Poveda-Pagán Emilio J, Lozano-Quijada Carlos, Segura-Heras Jose V, Peral-Berna María, Lumbreras Blanca
1 Physiotherapy Area, Pathology and Surgery Department, Centro de Investigación Traslacional en Fisioterapia, Miguel Hernandez University of Elche (UMH) , Alicante, Spain .
2 Centro de Investigación Operativa, Miguel Hernandez University of Elche (UMH) , Alicante, Spain .
J Altern Complement Med. 2017 Nov;23(11):890-896. doi: 10.1089/acm.2016.0306. Epub 2017 Mar 7.
To identify the most common referred pain (ReP) pattern of the infraspinatus myofascial trigger point (MTrP) and compare its coincidence with the original ReP pattern, to verify whether there are any significant differences by sex and types of technique and to determine the observed signs and symptoms evoked by deep dry needling (DDN) and manual palpation (MPal).
A cohort study of patients randomized to two different examination methods (July and August 2016).
Students and staff recruited from Miguel Hernandez University (Southeast Spain).
One hundred thirty-three participants (70.7% women) with shoulder complaints were randomly assigned to either an MPal (n = 67) or DDN group (n = 66).
The same physiotherapist carried out the techniques on all participants, and the same protocol was followed for both the DDN and MPal groups. The physiotherapist did not ask participants about their pain features or other relevant issues.
Local twitch response (LTR) and ReP assessed through a visual analogue scale and features of ReP of the infraspinatus muscle.
The areas with the highest percentage of ReP were the front (area 3; 27.1%) and back (area 11; 21.1%) of the arm, anterior (area 4; 36.1%) and posterior (area 12; 42.1%) shoulder, and infraspinatus muscle area. DDN proved to be significantly easier than MPal in evoking an LTR (p ≤ 0.001). There were significant differences between sexes in zone 2 (p = 0.041) and no statistically significant differences were found by technique.
The ReP pattern of the infraspinatus muscle coincides with the original pattern described by Travell and Simons, although the neck area should be questioned. The study found no significant differences in the ReP pattern by sex and when comparing MPal with DDN of MTrP of the infraspinatus muscle. DDN proved to be significantly easier than MPal in evoking an LTR.
确定冈下肌肌筋膜触发点（MTrP）最常见的牵涉痛（ReP）模式，并将其与原始的ReP模式进行比较，验证性别和技术类型是否存在显著差异，以及确定深部干针疗法（DDN）和手法触诊（MPal）所引发的观察到的体征和症状。
一项针对随机分为两种不同检查方法的患者的队列研究（2016年7月和8月）。
从米格尔·埃尔南德斯大学（西班牙东南部）招募的学生和工作人员。
133名有肩部不适的参与者（70.7%为女性）被随机分配到MPal组（n = 67）或DDN组（n = 66）。
同一名物理治疗师对所有参与者进行操作，DDN组和MPal组遵循相同的方案。物理治疗师未询问参与者的疼痛特征或其他相关问题。
通过视觉模拟量表评估局部抽搐反应（LTR）和ReP，以及冈下肌ReP的特征。
ReP百分比最高的区域是手臂前部（区域3；27.1%）和后部（区域11；21.1%）、肩部前部（区域4；36.1%）和后部（区域12；42.1%）以及冈下肌区域。事实证明，DDN在引发LTR方面比MPal明显更容易（p≤0.001）。在区域2中，性别之间存在显著差异（p = 0.041），按技术分类未发现统计学上的显著差异。
冈下肌的ReP模式与Travell和Simons描述的原始模式相符，尽管颈部区域值得怀疑。该研究发现，在性别方面以及比较MPal与冈下肌MTrP的DDN时，ReP模式没有显著差异。事实证明，DDN在引发LTR方面比MPal明显更容易。
