改善肌筋膜疼痛综合征的特征和诊断质量：与延迟性肌肉酸痛的临床和生物标志物重叠的系统评价。

Improving characterization and diagnosis quality of myofascial pain syndrome: a systematic review of the clinical and biomarker overlap with delayed onset muscle soreness.

机构信息

Technion American Medical School, The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel.

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

出版信息

Eur J Phys Rehabil Med. 2020 Aug;56(4):469-478. doi: 10.23736/S1973-9087.20.05820-7. Epub 2020 Feb 18.

DOI:10.23736/S1973-9087.20.05820-7

PMID:32072791

Abstract

INTRODUCTION

Myofascial pain syndrome (MPS) is one of the most common conditions of chronic musculoskeletal pain, yet its mechanisms are still poorly understood. Delayed Onset Muscle Soreness (DOMS) is also a regional pain syndrome that has clinical similarities to MPS, but has been better investigated. Emerging research suggests that DOMS may be a valid experimental model for studying MPS; however, a comparison of the similarities and differences of these two conditions has previously not been performed. Herein, we aimed to identify the similarities and differences in the clinical features and biomarkers between DOMS and MPS in order to better define MPS and identify future areas of (DOMS-informed) MPS research.

EVIDENCE ACQUISITION

In order to identify similarities and differences in the clinical manifestation and biomarkers of DOMS and MPS, scoping literature searches were performed using Medline (1965-2019), Embase (1966-2019) and Central (1966-2019) databases. Fifty-three full-text articles were reviewed out of the 2836 articles retrieved in the search.

EVIDENCE SYNTHESIS

A scoping review of the literature demonstrated that DOMS and MPS similarly present as conditions of musculoskeletal pain that are associated with decreased strength and limited range of motion. However, while taut bands and discrete tender spots were described in DOMS, none of the studies reviewed have characterized whether these tender points represent the classic myofascial trigger point phenomenon observed in MPS. Certain systemic circulation biomarkers, including inflammatory cytokines and growth factors, were commonly elevated in MPS and DOMS; further research is needed to determine if other biomarkers that are currently characterized in DOMS are useful to enhance the clinical evaluation of MPS.

CONCLUSIONS

DOMS and MPS share clinical and biomarker similarities suggesting that DOMS may be a useful model for studying MPS.

摘要

简介

肌筋膜疼痛综合征（MPS）是慢性肌肉骨骼疼痛最常见的病症之一，但其发病机制仍不清楚。延迟性肌肉酸痛（DOMS）也是一种局部疼痛综合征，与 MPS 具有临床相似性，但研究得更为充分。新兴研究表明，DOMS 可能是研究 MPS 的有效实验模型；然而，此前尚未对这两种病症的相似性和差异性进行比较。在此，我们旨在确定 DOMS 和 MPS 的临床特征和生物标志物之间的相似性和差异性，以便更好地定义 MPS，并确定未来的 MPS 研究领域（基于 DOMS 的研究）。

证据获取

为了确定 DOMS 和 MPS 在临床表现和生物标志物方面的相似性和差异性，我们使用 Medline（1965-2019 年）、Embase（1966-2019 年）和 Central（1966-2019 年）数据库进行了范围广泛的文献检索。从检索到的 2836 篇文章中，有 53 篇全文文章被审查。

证据综合

文献的范围综述表明，DOMS 和 MPS 同样表现为肌肉骨骼疼痛的病症，这些病症与力量下降和运动范围受限有关。然而，虽然在 DOMS 中描述了紧张带和离散的压痛点，但综述中没有任何研究描述这些痛点是否代表在 MPS 中观察到的经典肌筋膜触发点现象。某些全身性循环生物标志物，包括炎症细胞因子和生长因子，在 MPS 和 DOMS 中普遍升高；需要进一步研究以确定 DOMS 中目前所描述的其他生物标志物是否有助于增强 MPS 的临床评估。