Cagnie Barbara, Castelein Birgit, Pollie Flore, Steelant Lieselotte, Verhoeyen Hanne, Cools Ann
From the Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Am J Phys Med Rehabil. 2015 Jul;94(7):573-83. doi: 10.1097/PHM.0000000000000266.
The aim of this review was to describe the effects of ischemic compression and dry needling on trigger points in the upper trapezius muscle in patients with neck pain and compare these two interventions with other therapeutic interventions aiming to inactivate trigger points. Both PubMed and Web of Science were searched for randomized controlled trials using different key word combinations related to myofascial neck pain and therapeutic interventions. Four main outcome parameters were evaluated on short and medium term: pain, range of motion, functionality, and quality-of-life, including depression. Fifteen randomized controlled trials were included in this systematic review. There is moderate evidence for ischemic compression and strong evidence for dry needling to have a positive effect on pain intensity. This pain decrease is greater compared with active range of motion exercises (ischemic compression) and no or placebo intervention (ischemic compression and dry needling) but similar to other therapeutic approaches. There is moderate evidence that both ischemic compression and dry needling increase side-bending range of motion, with similar effects compared with lidocaine injection. There is weak evidence regarding its effects on functionality and quality-of-life. On the basis of this systematic review, ischemic compression and dry needling can both be recommended in the treatment of neck pain patients with trigger points in the upper trapezius muscle. Additional research with high-quality study designs are needed to develop more conclusive evidence.
本综述的目的是描述缺血性按压和干针疗法对颈部疼痛患者上斜方肌触发点的影响，并将这两种干预措施与其他旨在使触发点失活的治疗性干预措施进行比较。在PubMed和Web of Science数据库中检索了使用与肌筋膜性颈部疼痛和治疗性干预措施相关的不同关键词组合的随机对照试验。在短期和中期评估了四个主要结局参数：疼痛、活动范围、功能和生活质量，包括抑郁情况。本系统综述纳入了15项随机对照试验。有中等证据表明缺血性按压有效，有充分证据表明干针疗法对疼痛强度有积极影响。与主动活动范围锻炼（缺血性按压）以及无干预或安慰剂干预（缺血性按压和干针疗法）相比，这种疼痛减轻更为明显，但与其他治疗方法相似。有中等证据表明缺血性按压和干针疗法均可增加侧屈活动范围，与利多卡因注射效果相似。关于其对功能和生活质量影响的证据不足。基于本系统综述，缺血性按压和干针疗法均可推荐用于治疗上斜方肌有触发点的颈部疼痛患者。需要开展更多高质量研究设计的研究以得出更确凿的证据。
