头部前倾姿势患者慢性颈肩肌筋膜疼痛的非药物治疗

Iaroshevskyi Oleksandr A, Morozova Olga G, Logvinenko Anna V, Lypynska Yana V

Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine.

Wiad Lek. 2019;72(1):84-88.

OBJECTIVE

Introduction: Today, chronic pain remains a pressing medical and socio-economic problem, despite the rapid development of medical technologies, the presence of a vast arsenal of drug and non-drug treatments. Estimates for chronic pain prevalence ranged from 8% to 60%. At the same time, about 40% of patients report insufficient effectiveness in the treatment of chronic pain syndrome. The aim of the study was to compare the effectiveness of MTrPS management by biomechanical correction of the musculoskeletal system combined with therapeutic exercises, DN and TrPs-pressure release with the effectiveness of MTrPS management by therapeutic exercises combined with DN and TrPs-pressure release in patients with chronic neck-shoulder myofascial pain and FHP.

PATIENTS AND METHODS

Materials and methods: 87 patients (mean age - 39±4,9 years) with chronic neck-shoulder myofascial pain and FHP were randomly assigned to 2 treatment groups. Group 1 received a biomechanical correction, DN, TrPs-pressure release. Group 2 - therapeutic exercises, DN, TrPs-pressure release. Study protocol included CVA-measurement, assessment of pain intensity with VAS, assessment of QoL using MOS SF-36.

RESULTS

Results: increase of CVA (59,07°±1,41 in the 1st group, and 51,2°±2,01 in the 2nd group (p=0,036)), decrease of pain and decrease of influence of neck pain in performance of everyday activities, the improvement of QoL immediately after treatment occurred in both groups. However, after 3 months of therapy, 1-st group revealed more improvement than the 2-nd.

CONCLUSION

Conclusion: Comparison of the effectiveness of MTrPS management by biomechanical correction of the musculoskeletal system combined with therapeutic exercises, DN and TrPs-pressure release with the effectiveness of MTrPS management by therapeutic exercises combined with DN and TrPs-pressure release in patients with chronic neck-shoulder myofascial pain and FHP demonstrated no significant differences between the therapeutic approaches in the short term. In the medium term, the inclusion of biomechanical correction in the treatment protocol demonstrated higher efficiency compared with the combination of therapeutic exercises, DN and TrPs-pressure release.

目的

引言：如今，尽管医疗技术飞速发展，且有大量药物和非药物治疗手段，但慢性疼痛仍是一个紧迫的医学和社会经济问题。慢性疼痛患病率估计在8%至60%之间。与此同时，约40%的患者报告慢性疼痛综合征治疗效果不佳。本研究的目的是比较在慢性颈肩肌筋膜疼痛和功能性头痛患者中，通过肌肉骨骼系统生物力学矫正联合治疗性锻炼、干针疗法和激痛点按压释放来管理肌筋膜激痛点的效果，与通过治疗性锻炼联合干针疗法和激痛点按压释放来管理肌筋膜激痛点的效果。

患者与方法

材料与方法：87例慢性颈肩肌筋膜疼痛和功能性头痛患者（平均年龄 - 39±4.9岁）被随机分为2个治疗组。第1组接受生物力学矫正、干针疗法、激痛点按压释放。第2组接受治疗性锻炼、干针疗法、激痛点按压释放。研究方案包括颈椎活动度测量、使用视觉模拟评分法评估疼痛强度、使用MOS SF - 36评估生活质量。

结果

结果：颈椎活动度增加（第1组为59.07°±1.41，第2组为51.2°±2.01（p = 0.036）），疼痛减轻，颈部疼痛对日常活动的影响降低，两组治疗后生活质量均立即得到改善。然而，治疗3个月后，第1组的改善程度比第2组更大。

结论

结论：在慢性颈肩肌筋膜疼痛和功能性头痛患者中，比较通过肌肉骨骼系统生物力学矫正联合治疗性锻炼、干针疗法和激痛点按压释放来管理肌筋膜激痛点的效果，与通过治疗性锻炼联合干针疗法和激痛点按压释放来管理肌筋膜激痛点的效果，结果表明短期内两种治疗方法之间无显著差异。从中期来看，在治疗方案中加入生物力学矫正与治疗性锻炼、干针疗法和激痛点按压释放相结合相比，显示出更高的疗效。