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爆发型经皮神经电刺激对颈椎活动度和潜伏肌筋膜触发点疼痛敏感性的影响。

Effects of burst-type transcutaneous electrical nerve stimulation on cervical range of motion and latent myofascial trigger point pain sensitivity.

机构信息

Department of Physical Therapy, Faculty of Medicine, CEU-San Pablo University, Madrid, Spain.

出版信息

Arch Phys Med Rehabil. 2011 Sep;92(9):1353-8. doi: 10.1016/j.apmr.2011.04.010.

Abstract

OBJECTIVE

To assess the effects of a burst application of transcutaneous electrical nerve stimulation (TENS) on cervical range of motion and pressure point sensitivity of latent myofascial trigger points (MTrPs).

DESIGN

A single-session, single-blind randomized trial.

SETTING

General community rehabilitation clinic.

PARTICIPANTS

Individuals (N = 76; 45 men, 31 women) aged 18 to 41 years (mean ± SD, 23 ± 4y) with latent MTrPs in 1 upper trapezius muscle.

INTERVENTIONS

Subjects were randomly divided into 2 groups: a TENS group that received a burst-type TENS (pulse width, 200 μs; frequency, 100 Hz; burst frequency, 2 Hz) stimulation over the upper trapezius for 10 minutes, and a placebo group that received a sham-TENS application over the upper trapezius also for 10 minutes.

MAIN OUTCOME MEASURES

Referred pressure pain threshold (RPPT) over the MTrP and cervical range of motion in rotation were assessed before, and 1 and 5 minutes after the intervention by an assessor blinded to subjects' treatment.

RESULTS

The analysis of covariance revealed a significant group × time interaction (P < .001) for RPPT: the TENS group exhibited a greater increase compared with the control group; however, between-group differences were small at 1 minute (0.3 kg/cm²; 95% confidence interval [CI], 0.1-0.4) and at 5 minutes (0.6 kg/cm²; 95% CI, 0.3-0.8) after treatment. A significant group × time interaction (P=.01) was also found for cervical rotation in favor of the TENS group. Between-group differences were also small at 1 minute (2.0°; 95% CI, 1.0-2.8) and at 5 minutes (2.7°; 95% CI, 1.7-3.8) after treatment.

CONCLUSIONS

A 10-minute application of burst-type TENS increases in a small but statistically significant manner the RPPT over upper trapezius latent MTrPs and the ipsilateral cervical range of motion.

摘要

目的

评估经皮神经电刺激(TENS)爆发式应用对颈椎活动范围和潜在肌筋膜触发点(MTrP)压痛阈值的影响。

设计

单次、单盲随机试验。

地点

普通社区康复诊所。

参与者

76 名年龄在 18 至 41 岁(平均±标准差,23±4 岁)的个体,均有单侧上斜方肌的潜伏性 MTrP(45 名男性,31 名女性)。

干预

将受试者随机分为两组:TENS 组接受 10 分钟爆发式 TENS(脉冲宽度 200μs,频率 100Hz,爆发频率 2Hz)刺激上斜方肌,假 TENS 组接受 10 分钟假 TENS 上斜方肌刺激。

主要观察指标

在干预前、干预后 1 分钟和 5 分钟,由对受试者治疗情况不知情的评估者评估 MTrP 上的牵涉性压痛阈值(RPPT)和颈椎旋转活动度。

结果

协方差分析显示 RPPT 的组间×时间交互作用具有统计学意义(P<0.001):TENS 组的增加明显大于对照组;然而,治疗后 1 分钟和 5 分钟时组间差异较小(分别为 0.3kg/cm²,95%置信区间:0.1-0.4;0.6kg/cm²,95%置信区间:0.3-0.8)。颈椎旋转的组间×时间交互作用也具有统计学意义(P=.01),有利于 TENS 组。治疗后 1 分钟和 5 分钟时组间差异也较小(分别为 2.0°,95%置信区间:1.0-2.8;2.7°,95%置信区间:1.7-3.8)。

结论

10 分钟爆发式 TENS 应用可小幅度但具有统计学意义地增加上斜方肌潜伏性 MTrP 的 RPPT 和同侧颈椎活动度。

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