From the Department of Rehabilitation Medicine, Guangdong Second Provincial General Hospital, Southern Medical University, Guangzhou, People's Republic of China (SL); Department of Rehabilitation Medicine, Lianjiang People's Hospital, Guangdong, People's Republic of China (ZZ); Department of Rehabilitation, Sun Yat-Sen Memorial Hospital, Guangzhou, People's Republic of China (SL, C. Lin, SK, C. Liu, SW, CM); Department of Ultrasonic, Sun Yat-Sen Memorial Hospital, Guangzhou, People's Republic of China (JR); and Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China (WX).
Am J Phys Med Rehabil. 2019 Aug;98(8):677-684. doi: 10.1097/PHM.0000000000001173.
The aim of the study was to compare the efficacy of radial extracorporeal shock wave therapy and dry needling in the treatment of myofascial trigger points in the upper trapezius muscle.
A total of 65 patients with myofascial trigger points were randomly divided into extracorporeal shock wave therapy group (n = 32) and dry needling group (n = 33). Patients received 3 wks of treatment at 1-wk intervals (in both groups). Visual analog scale, pressure pain threshold, Neck Disability Index, and shear modulus were evaluated before treatment, immediately after the first therapy, 1 mo, and 3 mos after the completion of the third therapy.
Significant improvements of visual analog scale, pressure pain threshold, and Neck Disability Index scores were observed at all time points after treatment (P < 0.01) in both treatment groups. The shear modulus of myofascial trigger points was reduced in both dry needling group (P < 0.05) and extracorporeal shock wave therapy group (P < 0.01) immediately after the first treatment. Significant reductions in shear modulus were maintained up to 3-mo posttreatment in both groups (P < 0.01). There were no significant differences between the radial extracorporeal shock wave therapy group and dry needling group.
The extracorporeal shock wave therapy is as effective as dry needling for relieving pain, improving function, and reducing shear modulus for patients with myofascial trigger points after a series of three treatments.
本研究旨在比较体外冲击波疗法和干针治疗斜方肌上肌肌筋膜触发点的疗效。
共有 65 名肌筋膜触发点患者被随机分为体外冲击波治疗组（n = 32）和干针治疗组（n = 33）。两组患者均在 1 周间隔接受 3 周治疗（每组）。在治疗前、首次治疗后即刻、1 个月和 3 个月治疗结束后，评估视觉模拟评分、压痛阈值、颈部残疾指数和剪切模量。
两组治疗后所有时间点的视觉模拟评分、压痛阈值和颈部残疾指数评分均显著改善（P < 0.01）。干针组（P < 0.05）和体外冲击波治疗组（P < 0.01）在首次治疗后肌筋膜触发点的剪切模量均降低。两组的剪切模量均持续降低至治疗后 3 个月（P < 0.01）。体外冲击波治疗组和干针组之间无显著差异。
经过一系列 3 次治疗后，体外冲击波治疗在缓解疼痛、改善功能和降低肌筋膜触发点的剪切模量方面与干针治疗同样有效。
