Xia Chunfeng, Zhao Yanjun, Lin Lizhen, Yu Yanni, Wang Jialiang, Fan Jiecheng, Yuan Xiangzhen, Zhang Shuyun
Department of Rehabilitation Medicine, Weifang People's Hospital, Weifang, Shandong, China.
Department of Ultrasound, Weifang People's Hospital, Weifang, Shandong, China.
Turk J Phys Med Rehabil. 2024 Oct 31;71(1):56-65. doi: 10.5606/tftrd.2024.13994. eCollection 2025 Mar.
This study aims to investigate the effect of extracorporeal shock wave therapy (ESWT) and manual therapy (MT) on active trigger points of the sternocleidomastoid muscle (SCM) in patients with cervicogenic headache (CEH).
A total of 42 patients were included (27 females, 15 males; mean age: 33.2±7.7 years; range, 18 to 45 years) in the randomized controlled trial between March 2022 and December 2022. The patients were randomly divided into the ESWT group (n=21) and the MT group (n=21). Each group received therapy once a week for four weeks. The primary outcome measure was the Visual Analog Scale (VAS), and secondary outcome measures were pressure pain threshold (PPT), Neck Disability Index (NDI), and stiffness (shear elastic modulus) of the SCM measured at baseline, postintervention, and four weeks after treatment.
One patient from the ESWT group was lost to follow-up. The missing data were imputed for intention-to-treat analysis. Significant decreases of VAS, NDI, and shear elastic modulus of SCM were found at postintervention and four weeks after treatment in both groups (p<0.01). The PPT scores markedly increased over time compared to baseline in both groups (p<0.01). The repeated measures of analysis of variance revealed a significant time effect (p<0.001) in each outcome variable for both groups. There were no significant differences between the two groups in VAS, PPT, NDI, and the stiffness of SCM at each time point.
Extracorporeal shock wave therapy and MT were equally effective in pain relief, functional recovery, and reduction of muscle stiffness. Extracorporeal shock wave therapy may be used as an alternative treatment method for CEH patients with active myofascial trigger points of the SCM.
本研究旨在探讨体外冲击波疗法（ESWT）和手法治疗（MT）对颈源性头痛（CEH）患者胸锁乳突肌（SCM）活性触发点的影响。
2022年3月至2022年12月期间，共有42例患者纳入随机对照试验（27例女性，15例男性；平均年龄：33.2±7.7岁；范围18至45岁）。患者被随机分为ESWT组（n = 21）和MT组（n = 21）。每组每周接受一次治疗，共四周。主要结局指标为视觉模拟量表（VAS），次要结局指标为压力疼痛阈值（PPT）、颈部功能障碍指数（NDI）以及在基线、干预后和治疗后四周测量的SCM的僵硬度（剪切弹性模量）。
ESWT组有1例患者失访。对缺失数据进行意向性分析插补。两组在干预后和治疗后四周时，VAS、NDI和SCM的剪切弹性模量均显著降低（p<0.01）。与基线相比，两组的PPT评分随时间均显著增加（p<0.01）。重复测量方差分析显示，两组各结局变量均有显著的时间效应（p<0.001）。两组在各时间点的VAS、PPT、NDI和SCM僵硬度方面均无显著差异。
体外冲击波疗法和手法治疗在缓解疼痛、功能恢复和降低肌肉僵硬度方面同样有效。体外冲击波疗法可作为患有SCM活性肌筋膜触发点的CEH患者的替代治疗方法。
