触发点干针治疗可增加颞下颌关节紊乱病患者的咬肌氧合。
Trigger point dry needling increases masseter muscle oxygenation in patients with temporomandibular disorder.
机构信息
Universidade Federal de Santa Catarina, Centro de Ciências Biológicas, Departamento de Ciências Fisiológicas, Programa de Pós-Graduação em Neurociências Florianópolis, Laboratório de Neurobiologia da Dor e Inflamação, Santa Catarina, Brasil.
Universidade do Estado de Santa Catarina (UDESC), Programa de Pós-Graduação em Fisioterapia, Florianópolis, Laboratório de Desenvolvimento e Controle Postural (LADESCOP), Santa Catarina, Brasil.
出版信息
J Appl Oral Sci. 2023 Aug 25;31:e20230099. doi: 10.1590/1678-7757-2023-0099. eCollection 2023.
BACKGROUND
Temporomandibular disorder (TMD) is an umbrella term encompassing various clinical complaints involving the temporomandibular joints, masticatory muscles, and/or associated orofacial structures. Myogenous TMDs are the most frequent cause of chronic orofacial pain. Musculoskeletal pain is commonly associated with myofascial trigger points (MTPs), for which dry needling (DN) is a routine treatment.
OBJECTIVE
To investigate muscle oxygenation and pain immediately after DN application on an MTP in the masseter muscle of patients with myogenous TMDs.
METHODOLOGY
Masseter muscle oxygen tissue saturation indices (TSI%) were assessed by near-infrared spectroscopy (NIRS) pre- and post-interventions by a randomized, controlled, double-blind, crossover DN/Sham clinical trial (primary outcome). Pain was investigated by the visual analog scale (VAS). In total, 32 individuals aged from 18 to 37 years who were diagnosed with myogenous TMD and myofascial trigger points in their masseter muscles participated in this study. Relative deltas for the studied variables were calculated. Data normality was tested using the Shapiro-Wilk test. According to their distribution, data were analyzed by two-way ANOVA and the Student's t-, and Mann-Whitney tests. Statistical analyses were performed using Prism® 5.0 (GraphPad, USA).
RESULTS
We found a significant difference (2,108% vs. 0,142%) between masseter muscle TSI% deltas after the DN and Sham interventions, respectively (n=24). We only evaluated women since men refused to follow NIRS procedures. Pain increased immediately after DN (n=32, 8 men), in comparison to Sham delta VAS.
CONCLUSION
These findings show an increase in tissue oxygen saturation in the evaluated sample immediately after the DN intervention on the MTP of patients' masseter muscle. Pain may have increased immediately after DN due to the needling procedure.
背景
颞下颌关节紊乱(TMD)是一个涵盖涉及颞下颌关节、咀嚼肌和/或相关的口颌面部结构的各种临床症状的总称。肌源性 TMD 是慢性口颌面部疼痛最常见的原因。肌肉骨骼疼痛通常与肌筋膜触发点(MTP)相关,对此,干针疗法(DN)是一种常规治疗方法。
目的
研究肌源性 TMD 患者的咬肌 MTP 接受 DN 治疗后即刻的肌肉氧合和疼痛情况。
方法
通过一项随机、对照、双盲、交叉 DN/假对照临床试验(主要结局),使用近红外光谱(NIRS)在干预前和干预后评估咬肌的肌肉氧组织饱和度指数(TSI%)。使用视觉模拟量表(VAS)评估疼痛。共有 32 名年龄在 18 至 37 岁之间、被诊断为肌源性 TMD 和咬肌肌筋膜触发点的个体参与了这项研究。计算了研究变量的相对差值。使用 Shapiro-Wilk 检验测试数据正态性。根据其分布,使用双因素方差分析和学生 t-检验和曼-惠特尼检验分析数据。统计分析使用 Prism® 5.0(GraphPad,美国)进行。
结果
我们发现 DN 和 Sham 干预后,咬肌 TSI%差值分别为 2,108% 和 0,142%,存在显著差异(n=24)。由于男性拒绝进行 NIRS 检查,我们仅评估了女性。与 Sham 组相比,DN 组(n=32,8 名男性)疼痛立即增加。
结论
这些发现表明,在评估的样本中,DN 干预肌筋膜触发点后,肌肉组织氧饱和度立即增加。由于针刺过程,DN 后疼痛可能立即增加。