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急性机械性颈部疼痛患者应用触发点干针疗法后颈部疼痛、广泛压痛敏感性和颈椎活动范围的短期变化:一项随机临床试验。

Short-term changes in neck pain, widespread pressure pain sensitivity, and cervical range of motion after the application of trigger point dry needling in patients with acute mechanical neck pain: a randomized clinical trial.

作者信息

Mejuto-Vázquez María J, Salom-Moreno Jaime, Ortega-Santiago Ricardo, Truyols-Domínguez Sebastián, Fernández-de-Las-Peñas César

机构信息

Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.

出版信息

J Orthop Sports Phys Ther. 2014 Apr;44(4):252-60. doi: 10.2519/jospt.2014.5108. Epub 2014 Feb 25.

Abstract

STUDY DESIGN

Randomized clinical trial.

OBJECTIVES

To determine the effects of trigger point dry needling (TrPDN) on neck pain, widespread pressure pain sensitivity, and cervical range of motion in patients with acute mechanical neck pain and active trigger points in the upper trapezius muscle.

BACKGROUND

TrPDN seems to be effective for decreasing pain in individuals with upper-quadrant pain syndromes. Potential effects of TrPDN for decreasing pain and sensitization in individuals with acute mechanical neck pain are needed. Methods Seventeen patients (53% female) were randomly assigned to 1 of 2 groups: a single session of TrPDN or no intervention (waiting list). Pressure pain thresholds over the C5-6 zygapophyseal joint, second metacarpal, and tibialis anterior muscle; neck pain intensity; and cervical spine range-of-motion data were collected at baseline (pretreatment) and 10 minutes and 1 week after the intervention by an assessor blinded to the treatment allocation of the patient. Mixed-model analyses of variance were used to examine the effects of treatment on each outcome variable.

RESULTS

Patients treated with 1 session of TrPDN experienced greater decreases in neck pain, greater increases in pressure pain threshold, and higher increases in cervical range of motion than those who did not receive an intervention at both 10 minutes and 1 week after the intervention (P<.01 for all comparisons). Between-group effect sizes were medium to large immediately after the TrPDN session (standardized mean score differences greater than 0.56) and large at the 1-week follow-up (standardized mean score differences greater than 1.34).

CONCLUSION

The results of the current randomized clinical trial suggest that a single session of TrPDN may decrease neck pain intensity and widespread pressure pain sensitivity, and also increase active cervical range of motion, in patients with acute mechanical neck pain. Changes in pain, pressure pain threshold, and cervical range of motion surpassed their respective minimal detectable change values, supporting clinically relevant treatment effects. Level of Evidence Therapy, level 1b-.

摘要

研究设计

随机临床试验。

目的

确定触发点干针疗法(TrPDN)对急性机械性颈部疼痛且上斜方肌有活动性触发点的患者的颈部疼痛、广泛压痛敏感性和颈椎活动范围的影响。

背景

TrPDN似乎对减轻上象限疼痛综合征患者的疼痛有效。需要研究TrPDN对减轻急性机械性颈部疼痛患者疼痛和致敏作用的潜在效果。方法17例患者(53%为女性)被随机分为两组:单次TrPDN治疗组或无干预组(等待名单)。由对患者治疗分配不知情的评估者在基线(治疗前)、干预后10分钟和1周时收集C5 - 6关节突关节、第二掌骨和胫骨前肌的压痛阈值、颈部疼痛强度以及颈椎活动范围数据。采用混合模型方差分析来检验治疗对每个结局变量的影响。

结果

与未接受干预的患者相比,接受单次TrPDN治疗的患者在干预后10分钟和1周时颈部疼痛减轻更明显,压痛阈值升高更显著,颈椎活动范围增加更高(所有比较P<0.01)。TrPDN治疗后组间效应量为中等至大(标准化均数得分差异大于0.56),1周随访时为大(标准化均数得分差异大于1.34)。

结论

当前随机临床试验结果表明,单次TrPDN治疗可能减轻急性机械性颈部疼痛患者的颈部疼痛强度和广泛压痛敏感性,并增加颈椎主动活动范围。疼痛、压痛阈值和颈椎活动范围的变化超过了各自的最小可检测变化值,支持了具有临床意义的治疗效果。证据级别:治疗,1b - 级。

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