.-B.); (O.C.-C.); (J.R.-S.); (S.O.-M.); (T.M.-R.)
- ACTIUM Functional Anatomy Group, 08017 Barcelona, Spain
| | - Carlos López-de-Celis
- Basic Sciences Department, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain; (A.P.-B.); (O.C.-C.); (J.R.-S.); (S.O.-M.); (T.M.-R.)
- ACTIUM Functional Anatomy Group, 08017 Barcelona, Spain
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
- Correspondence: (C.L.-d.-C.); (C.F.-d.-l.-P.)
| | - Jacobo Rodríguez-Sanz
- Basic Sciences Department, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain; (A.P.-B.); (O.C.-C.); (J.R.-S.); (S.O.-M.); (T.M.-R.)
- ACTIUM Functional Anatomy Group, 08017 Barcelona, Spain
| | - Jorge Rodríguez-Jiménez
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Sara Ortiz-Miguel
- Basic Sciences Department, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain; (A.P.-B.); (O.C.-C.); (J.R.-S.); (S.O.-M.); (T.M.-R.)
- ACTIUM Functional Anatomy Group, 08017 Barcelona, Spain
| | - Toni Meca-Rivera
- Basic Sciences Department, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain; (A.P.-B.); (O.C.-C.); (J.R.-S.); (S.O.-M.); (T.M.-R.)
- ACTIUM Functional Anatomy Group, 08017 Barcelona, Spain
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Correspondence: (C.L.-d.-C.); (C.F.-d.-l.-P.)
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Yeste-Fabregat M, Baraja-Vegas L, Vicente-Mampel J, Pérez-Bermejo M, Bautista González IJ, Barrios C. Acute Effects of Tecar Therapy on Skin Temperature, Ankle Mobility and Hyperalgesia in Myofascial Pain Syndrome in Professional Basketball Players: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168756. [PMID: 34444508 PMCID: PMC8392258 DOI: 10.3390/ijerph18168756] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/10/2021] [Accepted: 08/13/2021] [Indexed: 12/17/2022]
Abstract
(1) Background: Myofascial pain syndrome (MPS) is a clinical condition characterized by localized non-inflammatory musculoskeletal pain caused by myofascial trigger points. Diathermy or Tecar therapy (TT) is a form of noninvasive electro-thermal therapy classified as deep thermotherapy based on the application of electric currents. This technique is characterized by immediate effects, and its being used by high performance athletes. (2) Methods: A total of thirty-two participants were included in the study who were professional basketball players. There was a 15-person Control Group and a 17-person Intervention Group. TT was applied in the Intervention Group, while TT with the device switched off (SHAM) was applied in the Control Group. The effects were evaluated through the Lunge test, infrared thermography, and pressure threshold algometry at baseline, 15, and 30 min after the intervention. (3) Results: the Intervention Group exhibited a greater increase in absolute temperature (F[1,62] = 4.60, p = 0.040, η2p = 0.13) compared to the Control Group. There were no differences between the groups in the Lunge Test (F[1.68,53.64] = 2.91, p = 0.072, η2p = 0.08) or in pressure algometry (visual analog scale, VAS) (F[3.90] = 0.73, p = 0.539, η2p = 0.02). No significant short-term significant differences were found in the rest of the variables. (4) Conclusions: Diathermy can induce changes in the absolute temperature of the medial gastrocnemius muscle.
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Affiliation(s)
- Mireia Yeste-Fabregat
- Doctoral School, Catholic University of Valencia (UCV), 46001 València, Spain
- Correspondence: ; Tel.: +34-697435317
| | - Luis Baraja-Vegas
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Catholic University of Valencia (UCV), 46001 València, Spain; (L.B.-V.); (J.V.-M.); (I.J.B.G.)
| | - Juan Vicente-Mampel
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Catholic University of Valencia (UCV), 46001 València, Spain; (L.B.-V.); (J.V.-M.); (I.J.B.G.)
| | - Marcelino Pérez-Bermejo
- Department of Biostatistics, Epidemiology and Public Health, Faculty of Medicine and Health Sciences, Catholic University of Valencia, 46001 València, Spain;
| | - Iker J. Bautista González
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Catholic University of Valencia (UCV), 46001 València, Spain; (L.B.-V.); (J.V.-M.); (I.J.B.G.)
