Olesiejuk Maciej, Chalimoniuk Małgorzata, Sacewicz Tomasz
Department of Physical Education and Health in Biala Podlaska, Jozef Pilsudski University of Physical Education in Warsaw, Faculty in Biala Podlaska, 2 Akademicka st., 21-500 Biala, Podlaska, Poland.
BMC Musculoskelet Disord. 2025 Feb 1;26(1):105. doi: 10.1186/s12891-025-08360-1.
This study aimed to evaluate the effects of Ischemic Compression Myofascial Trigger Points (IC-MTrPs) therapy, applied mainly to the upper trapezius muscle (UTM), on: [1] cervical spine range of motion (CS-ROM), and [2] headache characteristics in migraine patients. Reduced CS-ROM can further contribute to musculoskeletal strain and neurological discomfort in migraine sufferers. The application of IC-MTrPs therapy is of particular interest because it targets these trigger points, potentially normalizing muscle tone and improving local blood flow, which may alleviate pain and restore mobility.
A case series employing a repeated-measures design; pilot study.
Fifty-three adult female migraine patients were classified into three groups: episodic migraine without aura (MO, n = 31), episodic migraine with aura (MA, n = 15), and chronic migraine (CM, n = 7). Patients underwent seven sessions of IC-MTrPs therapy targeting the shoulder and neck muscles. Assessments were conducted across five sessions: pre-therapy (baseline), post-1st therapy, post-4th therapy, post-7th therapy, and at a 1-month follow-up. Outcome measures included: CS-ROM (assessed using an accelerometer system), subjective headache pain intensity (evaluated via the Visual Analog Scale (VAS)), and calcitonin gene-related peptide (CGRP) concentrations.
CS-ROM for horizontal rotation and forward flexion improved significantly at the 1-month follow-up compared to pre-therapy (baseline) (P < 0.05). Headache intensity during a migraine attacks, as well as headache frequency and duration, significantly decreased at post-7th therapy compared to baseline across all patients (P < 0.05). The highest CGRP concentrations were recorded in CM patients (240.73 ± 79.51 ng/ml). While no significant changes in CGRP levels were observed in patients with MO, CGRP concentration in patients with MA increased significantly at the 1-month follow-up compared to baseline, rising from 151.70 ± 50.85 ng/ml to 176.17 ± 77.21 ng/ml. In patients with CM, the therapy did not result in statistically significant changes in CGRP levels, although reductions in headache frequency and intensity were noted.
IC-MTrPs therapy proved effective in increasing CS-ROM and alleviating headache characteristics in all migraine subtypes. However, no significant changes in CGRP levels were observed. Distinct characteristics and responses among different migraine subtypes highlight the need for tailored therapeutic approaches.
The study protocol was retrospectively registered on December 2, 2022, as a clinical trial in the international clinical trial database ClinicalTrials.gov (identifier: NCT05646160).
not applicable.
本研究旨在评估主要应用于上斜方肌（UTM）的缺血性按压肌筋膜触发点（IC-MTrP）疗法对以下方面的影响：[1]颈椎活动范围（CS-ROM），以及[2]偏头痛患者的头痛特征。CS-ROM降低会进一步加重偏头痛患者的肌肉骨骼劳损和神经不适。IC-MTrP疗法的应用尤其值得关注，因为它针对这些触发点，有可能使肌张力正常化并改善局部血流，从而减轻疼痛并恢复活动能力。
采用重复测量设计的病例系列；试点研究。
53名成年女性偏头痛患者被分为三组：无先兆发作性偏头痛（MO，n = 31）、有先兆发作性偏头痛（MA，n = 15）和慢性偏头痛（CM，n = 7）。患者接受了针对肩部和颈部肌肉的七次IC-MTrP疗法治疗。在五个疗程中进行评估：治疗前（基线）、第1次治疗后、第4次治疗后、第7次治疗后以及1个月随访时。结果指标包括：CS-ROM（使用加速度计系统评估）、主观头痛疼痛强度（通过视觉模拟量表（VAS）评估）和降钙素基因相关肽（CGRP）浓度。
与治疗前（基线）相比，1个月随访时水平旋转和前屈的CS-ROM有显著改善（P < 0.05）。与基线相比，所有患者在第7次治疗后偏头痛发作期间的头痛强度以及头痛频率和持续时间均显著降低（P < 0.05）。CM患者的CGRP浓度最高（240.73 ± 79.51 ng/ml）。MO患者的CGRP水平未观察到显著变化，而MA患者在1个月随访时的CGRP浓度与基线相比显著增加，从151.70 ± 50.85 ng/ml升至176.17 ± 77.21 ng/ml。在CM患者中，尽管头痛频率和强度有所降低，但治疗并未导致CGRP水平有统计学意义的变化。
IC-MTrP疗法被证明对增加所有偏头痛亚型的CS-ROM和减轻头痛特征有效。然而，未观察到CGRP水平有显著变化。不同偏头痛亚型之间的独特特征和反应凸显了需要采用量身定制的治疗方法。
该研究方案于2022年12月2日在国际临床试验数据库ClinicalTrials.gov中作为一项临床试验进行了回顾性注册（标识符：NCT05646160）。
不适用。
