Hains Guy, Descarreaux Martin, Hains François
Private practice, Trois-Rivières, Côte Richelieu, Trois-Rivières, Québec, Canada.
J Manipulative Physiol Ther. 2010 Jun;33(5):362-9. doi: 10.1016/j.jmpt.2010.05.003.
The aim of this clinical trial was to evaluate the effect of 15 myofascial therapy treatments using ischemic compression on shoulder trigger points in patients with chronic shoulder pain.
Forty-one patients received 15 experimental treatments, which consisted of ischemic compressions on trigger points located in the supraspinatus muscle, the infraspinatus muscle, the deltoid muscle, and the biceps tendon. Eighteen patients received the control treatment involving 15 ischemic compression treatments of trigger points located in cervical and upper thoracic areas. Of the 18 patients forming the control group, 16 went on to receive 15 experimental treatments after having received their initial control treatments. Outcome measures included a validated 13-question questionnaire measuring shoulder pain and functional impairment. A second questionnaire was used to assess patients' perceived amelioration, using a scale from 0% to 100%. Outcome measure evaluation was completed for both groups at baseline after 15 treatments, 30 days after the last treatment, and finally for the experimental group only, 6 months later.
A significant group x time interval interaction was observed after the first 15 treatments, indicating that the experimental group had a significant reduction in their Shoulder Pain and Disability Index (SPADI) score compared with the control group (62% vs 18% amelioration). Moreover, the patients perceived percentages of amelioration were higher in the experimental group after 15 treatments (75% vs 29%). Finally, the control group subjects significantly reduced their SPADI scores after crossover (55%).
The results of this study suggest that myofascial therapy using ischemic compression on shoulder trigger points may reduce the symptoms of patients experiencing chronic shoulder pain.
本临床试验旨在评估采用缺血性按压的15次肌筋膜治疗对慢性肩痛患者肩部触发点的影响。
41名患者接受了15次实验性治疗,包括对位于冈上肌、冈下肌、三角肌和肱二头肌肌腱的触发点进行缺血性按压。18名患者接受了对照治疗,包括对位于颈部和上胸部区域的触发点进行15次缺血性按压。在构成对照组的18名患者中,有16名在接受初始对照治疗后继续接受15次实验性治疗。结果测量包括一份经过验证的13个问题的问卷,用于测量肩部疼痛和功能障碍。使用另一份问卷,通过0%至100%的量表评估患者的自我感觉改善情况。在基线、15次治疗后、最后一次治疗后30天以及6个月后(仅针对实验组)对两组进行结果测量评估。
在前15次治疗后观察到显著的组×时间间隔交互作用,表明与对照组相比,实验组的肩部疼痛和功能障碍指数(SPADI)得分显著降低(改善率分别为62%和18%)。此外,在15次治疗后,实验组患者自我感觉的改善百分比更高(75%对29%)。最后,对照组患者在交叉治疗后其SPADI得分显著降低(55%)。
本研究结果表明,对肩部触发点采用缺血性按压的肌筋膜治疗可能会减轻慢性肩痛患者的症状。