| | - Carlos Barrios
- Institute for Research on Musculoskeletal Disorders, Catholic University of Valencia, 46001 Valencia, Spain;
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Sánchez-Infante J, Bravo-Sánchez A, Jiménez F, Abián-Vicén J. Effects of Dry Needling on Muscle Stiffness in Latent Myofascial Trigger Points: A Randomized Controlled Trial. THE JOURNAL OF PAIN 2021; 22:817-825. [PMID: 33636373 DOI: 10.1016/j.jpain.2021.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/06/2021] [Accepted: 02/03/2021] [Indexed: 11/18/2022]
Abstract
The aim of this study was to analyze the effects of dry needling (DN) in upper trapezius latent trigger points (LTrPs) on muscle stiffness. A total of 51 recreational physically active subjects with LTrPs in the upper trapezius volunteered to participate and were randomly divided into a DN-group (n = 27) and a sham-DN group (n = 24). Volunteers received 1-session of DN or placebo treatment. Muscle stiffness, measured with strain and shear-wave elastography, pressure pain threshold (PPT), post-needling soreness, and muscle thickness were evaluated before treatment, and at 30-min, 24-hours, and 72-hours follow-up after treatment. The DN-group showed lower values from baseline for muscle stiffness measured with shear-wave elastrography at 24-hours (from 44.44 ± 15.97 to 35.78 ± 11.65 kpa; P < .01) and at 72-hours (35.04 ± 12.61 kpa; P < .01) and with strain elastography at 72-hours (from 1.75 ± 0.50 to 1.36 ± 0.40 AU; P < .01). The DN-group showed higher values of PPT than the sham-DN group at 72-hours (4.23 ± 0.75 vs. 5.19 ± 1.16 kg/cm2; P < .05). There was a progressive decrease in post-needling soreness compared to pain during needling of 33.13 ± 21.31% at 30-min, 80.92 ± 10.06% at 24-hours, and a total decrease in post-needling soreness in all participants at 72-hours. DN therapy is effective in reducing short-term muscle stiffness and increasing the PPT in volunteers with LTrPs in the upper trapezius after a treatment session. PERSPECTIVE: This study found that one session of DN intervention in latent trigger points of the upper trapezius muscle reduced muscle stiffness and the pressure pain threshold for the dry needling group compared to the sham dry needling group.
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Affiliation(s)
- Jorge Sánchez-Infante
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain; Hospital Universitario Virgen de la Salud, Castilla La Mancha, Toledo, Spain
| | - Alfredo Bravo-Sánchez
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Fernando Jiménez
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Javier Abián-Vicén
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain.
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Bynum R, Garcia O, Herbst E, Kossa M, Liou K, Cowan A, Hilton C. Effects of Dry Needling on Spasticity and Range of Motion: A Systematic Review. Am J Occup Ther 2021; 75:7501205030p1-7501205030p13. [PMID: 33399051 DOI: 10.5014/ajot.2021.041798] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE This systematic review summarizes existing studies on dry needling for spasticity and range of motion (ROM) and discusses its potential for use as an occupational therapy intervention. OBJECTIVE To examine existing studies on the effects of dry needling on spasticity and ROM. DATA SOURCES Article citations and abstracts from Scopus, Cochrane Library, PubMed, CINAHL, and a university library search. STUDY SELECTION AND DATA COLLECTION Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used in abstracting data. Peer-reviewed journal articles published in English between January 2007 and June 2019 were searched. Of 270 identified studies, 10 met the inclusion criteria. Studies were divided into categories on the basis of outcome measures (Modified Modified Ashworth Scale and ROM). Pain outcome measures were excluded because a systematic review addressing this outcome has recently been completed. FINDINGS Strong evidence was found to support the use of dry needling to decrease spasticity and increase ROM. CONCLUSIONS AND RELEVANCE This systematic review suggests that dry needling is an effective physical agent modality to decrease spasticity and increase ROM, both of which are potentially beneficial to functional outcomes. WHAT THIS ARTICLE ADDS This article provides information that may be helpful in determining the appropriateness of dry needling as an occupational therapy intervention.
