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慢性颈痛患者接受干针治疗后斜方肌上束激痛点活动性僵硬的变化:一项随机对照试验。

Changes in stiffness at active myofascial trigger points of the upper trapezius after dry needling in patients with chronic neck pain: a randomized controlled trial.

机构信息

Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Madrid, Spain.

VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Madrid, Spain.

出版信息

Acupunct Med. 2023 Jun;41(3):121-129. doi: 10.1177/09645284221104831. Epub 2022 Jun 28.

Abstract

BACKGROUND/OBJECTIVE: Since, to our knowledge, the effects of dry needling (DN) on active myofascial trigger point (MTrP) stiffness have not been analyzed previously with shear wave elastography (SWE), our aim was to compare the effects of a single session of DN and sham DN applied to the most active MTrP located in the upper trapezius muscle on clinical outcomes.

METHODS

A randomized, double-blinded sham-controlled trial was conducted; 60 patients were randomized into an experimental (DN) or sham (sham DN) group. Baseline data including sociodemographic and clinical characteristics were collected. SWE and pain pressure thresholds (PPTs) at the MTrP and a control point located 3 cm laterally were the main outcomes assessed before and 10 min after the interventions.

RESULTS

Patients receiving DN interventions experienced greater increases in the control point PPTs immediately after receiving the intervention compared with sham DN ( < 0.05), but no differences were found for the MTrP ( > 0.05). Post-intervention PPT improvements were found at both locations for both groups ( < 0.01). No significant changes for either MTrP or control locations were found for SWE outcomes in either group (all s > 0.05). No significant within-group SWE differences were found in the DN or sham DN groups ( > 0.05).

CONCLUSION

A single session of DN or sham DN applied to active MTrPs located in the upper trapezius muscle produced no detectable changes in stiffness at the MTrP or control locations. Real DN induced an immediate analgesic response at both MTrP and control locations, while sham DN induced an immediate MTrP response.

TRIAL REGISTRATION NUMBER

NCT04832074 (ClinicalTrials.gov).

摘要

背景/目的:由于据我们所知,先前尚未使用剪切波弹性成像(SWE)分析干针疗法(DN)对活动肌筋膜触发点(MTrP)硬度的影响,因此我们的目的是比较单次 DN 和假 DN 治疗上斜方肌中最活跃的 MTrP 在临床结果上的差异。

方法

这是一项随机、双盲、假对照试验;将 60 名患者随机分为实验组(DN)或假治疗组(假 DN)。收集基线数据,包括社会人口统计学和临床特征。SWE 和 MTrP 及位于外侧 3cm 处的对照点的疼痛压力阈值(PPT)是主要的评估结果,在干预前和干预后 10 分钟进行评估。

结果

接受 DN 干预的患者在接受干预后即刻在对照点 PPT 增加较大,与假 DN 相比(<0.05),但 MTrP 无差异(>0.05)。两组患者在两个部位的干预后 PPT 均有改善(<0.01)。两组患者 MTrP 或对照部位的 SWE 结果均无显著变化(均 s >0.05)。在 DN 或假 DN 组内,均未发现 MTrP 或对照部位的 SWE 差异有统计学意义(均>0.05)。

结论

单次 DN 或假 DN 治疗上斜方肌中活跃的 MTrP 不会导致 MTrP 或对照部位的硬度发生可检测的变化。真 DN 即刻在 MTrP 和对照部位产生镇痛反应,而假 DN 即刻在 MTrP 产生反应。

试验注册

NCT04832074(ClinicalTrials.gov)。

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