Haueise Andreas, Le Sant Guillaume, Eisele-Metzger Angelika, Dieterich Angela V
Faculty of Health, Security, Society, Furtwangen University, Furtwangen, Germany.
CHU Nantes, Movement-Interactions-Performance, MIP, Nantes Université, Nantes, France.
Clin Physiol Funct Imaging. 2024 May;44(3):187-204. doi: 10.1111/cpf.12870. Epub 2024 Jan 9.
Approximately 21% of the world's population suffers from musculoskeletal conditions, often associated with sensations of stiff muscles. Targeted therapy requires knowing whether typically involved muscles are objectively stiffer compared to asymptomatic individuals. Muscle stiffness is quantified using ultrasound shear wave elastography (SWE). Publications on SWE-based comparisons of muscle stiffness between individuals with and without musculoskeletal pain are increasing rapidly. This work reviewed and mapped the existing evidence regarding objectively measured muscle stiffness in musculoskeletal pain conditions and surveyed current methods of applying SWE to measure muscle stiffness.
A systematic search was conducted in PubMed and CINAHL using the keywords "muscle stiffness", "shear wave elastography", "pain", "asymptomatic controls" and synonyms. The search was supplemented by a hand search using Google Scholar. Included articles were critically appraised with the AXIS tool, supplemented by items related to SWE methods. Results were visually mapped and narratively described.
Thirty of 137 identified articles were included. High-quality evidence was missing. The results comprise studies reporting lower stiffness in symptomatic participants, no differences between groups and higher stiffness in symptomatic individuals. Results differed between pain conditions and muscles, and also between studies that examined the same muscle(s) and pathology. The methods of the application of SWE were inconsistent and the reporting was often incomplete.
Existing evidence regarding the objective stiffness of muscles in musculoskeletal pain conditions is conflicting. Methodological differences may explain most of the inconsistencies between findings. Methodological standards for SWE measurements of muscles are urgently required.
全球约21%的人口患有肌肉骨骼疾病，常伴有肌肉僵硬感。靶向治疗需要了解与无症状个体相比，典型受累肌肉在客观上是否更僵硬。肌肉僵硬程度通过超声剪切波弹性成像（SWE）进行量化。关于基于SWE比较有和没有肌肉骨骼疼痛个体之间肌肉僵硬程度的出版物正在迅速增加。这项工作回顾并梳理了有关肌肉骨骼疼痛状况下客观测量肌肉僵硬程度的现有证据，并调查了当前应用SWE测量肌肉僵硬程度的方法。
在PubMed和CINAHL中使用关键词“肌肉僵硬”“剪切波弹性成像”“疼痛”“无症状对照”及其同义词进行系统检索。通过谷歌学术进行手工检索对搜索进行补充。使用AXIS工具对纳入的文章进行严格评估，并辅以与SWE方法相关的项目。结果以可视化方式绘制并进行叙述性描述。
在137篇已识别的文章中，有30篇被纳入。缺乏高质量证据。结果包括报告有症状参与者僵硬程度较低、两组之间无差异以及有症状个体僵硬程度较高的研究。结果在疼痛状况和肌肉之间存在差异，在研究相同肌肉和病理情况的研究之间也存在差异。SWE的应用方法不一致，报告往往不完整。
关于肌肉骨骼疼痛状况下肌肉客观僵硬程度的现有证据相互矛盾。方法学差异可能解释了研究结果之间的大部分不一致之处。迫切需要肌肉SWE测量的方法学标准。
