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干针疗法对纤维肌痛综合征患者脊柱活动度和触发点的影响。

Effects of Dry Needling on Spinal Mobility and Trigger Points in Patients with Fibromyalgia Syndrome.

作者信息

Castro-Sanchez Adelaida Maria, Garcia-Lopez Hector, Mataran-Penarrocha Guillermo A, Fernandez-Sanchez Manuel, Fernandez-Sola Cayetano, Granero-Molina Jose, Aguilar-Ferrandiz Maria Encarnacion

机构信息

Department of Nursing, Physical Therapy, and Medicine, University of Almeria (UAL) Almeria, Spain.

出版信息

Pain Physician. 2017 Feb;20(2):37-52.

Abstract

BACKGROUND

The etiology of fibromyalgia syndrome (FMS) is inconclusive, but central mechanisms are well accepted for this pain condition. Myofascial pain syndrome (MPS) is one of the most common musculoskeletal pain diseases and is characterized by myofascial trigger points (MTrPs). It has been suggest that MTrPs have an important factor in the genesis of FMS.

OBJECTIVE

The purpose of the current randomized clinical trial was to compare the effectiveness of dry needling versus cross tape on spinal mobility and MTrPs in spinal muscles in patients with FMS.

STUDY DESIGN

A single-blind randomized controlled trial was conducted on patients with FMS.

SETTING

Clinical setting.

METHODS

Sixty-four patients with FMS were randomly assigned to an experimental group receiving dry needling therapy or to a control group for cross tape therapy in the MTrPs in the latissimus dorsi, iliocostalis, multifidus, and quadratus lumbourum muscles. Spinal mobility measures and MTrPs algometry were recorded at baseline and after 5 weeks of treatment.

RESULTS

The repeated measures analysis of variance (ANOVA) demonstrated that significant differences between groups were achieved for the MTrPs in latissimus dorsi muscle (right axillary portion: F = 9.80, P = 0.003); multifidus muscle (right L2 level: F = 11.80, P = 0.001); quadratus lumborum (right lateral superficial upper: F = 6.67, P = 0.012; and right lateral superficial lower: F = 5.38, P = 0.024). In addition, the ANOVA repeated measures test showed significant differences between groups for the segmental amplitude thoracic spine in the standing erect position (F = 7.33, P = 0.009), and segmental amplitude of lumbar spine (F = 11.60, P = 0.001) in the sitting erect position.

LIMITATIONS

The outcomes were not collected from a long-term follow-up period. Dry needling therapy or cross tape were used alone when in reality physical therapists usually treat patients with FMS using a multi-modal approach. A non-treatment control group was not included.

CONCLUSIONS

This study has demonstrated that dry needling therapy reduces myofacial trigger points algometry on thoracic and lumbar muscles. Dry needling and cross tape approaches reported a similar effect size for spinal mobility measures in patients with FMS.Key words: Fibromyalgia, trigger points, physical therapy modalities, musculoskeletalequilibrium, myofascial pain syndromes.

摘要

背景

纤维肌痛综合征(FMS)的病因尚无定论,但这种疼痛状况的中枢机制已得到广泛认可。肌筋膜疼痛综合征(MPS)是最常见的肌肉骨骼疼痛疾病之一,其特征为肌筋膜触发点(MTrP)。有人提出,MTrP是FMS发病的一个重要因素。

目的

本随机临床试验的目的是比较干针疗法与交叉贴扎疗法对FMS患者脊柱活动度及脊柱肌肉中MTrP的疗效。

研究设计

对FMS患者进行单盲随机对照试验。

研究地点

临床环境。

方法

64例FMS患者被随机分为实验组接受干针疗法,或对照组接受背阔肌、髂肋肌、多裂肌和腰方肌中MTrP的交叉贴扎疗法。在基线和治疗5周后记录脊柱活动度测量值和MTrP痛觉测定值。

结果

重复测量方差分析(ANOVA)表明,两组之间在背阔肌MTrP(右腋窝部分:F = 9.80,P = 0.003)、多裂肌(右L2水平:F = 11.80,P = 0.001)、腰方肌(右外侧浅上部:F = 6.67,P = 0.012;右外侧浅下部:F = 5.38,P = 0.024)方面存在显著差异。此外,ANOVA重复测量检验显示,两组之间在直立位胸椎节段活动幅度(F = 7.33,P = 0.009)和直立坐位腰椎节段活动幅度(F = 11.60,P = 0.001)方面存在显著差异。

局限性

未从长期随访中收集结果。实际中物理治疗师通常采用多模式方法治疗FMS患者,而本研究仅单独使用干针疗法或交叉贴扎疗法。未纳入非治疗对照组。

结论

本研究表明,干针疗法可降低胸腰段肌肉的肌筋膜触发点痛觉测定值。对于FMS患者的脊柱活动度测量,干针疗法和交叉贴扎疗法的效应量相似。关键词:纤维肌痛;触发点;物理治疗方式;肌肉骨骼平衡;肌筋膜疼痛综合征

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