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Affiliation(s)
- Rachel Bynum
- Rachel Bynum, MOT, OTR, is Graduate, Occupational Therapy Department, University of Texas Medical Branch, Galveston
| | - Olivia Garcia
- Olivia Garcia, MOT, OTR, is Occupational Therapist, Winter Pediatric Therapy, Houston, TX. At the time of the study, Garcia was Graduate Student, Occupational Therapy Department, University of Texas Medical Branch, Galveston
| | - Emily Herbst
- Emily Herbst, MOT, OTR, is Occupational Therapist, Encompass Health Rehabilitation Hospital, Round Rock, TX. At the time of the study, Herbst was Graduate Student, Occupational Therapy Department, University of Texas Medical Branch, Galveston
| | - Mary Kossa
- Mary Kossa, MOT, OTR, is Graduate, Occupational Therapy Department, University of Texas Medical Branch, Galveston
| | - Katrina Liou
- Katrina Liou, MOT, OTR, is Graduate, Occupational Therapy Department, University of Texas Medical Branch, Galveston
| | - April Cowan
- April Cowan, OTD, OTR, CHT, is Associate Professor of Instruction, Occupational Therapy Department, University of Texas Medical Branch, Galveston
| | - Claudia Hilton
- Claudia Hilton, PhD, MBA, OTR, FAOTA, is Associate Professor, Occupational Therapy Department, University of Texas Medical Branch, Galveston;
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Li L, Stoop R, Clijsen R, Hohenauer E, Fernández-de-Las-Peñas C, Huang Q, Barbero M. Criteria Used for the Diagnosis of Myofascial Trigger Points in Clinical Trials on Physical Therapy: Updated Systematic Review. Clin J Pain 2020; 36:955-967. [PMID: 32841969 DOI: 10.1097/ajp.0000000000000875] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The objective of this study was to conduct an updated systematic review of diagnostic criteria for myofascial trigger points (MTrPs) used in clinical trials of physical therapy interventions from 2007 to 2019. METHODS MEDLINE and Physiotherapy Evidence Database (PEDro) were searched using the following MeSH keywords: "trigger points," "trigger point," "myofascial trigger point," "myofascial trigger points," "myofascial pain," and "myofascial pain syndrome." The MeSH keywords were combined by using Boolean operators "OR"/"AND." All physiotherapy clinical trials including patients with musculoskeletal conditions characterized by at least 1 active MTrP or latent MTrP in any body area were selected. We pooled data from an individual criterion and criteria combinations used to diagnose MTrPs. The protocol was developed in accordance with the PRISMA-P guidelines. RESULTS Of 478 possibly relevant publications, 198 met the inclusion criteria. Of these 198 studies, 129 studies (65.1%) stated specifically the diagnostic criteria used for MTrPs in the main text, 56 studies (28.3%) failed to report any method whereby MTrP was diagnosed, and 13 studies (6.6%) adopted expert-based definitions for MTrPs without specification. Of 129 studies, the 6 criteria applied most commonly were: "spot tenderness" (n=125, 96.9%), "referred pain" (95, 73.6%), "local twitch response" (63, 48.8%), pain recognition (59, 45.7%), limited range of motion" (29, 22.5%), and "jump sign" (10, 7.8%). Twenty-three combinations of diagnostic criteria were identified. The most frequently used combination was "spot tenderness," "referred pain," and "local twitch response" (n=28 studies, 22%). CONCLUSIONS A number of the included studies failed in properly reporting the MTrP diagnostic criteria. Moreover, high variability in the use of MTrP diagnostic was also observed. Spot tenderness, referred pain, and local twitch response were the 3 most popular criteria (and the most frequently used combination). A lack of transparency in the reporting of MTrP diagnostic criteria is present in the literature. REGISTRY This systematic review was registered under the Centre for Reviews and Dissemination, PROSPERO number: CRD42018087420.
