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肌筋膜触发点敏感性评估中痛觉计应用速率与疼痛压力阈值之间的关系

The Relationship between Rate of Algometer Application and Pain Pressure Threshold in the Assessment of Myofascial Trigger Point Sensitivity.

作者信息

Linde Lukas D, Kumbhare Dinesh A, Joshi Maneil, Srbely John Z

机构信息

Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada.

Department of Medicine, Division of Physical Medicine and Rehabilitation, Toronto Rehabilitation Institute, University of Toronto, Toronto, Ontario, Canada.

出版信息

Pain Pract. 2018 Feb;18(2):224-229. doi: 10.1111/papr.12597. Epub 2017 Jun 14.

Abstract

BACKGROUND

Pressure algometry is a commonly employed technique in the assessment of both regional and widespread musculoskeletal pain. Despite its acceptance amongst clinicians and scientists, the relationship between rate of pressure application (RoA) and pain pressure threshold (PPT) remains poorly understood. We set out to test the hypothesis that a strong, positive, linear relationship exists between the RoA and the PPT within the infraspinatus of young healthy subjects.

METHODS

Thirty-three participants were randomly recruited from the local university community. PPT measures were recorded from a clinically identified myofascial trigger point within the right infraspinatus muscle during pressure algometry. A total of 2 PPT measures were recorded using each of 3 different RoAs, including low (15 N/s), medium (35 N/s), and high (55 N/s). Three baseline trials were also conducted at 30 N/s. The Pearson's correlation coefficient between RoA and PPT was calculated for each subject and averaged across participants.

RESULTS

The mean(SD) correlation between subjects was 0.77 (0.19), and the mean (SD) slope of the linear regression was 0.13 (0.09).

CONCLUSION

Our results demonstrate that there is a strong, linear relationship between the RoA and PPT when using the pressure algometry technique. The low slope between RoA and PPT suggests clinicians can rely on PPT assessments despite small RoA fluctuations. Future research should explore this relationship further in a clinical population and in other muscles affected by chronic myofascial pain. Advancing cost-effective, reliable, and clinically feasible tools such as algometry is important to enhancing the diagnosis and management of chronic myofascial pain.

摘要

背景

压力痛觉测定法是评估局部和广泛性肌肉骨骼疼痛时常用的技术。尽管它在临床医生和科学家中已被接受,但压力施加速率(RoA)与疼痛压力阈值(PPT)之间的关系仍知之甚少。我们着手检验这一假设:在年轻健康受试者的冈下肌中,RoA与PPT之间存在强的、正的线性关系。

方法

从当地大学社区随机招募33名参与者。在压力痛觉测定期间,从临床确定的右侧冈下肌肌筋膜触发点记录PPT测量值。使用3种不同的RoA(包括低速率15N/s、中速率35N/s和高速率55N/s)分别记录2次PPT测量值。还以30N/s进行了3次基线试验。计算每个受试者RoA与PPT之间的Pearson相关系数,并在参与者之间求平均值。

结果

受试者之间的平均(标准差)相关性为0.77(0.19),线性回归的平均(标准差)斜率为0.13(0.09)。

结论

我们的结果表明,使用压力痛觉测定技术时,RoA与PPT之间存在强线性关系。RoA与PPT之间的低斜率表明,尽管RoA存在小的波动,临床医生仍可依赖PPT评估。未来的研究应在临床人群和受慢性肌筋膜疼痛影响的其他肌肉中进一步探索这种关系。推广诸如痛觉测定法这样具有成本效益、可靠且临床可行的工具对于加强慢性肌筋膜疼痛的诊断和管理很重要。

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