Chu Jennifer, Yuen Ka-fai, Wang Bo-han, Chan Rai-chi, Schwartz Ira, Neuhauser Duncan
Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104-4283, USA.
Am J Phys Med Rehabil. 2004 Feb;83(2):104-11. doi: 10.1097/01.PHM.0000107485.86594.8B.
To determine if electrical twitch-obtaining intramuscular stimulation (ETOIMS) provides greater myofascial lower back pain relief than muscle stimulation or skin stimulation.
In this single-blinded, crossover, pilot trial performed at a university-affiliated outpatient rehabilitation medicine department in Taiwan, 12 acupuncture-naive patients with lower back pain of 3-60 mos duration received one crossover treatment every 2 wks by monopolar needle electrode insertion at bilateral T10-S1 levels to: (1) paraspinal muscles, (2) overlying skin, and (3) paraspinal muscles with ETOIMS applied via the needle electrode at individual treatment sites. A total of 30 manual insertions per side per treatment were performed, with withdrawal after 2 secs. Beginning 1 wk before each trial and continuing until 2 wks after, patients completed a visual analog scale twice daily. In addition, on the day of treatment, patients received a physical examination and completed a visual analog scale both before and after treatment.
Significant and immediate reduction in the visual analog scale levels was noted only with ETOIMS. Immediate improvement occurred in one of nine physical tests with muscle stimulation and ETOIMS only. In the 2 wks after treatment, absolute visual analog scale levels for ETOIMS were significantly lower than muscle stimulation and skin stimulation. ETOIMS resulted in a greater percentage of pain relief in the first week after treatment, although it was not statistically significant from muscle stimulation and skin stimulation.
ETOIMS provided significantly greater immediate and sustained myofascial lower back pain relief than muscle stimulation and skin stimulation. Although a greater percentage of pain reduction occurred with ETOIMS, it was not statistically significant.
确定电抽搐获取肌内刺激（ETOIMS）是否比肌肉刺激或皮肤刺激能更有效地缓解肌筋膜性下背痛。
在台湾一所大学附属医院门诊康复医学科进行的这项单盲、交叉、试点试验中，12名从未接受过针灸治疗、下背痛持续3至60个月的患者，每2周接受一次交叉治疗，通过在双侧T10 - S1水平插入单极针电极进行以下操作：（1）椎旁肌肉，（2）覆盖皮肤，（3）在各个治疗部位通过针电极施加ETOIMS刺激椎旁肌肉。每次治疗每侧共进行30次手动插入，2秒后拔出。从每次试验前1周开始，持续至试验后2周，患者每天进行两次视觉模拟评分。此外，在治疗当天，患者接受体格检查，并在治疗前后完成视觉模拟评分。
仅ETOIMS能使视觉模拟评分水平显著且立即降低。仅肌肉刺激和ETOIMS在九项体格检查中的一项出现了即时改善。治疗后2周，ETOIMS的绝对视觉模拟评分水平显著低于肌肉刺激和皮肤刺激。ETOIMS在治疗后的第一周疼痛缓解百分比更高，尽管与肌肉刺激和皮肤刺激相比无统计学差异。
与肌肉刺激和皮肤刺激相比，ETOIMS能显著更迅速且持续地缓解肌筋膜性下背痛。尽管ETOIMS的疼痛减轻百分比更高，但无统计学意义。
