不同深度干针剂量治疗颈肌筋膜疼痛患者的有效性：一项前瞻性随机对照试验
Effectiveness of Different Deep Dry Needling Dosages in the Treatment of Patients With Cervical Myofascial Pain: A Pilot RCT.
作者信息
Fernández-Carnero Josué, Gilarranz-de-Frutos Laura, León-Hernández Jose Vicente, Pecos-Martin Daniel, Alguacil-Diego Isabel, Gallego-Izquierdo Tomás, Martín-Pintado-Zugasti Aitor
机构信息
From the Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain (JF-C, LG-d-F, IA-D); Research Group on Movement and Behavioural Science and Study of Pain, The Center for Advanced Studies University La Salle, Autónoma University, Madrid, Spain (JF-C, JVL-H); La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain (JF-C); Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, Madrid, Spain (JF-C); Department of Physiotherapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Autónoma University, Madrid, Spain (JVL-H); Department of Nurse and Physical Therapy of Alcalá University, Alcalá de Henares, Spain (DP-M, TG-I); Physiotherapy and Pain Group, Alcalá de Henares, Spain (DP-M, TG-I); and Department of Physical Therapy, Faculty of Medicine, CEU-San Pablo University, Madrid, Spain (AM-P-Z).
出版信息
Am J Phys Med Rehabil. 2017 Oct;96(10):726-733. doi: 10.1097/PHM.0000000000000733.
OBJECTIVE
To assess the effectiveness of different dosages of local twitch responses (LTRs) elicited by deep dry needling (DDN) in relation to pain intensity, pressure pain threshold (PPT), cervical range of movement (CROM), and disability degree in cervical myofascial pain patients.
DESIGN
A randomized, double-blind clinical trial.
PARTICIPANTS
Eighty-four patients (21 males, 63 females; 27.18 ± 10.91 yrs) with cervical pain.
INTERVENTIONS
DDN in active myofascial trigger points (MTrPs) in the upper trapezius. Patients were randomly divided into four groups: (a) no LTRs elicited, (b) four LTRs elicited, (c) six LTRs elicited, and (d) needling until no more LTRs were elicited.
OUTCOME MEASURES
Pain intensity, PPT, CROM, and disability degree were assessed before treatment, post-immediate, 48 hrs, 72 hrs, and 1 wk after treatment.
RESULTS
Significant differences were found in the time factor for all the variables (P < 0.005), but no significant changes were found in the group-time interaction (P > 0.05).
CONCLUSIONS
DDN in the upper trapezius MTrP improved pain at a 1-wk follow-up, but improvements were not significantly different among DDN dosages. A higher number of patients with neck pain improvements superior to the moderate clinically important differences were observed when eliciting 6 LTRs and LTRs until exhaustion compared with not eliciting LTRs.
目的
评估深层干针疗法（DDN）引发的不同剂量局部抽搐反应（LTRs）对颈部肌筋膜疼痛患者疼痛强度、压痛阈（PPT）、颈椎活动范围（CROM）及残疾程度的效果。
设计
一项随机双盲临床试验。
参与者
84例颈部疼痛患者（男性21例，女性63例；年龄27.18±10.91岁）。
干预措施
对上斜方肌的活跃肌筋膜触发点（MTrPs）进行DDN。患者被随机分为四组：（a）未引发LTRs；（b）引发4次LTRs；（c）引发6次LTRs；（d）针刺直至不再引发LTRs。
观察指标
在治疗前、治疗后即刻、治疗后48小时、72小时及1周时评估疼痛强度、PPT、CROM和残疾程度。
结果
所有变量在时间因素上存在显著差异（P<0.005），但组间时间交互作用无显著变化（P>0.05）。
结论
对上斜方肌MTrP进行DDN在1周随访时可改善疼痛，但不同DDN剂量之间的改善无显著差异。与未引发LTRs相比，引发6次LTRs和引发LTRs直至耗竭时，更多颈部疼痛得到改善的患者其改善程度优于中度临床重要差异。
Zotero 插件