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Affiliation(s)
- Lihui Li
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- School of Medicine, Southern University of Science and Technology, Shenzhen
- Department of Sport Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai, China
| | - Rahel Stoop
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- International University of Applied Sciences THIM, Landquart, Switzerland
| | - Ron Clijsen
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Erich Hohenauer
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Qiangmin Huang
- Department of Sport Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai, China
| | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
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11
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Navarro-Santana MJ, Sanchez-Infante J, Fernández-de-las-Peñas C, Cleland JA, Martín-Casas P, Plaza-Manzano G. Effectiveness of Dry Needling for Myofascial Trigger Points Associated with Neck Pain Symptoms: An Updated Systematic Review and Meta-Analysis. J Clin Med 2020; 9:E3300. [PMID: 33066556 PMCID: PMC7602246 DOI: 10.3390/jcm9103300] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 12/19/2022] Open
Abstract
Our aim was to evaluate the effect of dry needling alone as compared to sham needling, no intervention, or other physical interventions applied over trigger points (TrPs) related with neck pain symptoms. Randomized controlled trials including one group receiving dry needling for TrPs associated with neck pain were identified in electronic databases. Outcomes included pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion. The Cochrane risk of bias tool and the Physiotherapy Evidence Database (PEDro) score were used to assessed risk of bias (RoB) and methodological quality of the trials. The quality of evidence was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Between-groups mean differences (MD) and standardized mean differences (SMD) were calculated (3) Twenty-eight trials were finally included. Dry needling reduced pain immediately after (MD -1.53, 95% CI -2.29 to -0.76) and at short-term (MD -2.31, 95% CI -3.64 to -0.99) when compared with sham/placebo/waiting list/other form of dry needling and, also, at short-term (MD -0.51, 95% CI -0.95 to -0.06) compared with manual therapy. No differences in comparison with other physical therapy interventions were observed. An effect on pain-related disability at the short-term was found when comparing dry needing with sham/placebo/waiting list/other form of dry needling (SMD -0.87, 95% CI -1.60 to -0.14) but not with manual therapy or other interventions. Dry needling was effective for improving pressure pain thresholds immediately after the intervention (MD 55.48 kPa, 95% CI 27.03 to 83.93). No effect on cervical range of motion of dry needling against either comparative group was found. No between-treatment effect was observed in any outcome at mid-term. Low to moderate evidence suggests that dry needling can be effective for improving pain intensity and pain-related disability in individuals with neck pain symptoms associated with TrPs at the short-term. No significant effects on pressure pain sensitivity or cervical range of motion were observed. Registration number: OSF Registry-https://doi.org/10.17605/OSF.IO/P2UWD.
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Affiliation(s)
- Marcos J. Navarro-Santana
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.J.N.-S.); (P.M.-C.); (G.P.-M.)
- Department of Physical Therapy, Rehabilitación San Fernando, 28807 Madrid, Spain
| | - Jorge Sanchez-Infante
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, 45003 Toledo, Spain;
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Alcorcón, 28922 Madrid, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
| | - Joshua A. Cleland
- Doctor of Physical Therapy Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA;
| | - Patricia Martín-Casas
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.J.N.-S.); (P.M.-C.); (G.P.-M.)
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.J.N.-S.); (P.M.-C.); (G.P.-M.)
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
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12
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Papadopoulos ES, Mani R. The Role of Ultrasound Therapy in the Management of Musculoskeletal Soft Tissue Pain. INT J LOW EXTR WOUND 2020; 19:350-358. [DOI: 10.1177/1534734620948343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ultrasound is an invaluable physical modality widely used for diagnosis and therapy in humans and animals. It is noninvasive, atraumatic, and may be used repeatedly. As a therapeutic tool, ultrasound has been in use for some 6 decades. Therapeutic ultrasound (TUS) is used for the treatment of musculoskeletal disorders, including acute soft tissue injuries, overuse syndromes, as well as chronic orthopedic and rheumatologic conditions. The aim of this review was to investigate the clinical effectiveness of TUS in musculoskeletal acute and chronic pain, mainly through the control of inflammation and the promotion of soft tissue injury healing. Based on the evidence presented, TUS is clinically effective in some musculoskeletal soft tissue pain conditions, but due to conflicting results in some studies, no specific positive recommendations can be made, nor does it permit exclusion of TUS from clinical practice. In phonophoresis, TUS plays a significant role, without reported adverse effects. There is scope for improving the evidence base with better designed studies.
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Affiliation(s)
| | - Raj Mani
- Shanghai Jiao Tong University, Shanghai, China
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