Itoh Kazunori, Okada Kaoru, Kawakita Kenji
Meiji University of Oriental Medicine, Kyoto, Japan.
Acupunct Med. 2004 Mar;22(1):2-12; discussion 12-3. doi: 10.1136/aim.22.1.2.
The purpose of this study was to develop an experimental model of myofascial trigger points to investigate their pathophysiology.
Fifteen healthy volunteers who gave informed consent underwent repetitive eccentric exercise of the third finger of one hand (0.1 Hz repetitions, three sets at five minute intervals) until exhaustion. Physical examination, pressure pain threshold, and electrical pain threshold of the skin, fascia and muscle were measured immediately afterwards and for seven days. Needle electromyogram (EMG) was also recorded in a subgroup of participants.
Pressure pain thresholds decreased to a minimum on the second day after the exercise, then gradually returned to baseline values by the seventh day. On the second day, a ropy band was palpated in the exercised forearm muscle and the electrical pain threshold of the fascia at the palpable band was the lowest among the measured loci and tissues. Needle EMG activity accompanied with dull pain sensation was recorded only when the electrode was located on or near the fascia of the palpable band on the second day of exercise.
These results suggest that eccentric exercise may yield a useful model for the investigation of the myofascial trigger points and/or acupuncture points. The sensitised nociceptors at the fascia of the palpable band might be a possible candidate for the localised tender region.
本研究的目的是建立一个肌筋膜触发点的实验模型,以研究其病理生理学。
15名签署知情同意书的健康志愿者对一只手的无名指进行重复性离心运动(0.1赫兹重复频率,每隔5分钟进行三组,直至疲劳)。运动结束后立即以及在随后7天内测量皮肤、筋膜和肌肉的体格检查、压痛阈值和电痛阈值。还对部分参与者记录了针极肌电图(EMG)。
运动后第二天压痛阈值降至最低,然后在第七天逐渐恢复到基线值。第二天,在运动的前臂肌肉中可触及一条条索状带,在可触及带处筋膜的电痛阈值在所测量的位点和组织中最低。仅在运动第二天,当电极位于可触及带的筋膜上或其附近时,记录到伴有钝痛感觉的针极EMG活动。
这些结果表明,离心运动可能为肌筋膜触发点和/或穴位的研究提供一个有用的模型。可触及带处筋膜上的致敏伤害感受器可能是局部压痛区域的一个潜在原因。