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干针疗法对腰痛患者腰椎肌肉僵硬的影响:一项使用剪切波弹性成像的双盲、随机对照试验。

Effect of dry needling on lumbar muscle stiffness in patients with low back pain: A double blind, randomized controlled trial using shear wave elastography.

机构信息

Physical Therapy Department, Baylor University Doctoral Program in Physical Therapy, Waco, Texas, USA.

Army Medical Center of Excellence, U.S. Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, Texas, USA.

出版信息

J Man Manip Ther. 2022 Jun;30(3):154-164. doi: 10.1080/10669817.2021.1977069. Epub 2021 Sep 16.

Abstract

BACKGROUND

Dry needling treatment focuses on restoring normal muscle function in patients with musculoskeletal pain; however, little research has investigated this assertion. Shear wave elastography (SWE) allows quantification of individual muscle function by estimating both resting and contracted muscle stiffness.

OBJECTIVE

To compare the effects of dry needling to sham dry needling on lumbar muscle stiffness in individuals with low back pain (LBP) using SWE.

METHODS

Sixty participants with LBP were randomly allocated to receive one session of dry needling or sham dry needling treatment to the lumbar multifidus and erector spinae muscles on the most painful side and spinal level. Stiffness (shear modulus) of the lumbar multifidus and erector spinae muscles was assessed using SWE at rest and during submaximal contraction before treatment, immediately after treatment, and 1 week later. Treatment effects were estimated using linear mixed models.

RESULTS

After 1 week, resting erector spinae muscle stiffness was lower in individuals who received dry needling than those that received sham dry needling. All other between-groups differences in muscle stiffness were similar, but non-significant.

CONCLUSION

Dry needling appears to reduce resting erector spinae muscle following treatment of patients with LBP. Therefore, providers should consider the use of dry needling when patients exhibit aberrant stiffness of the lumbar muscles.

摘要

背景

干针治疗侧重于恢复有肌肉骨骼疼痛的患者的正常肌肉功能;然而,很少有研究对此进行调查。剪切波弹性成像(SWE)通过估计静止和收缩肌肉的硬度来定量评估个体肌肉功能。

目的

使用 SWE 比较腰痛(LBP)患者接受干针治疗和假干针治疗对腰椎肌肉僵硬的影响。

方法

60 名 LBP 参与者被随机分配接受一次单侧腰椎多裂肌和竖脊肌的干针或假干针治疗,在治疗前、治疗后即刻和 1 周后,使用 SWE 评估腰椎多裂肌和竖脊肌在休息和次最大收缩时的僵硬(剪切模量)。使用线性混合模型估计治疗效果。

结果

1 周后,接受干针治疗的个体的竖脊肌在休息时的僵硬度低于接受假干针治疗的个体。肌肉僵硬的所有其他组间差异相似,但无统计学意义。

结论

干针治疗似乎可以降低 LBP 患者治疗后竖脊肌的静息僵硬度。因此,当患者表现出腰椎肌肉异常僵硬时,提供者应考虑使用干针治疗。

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