Chiarotto Alessandro, Clijsen Ron, Fernandez-de-Las-Penas Cesar, Barbero Marco
Department of Health Sciences, Faculty of Earth and Life Sciences, EMGO(+) Institute for Health and Care Research, Vrije Universiteit, Amsterdam, The Netherlands.
Department of Business, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland.
Arch Phys Med Rehabil. 2016 Feb;97(2):316-37. doi: 10.1016/j.apmr.2015.09.021. Epub 2015 Oct 17.
To retrieve, appraise, and synthesize the results of studies on the prevalence of active and latent myofascial trigger points (MTrPs) in subjects with spinal pain disorders.
The databases PubMed, Embase, and CINAHL were searched, with no date or language restrictions. Search terms included controlled and free-text terms for spinal disorders and MTrPs. Further searches were conducted in Google Scholar and by contacting 3 experts in the field. Citation tracking of eligible studies was performed.
Two reviewers independently selected observational studies assessing the prevalence of active and/or latent MTrPs in at least 1 group of adults with a spinal disorder. Twelve studies met the eligibility criteria.
Methodologic quality was assessed by 2 reviewers independently using a modified version of the Downs and Black checklist. Two reviewers also used a customized form to extract studies and subjects' characteristics and the proportions of subjects with active and/or latent MTrPs in each muscle assessed.
A meta-analysis was performed when there was sufficient clinical homogeneity in at least 2 studies for the same spinal disorder. The Grading of Recommendations Assessment, Development and Evaluation approach was used to rate the body of evidence in each meta-analysis. A qualitative description of the results of single studies was provided. Low-quality evidence underpinned pooled estimates of MTrPs in the upper-body muscles of subjects with chronic neck pain. The point prevalence of MTrPs in different muscles of other disorders (eg, whiplash-associated disorders, nonspecific low back pain) was extracted from single studies with low methodologic quality and small samples. Active MTrPs were found to be present in all assessed muscles of subjects diagnosed with different spinal pain disorders. Latent MTrPs were not consistently more prevalent in subjects with a spinal disorder than in healthy controls.
The MTrPs point prevalence estimates in this review should be viewed with caution because future studies with large samples and high methodologic quality are likely to change them substantially.
检索、评估并综合有关脊柱疼痛性疾病患者中活动性和潜伏性肌筋膜触发点（MTrP）患病率的研究结果。
检索了PubMed、Embase和CINAHL数据库，无日期或语言限制。检索词包括脊柱疾病和MTrP的受控词和自由文本词。还在谷歌学术中进行了进一步检索，并联系了该领域的3位专家。对符合条件的研究进行了引文追踪。
两名评审员独立选择观察性研究，评估至少一组患有脊柱疾病的成年人中活动性和/或潜伏性MTrP的患病率。12项研究符合纳入标准。
两名评审员独立使用修改版的唐斯和布莱克检查表评估方法学质量。两名评审员还使用定制表格提取研究和受试者特征，以及在每个评估肌肉中患有活动性和/或潜伏性MTrP的受试者比例。
当至少两项针对同一脊柱疾病的研究具有足够的临床同质性时，进行荟萃分析。使用推荐分级评估、制定和评价方法对每项荟萃分析中的证据体进行评级。对单项研究的结果进行了定性描述。低质量证据支持了慢性颈痛患者上身肌肉中MTrP的汇总估计。其他疾病（如挥鞭样损伤相关疾病、非特异性下腰痛）不同肌肉中MTrP的时点患病率是从方法学质量低且样本量小的单项研究中提取的。发现患有不同脊柱疼痛性疾病的受试者的所有评估肌肉中均存在活动性MTrP。潜伏性MTrP在脊柱疾病患者中并不总是比健康对照者更普遍。
本综述中MTrP时点患病率的估计应谨慎看待，因为未来大样本和高方法学质量的研究可能会使其发生重大变化。
