干针疗法可改变上斜方肌激痛点并减轻慢性肌筋膜疼痛患者的疼痛。
Dry Needling Alters Trigger Points in the Upper Trapezius Muscle and Reduces Pain in Subjects With Chronic Myofascial Pain.
作者信息
Gerber Lynn H, Shah Jay, Rosenberger William, Armstrong Kathryn, Turo Diego, Otto Paul, Heimur Juliana, Thaker Nikki, Sikdar Siddhartha
机构信息
Center for the Study of Chronic Illness and Disability, George Mason University, CCID, 4400 University Dr, Fairfax, VA 22030.
Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD.
出版信息
PM R. 2015 Jul;7(7):711-718. doi: 10.1016/j.pmrj.2015.01.020. Epub 2015 Feb 4.
OBJECTIVE
To determine whether dry needling of an active myofascial trigger point (MTrP) reduces pain and alters the status of the trigger point to either a non-spontaneously tender nodule or its resolution.
DESIGN
A prospective, nonrandomized, controlled, interventional clinical study.
SETTING
University campus.
PARTICIPANTS
A total of 56 subjects with neck or shoulder girdle pain of more than 3 months duration and active MTrPs were recruited from a campus-wide volunteer sample. Of these, 52 completed the study (23 male and 33 female). Their mean age was 35.8 years.
INTERVENTIONS
Three weekly dry needling treatments of a single active MTrP.
PRIMARY OUTCOMES
Baseline and posttreatment evaluations of pain using a verbal analogue scale, the Brief Pain Inventory, and the status of the MTrP as determined by digital palpation. Trigger points were rated as active (spontaneously painful), latent (requiring palpation to reproduce the characteristic pain), or resolved (no palpable nodule).
SECONDARY OUTCOMES
Profile of Mood States, Oswestry Disability Index, and Short Form 36 scores, and cervical range of motion.
PRIMARY OUTCOMES
A total of 41 subjects had a change in trigger point status from active to latent or resolved, and 11 subjects had no change (P < .001). Reduction in all pain scores was significant (P < .001).
SECONDARY OUTCOMES
Significant improvement in posttreatment cervical rotational asymmetry in subjects as follows: unilateral/bilateral MTrPs (P = .001 and P = 21, respectively); in pain pressure threshold in subjects with unilateral/bilateral MTrPs, (P = .006 and P = .012, respectively); improvement in the SF-36 mental health and physical functioning subscale scores (P = .019 and P = .03), respectively; and a decrease in the Oswestry Disability Index score (P = .003).
CONCLUSIONS
Dry needling reduces pain and changes MTrP status. Change in trigger point status is associated with a statistically and clinically significant reduction in pain. Reduction of pain is associated with improved mood, function, and level of disability.
目的
确定对活跃性肌筋膜触发点(MTrP)进行干针疗法是否能减轻疼痛,并将触发点状态改变为非自发压痛结节或使其消散。
设计
一项前瞻性、非随机、对照、干预性临床研究。
地点
大学校园。
参与者
从全校志愿者样本中招募了56名颈部或肩带疼痛持续超过3个月且有活跃性MTrP的受试者。其中,52名完成了研究(23名男性和33名女性)。他们的平均年龄为35.8岁。
干预措施
对单个活跃性MTrP进行每周3次的干针治疗。
主要结局
使用视觉模拟量表、简明疼痛问卷对疼痛进行基线和治疗后评估,以及通过数字触诊确定MTrP的状态。触发点被评定为活跃(自发疼痛)、潜伏(需触诊以再现特征性疼痛)或消散(无可触及结节)。
次要结局
情绪状态剖面图、Oswestry功能障碍指数、简短健康调查问卷36项评分以及颈椎活动范围。
主要结局
共有41名受试者的触发点状态从活跃变为潜伏或消散,11名受试者无变化(P <.001)。所有疼痛评分均显著降低(P <.001)。
次要结局
治疗后受试者的颈椎旋转不对称性有显著改善,如下:单侧/双侧MTrP(分别为P =.001和P = 21);单侧/双侧MTrP受试者的疼痛压力阈值(分别为P =.006和P =.012);简短健康调查问卷36项心理健康和身体功能分量表评分有所改善(分别为P =.019和P =.03);Oswestry功能障碍指数评分降低(P =.003)。
结论
干针疗法可减轻疼痛并改变MTrP状态。触发点状态的改变与疼痛在统计学和临床上的显著减轻相关。疼痛减轻与情绪、功能和残疾程度的改善相关。
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