Alburquerque-García Anabel, Rodrigues-de-Souza Daiana P, Fernández-de-las-Peñas César, Alburquerque-Sendín Francisco
Physical Therapist, Residencia de Mayores de Guadaira, Alcalá de Guadaira, Sevilla, Spain.
Physical Therapist, Department of Psychology, Social and Anthropology, University of Salamanca, Salamanca, Spain.
J Manipulative Physiol Ther. 2015 May;38(4):262-8. doi: 10.1016/j.jmpt.2014.10.018. Epub 2015 Apr 27.
The objectives of this study were to investigate if referred pain elicited by active trigger points (TrPs) reproduced the symptoms in individuals with painful knee osteoarthritis (OA) and to determine the relationship between the presence of active TrPs, intensity of ongoing pain, function, quality of life, and sleep quality in individuals with painful knee OA.
Eighteen women with bilateral painful knee OA, aged 79 to 90 years, and 18 matched controls participated. Muscle TrPs were bilaterally explored in several muscles of the lower extremity. Trigger points were considered active if the elicited referred pain reproduced knee symptoms, and TrPs were considered latent if the elicited pain did not reproduce symptoms. Pain was collected with a numerical pain rate scale (0-10), function was assessed with Western Ontario and McMaster Universities, quality of life was assessed with the Medical Outcomes Study Short Form 36 questionnaire, and sleep quality was determined with the Pittsburgh Sleep Quality Index.
Women with knee OA exhibited a greater number of active TrPs (mean, 1 ± 1; P < .001) but similar number of latent TrPs (mean, 4 ± 2) than healthy women (mean, 4 ± 3; P = .613). A greater number of active TrPs were associated with higher intensity of ongoing pain (r = 0.605; P = .007). Higher intensity of ongoing knee pain was associated with lower physical function (P < .05).
The referred pain elicited by active TrPs in the lower extremity muscles contributed to pain symptoms in painful knee OA. A higher number of active TrPs was associated with higher intensity of ongoing knee pain.
本研究的目的是调查主动触发点（TrP）引发的牵涉痛是否会再现疼痛性膝骨关节炎（OA）患者的症状，并确定疼痛性膝OA患者中主动TrP的存在、持续疼痛强度、功能、生活质量和睡眠质量之间的关系。
18名年龄在79至90岁之间的双侧疼痛性膝OA女性和18名匹配的对照者参与了研究。对下肢的几块肌肉进行双侧触诊以检查肌肉TrP。如果引发的牵涉痛再现了膝部症状，则认为TrP是活跃的；如果引发的疼痛未再现症状，则认为TrP是潜伏的。使用数字疼痛评分量表（0-10）收集疼痛情况，采用西安大略和麦克马斯特大学骨关节炎指数评估功能，采用医学结局研究简明健康调查36项问卷评估生活质量，采用匹兹堡睡眠质量指数确定睡眠质量。
与健康女性（平均4±3；P = 0.613）相比，膝OA女性表现出更多的活跃TrP（平均1±1；P < 0.001），但潜伏TrP数量相似（平均4±2）。更多的活跃TrP与更高的持续疼痛强度相关（r = 0.605；P = 0.007）。更高的持续膝痛强度与更低的身体功能相关（P < 0.05）。
下肢肌肉中活跃TrP引发的牵涉痛导致了疼痛性膝OA的疼痛症状。更多的活跃TrP与更高的持续膝痛强度相关。
