仪器辅助软组织松动术联合体外冲击波疗法治疗肌筋膜疼痛综合征
Instrumented assisted soft tissue mobilization extracorporeal shock wave therapy in treatment of myofascial pain syndrome.
作者信息
Shamseldeen Nourhan Elsayed, Hegazy Mohammed Moustafa Aldosouki, Fayaz Nadia Abdalazeem, Mahmoud Nesreen Fawzy
机构信息
Department of Physical Therapy for Musculoskeletal Disorders & Its Surgery, Faculty of Physical Therapy, Cairo University, Cairo 14531, Egypt.
出版信息
World J Orthop. 2023 Jul 18;14(7):572-581. doi: 10.5312/wjo.v14.i7.572.
BACKGROUND
Active myofascial trigger points (TrPs) often occur in the upper region of the upper trapezius (UT) muscle. These TrPs can be a significant source of neck, shoulder, and upper back pain and headaches. These TrPs and their related pain and disability can adversely affect an individual's everyday routine functioning, work-related productivity, and general quality of life.
AIM
To investigate the effects of instrument assisted soft tissue mobilization (IASTM) extracorporeal shock wave therapy (ESWT) on the TrPs of the UT muscle.
METHODS
A randomized, single-blind, comparative clinical study was conducted at the Medical Center of the Egyptian Railway Station in Cairo. Forty patients (28 females and 12 males), aged between 20-years-old and 40-years-old, with active myofascial TrPs in the UT muscle were randomly assigned to two equal groups (A and B). Group A received IASTM, while group B received ESWT. Each group was treated twice weekly for 2 weeks. Both groups received muscle energy technique for the UT muscle. Patients were evaluated twice (pre- and post-treatment) for pain intensity using the visual analogue scale and for pain pressure threshold (PPT) using a pressure algometer.
RESULTS
Comparing the pre- and post-treatment mean values for all variables for group A, there were significant differences in pain intensity for TrP1 and TrP2 ( = 0.0001) and PPT for TrP1 ( = 0.0002) and TrP2 ( = 0.0001). Also, for group B, there were significant differences between the pre- and post-treatment pain intensity for TrP1 and TrP2 and PPT for TrP1 and TrP2 ( = 0.0001). There were no significant differences between the two groups in the post-treatment mean values of pain intensity for TrP1 ( = 0.9) and TrP2 ( = 0.76) and PPT for TrP1 ( = 0.09) and for TrP2 ( = 0.91).
CONCLUSION
IASTM and ESWT are effective methods for improving pain and PPT in patients with UT muscle TrPs. There is no significant difference between either treatment method.
背景
活跃肌筋膜触发点（TrP）常出现在上斜方肌（UT）上部区域。这些触发点可能是颈部、肩部、上背部疼痛及头痛的重要根源。这些触发点及其相关疼痛和功能障碍会对个体的日常功能、工作效率及总体生活质量产生不利影响。
目的
探讨器械辅助软组织松动术（IASTM）和体外冲击波疗法（ESWT）对上斜方肌触发点的影响。
方法
在开罗埃及火车站医疗中心进行了一项随机、单盲、对照临床研究。40例年龄在20至40岁之间、上斜方肌存在活跃肌筋膜触发点的患者（28例女性和12例男性）被随机分为两组（A组和B组），每组人数相等。A组接受器械辅助软组织松动术，而B组接受体外冲击波疗法。每组每周治疗两次，共治疗2周。两组均接受针对上斜方肌的肌肉能量技术治疗。使用视觉模拟量表对患者疼痛强度进行治疗前和治疗后两次评估，使用压力痛觉计对疼痛压力阈值（PPT）进行评估。
结果
比较A组所有变量的治疗前和治疗后平均值，TrP1和TrP2的疼痛强度（P = 0.0001）以及TrP1的PPT（P = 0.0002）和TrP2的PPT（P = 0.0001）存在显著差异。此外，对于B组，TrP1和TrP2的治疗前和治疗后疼痛强度以及TrP1和TrP2的PPT之间也存在显著差异（P = 0.0001）。两组在治疗后TrP1的疼痛强度平均值（P = 0.9）和TrP2的疼痛强度平均值（P = 0.76）以及TrP1的PPT（P = 0.09）和TrP2的PPT（P = 0.91）方面没有显著差异。
结论
器械辅助软组织松动术和体外冲击波疗法是改善上斜方肌触发点患者疼痛和疼痛压力阈值的有效方法。两种治疗方法之间没有显著差异。
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