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深层干针疗法对非特异性肩痛老年人潜在肌筋膜触发点的疗效:一项随机对照临床试验的初步研究

Efficacy of Deep Dry Needling on Latent Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized, Controlled Clinical Trial Pilot Study.

作者信息

Calvo-Lobo César, Pacheco-da-Costa Soraya, Hita-Herranz Edgar

机构信息

1Physiotherapy Department, Faculty of Health, Exercise and Sport, European University of Madrid, Villaviciosa de Odón, Madrid, Spain. 2Nursing and Physiotherapy Department, Physiotherapy Teaching Unit, University of Alcalá, Alcalá de Henares, Madrid, Spain. 3Nursing and Physiotherapy Department, Nursing Teaching Unit, University of Alcalá, Alcalá de Henares, Madrid, Spain.

出版信息

J Geriatr Phys Ther. 2017 Apr/Jun;40(2):63-73. doi: 10.1519/JPT.0000000000000048.

Abstract

BACKGROUND

Nonspecific shoulder pain has a high prevalence in older adults and causes functional alterations. Furthermore, there are difficulties in establishing a clinical diagnosis, effective treatments are lacking, and little evidence has been found regarding the use of invasive physical therapy techniques in this age group.

PURPOSE

To determine the efficacy of a single physical therapy intervention with deep dry needling (DDN) on latent and active myofascial trigger points (MTrPs) in older adults with nonspecific shoulder pain.

METHODS

This pilot study is a single-blind, randomized, controlled clinical trial that included 20 participants, aged 65 years and older, who were diagnosed with nonspecific shoulder pain. The study was approved by the Clinical Research Ethics Committee of the area. Participants were recruited at their homes or at a care center and were randomly assigned into either an experimental group (n = 10), which received a session of DDN on 1 active and 1 latent MTrP of the infraspinatus muscle, or a control group (n = 10), which received a session of DDN on only 1 active MTrP. A blind examiner assessed the pain intensity, pain pressure threshold on the anterior deltoid, and extensor carpi radialis brevis muscles and grip strength before, immediately after, and 1 week after the intervention.

RESULTS

Statistically significant differences (P < .05) in the pressure pain thresholds (PPTs) of the extensor carpi radialis brevis were found in the experimental group in both posttreatment assessments. Moreover, the effect size values (d Cohen) varied from small for grip strength (0.017-0.36) to moderate for the pain intensity (0.46-0.78) and PPT in the anterior deltoid (0.49-0.66) and to large for the PPT in the extensor carpi radialis brevis (1.06-1.58).

CONCLUSIONS

A single physical therapy intervention with DDN on 1 latent MTrP, in conjunction with 1 active MTrP, in the infraspinatus muscle may increase the PPT of the extensor carpi radialis brevis muscle area immediately following and 1 week after the intervention in older adults with nonspecific shoulder pain.

摘要

背景

非特异性肩痛在老年人中患病率较高,并会导致功能改变。此外,临床诊断存在困难,缺乏有效的治疗方法,且关于该年龄组使用侵入性物理治疗技术的证据很少。

目的

确定单次深层干针(DDN)物理治疗干预对非特异性肩痛老年人潜在和活跃肌筋膜触发点(MTrP)的疗效。

方法

这项初步研究是一项单盲、随机、对照临床试验,纳入了20名65岁及以上被诊断为非特异性肩痛的参与者。该研究得到了该地区临床研究伦理委员会的批准。参与者在其家中或护理中心招募,并被随机分为实验组(n = 10),接受对冈下肌1个活跃和1个潜在MTrP进行一次DDN治疗,或对照组(n = 10),仅对1个活跃MTrP进行一次DDN治疗。一名盲法检查者在干预前、干预后立即和干预后1周评估疼痛强度、三角肌前部和桡侧腕短伸肌的疼痛压力阈值以及握力。

结果

在两个治疗后评估中,实验组桡侧腕短伸肌的压力疼痛阈值(PPT)有统计学显著差异(P < .05)。此外,效应量值(科恩d值)从握力的小效应(0.017 - 0.36)到疼痛强度的中等效应(0.46 - 0.78)、三角肌前部PPT的中等效应(0.49 - 0.66)以及桡侧腕短伸肌PPT的大效应(1.06 - 1.58)不等。

结论

对非特异性肩痛老年人的冈下肌1个潜在MTrP联合1个活跃MTrP进行单次DDN物理治疗干预,可能会在干预后立即和干预后1周增加桡侧腕短伸肌区域的PPT。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37d2/5367514/3eaa2e8ae3d4/jgpt-40-063-g001.jpg

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