Dry Needling Alters Trigger Points in the Upper Trapezius Muscle and Reduces Pain in Subjects With Chronic Myofascial Pain.
Dry Needling Alters Trigger Points in the Upper Trapezius Muscle and Reduces Pain in Subjects With Chronic Myofascial Pain.
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DOI：
10.1016/j.pmrj.2015.01.020
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发表时间：
2015-07
期刊：
影响因子：
--
通讯作者：
Sikdar S
中科院分区：
文献类型：
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作者：
Gerber LH;Shah J;Rosenberger W;Armstrong K;Turo D;Otto P;Heimur J;Thaker N;Sikdar S
确定干刺活动肌筋膜触发点（MTrP）是否可减轻疼痛并将触发点的状态改变为非自发性压痛结节或其消退。一项前瞻性、非随机、对照干预性临床研究大学校园五十六例颈部或肩带疼痛持续时间> 3个月且有活动性肌张力的受试者从校园范围内的志愿者样本中招募。52例患者完成了研究（23例男性/33例女性），平均年龄为35.8岁。单一活性MTRP的每周三次干针治疗主要结局：使用口头模拟量表、简明疼痛量表和通过手指触诊确定的MTRP状态对疼痛进行基线和治疗后评价。触发点评级：活动性（自发性疼痛）、潜伏性（需要触诊以重现特征性疼痛）和消退（未触及结节）。次要结局：情绪状态概况、奥斯韦斯特里残疾指数、简明量表36、颈椎活动度。主要结局：41例受试者的触发点状态从活动性变为潜伏性或消退; 11例无变化（p <0.001）。所有疼痛评分均显著降低（p<0.001）。次要结局：单侧/双侧MTrP受试者治疗后颈椎旋转不对称性显著改善（分别为p= 0.001，p=21）;单侧/双侧MTrP受试者的疼痛压力阈值，（p=.006，p=.012）; SF-36心理健康和身体功能子量表的改善（p= 0.019，p= 0.03）;奥斯韦斯特里残疾量表下降（p= 0.003）。干针可减轻疼痛并改变MTRP状态。触发点状态的变化与疼痛的统计学和临床显著性减轻相关。疼痛的减轻与情绪、功能和残疾程度的改善有关。
To determine whether dry needling of an active myofascial trigger point (MTrP) reduces pain and alters the status of the trigger point to either a non-spontaneously tender nodule or its resolution. A prospective, non-randomized, controlled interventional clinical study University campus Fifty-six subjects with neck or shoulder girdle pain > 3 months duration and active MTrPs were recruited from a campus-wide, volunteer sample. Fifty-two completed the study (23 male/33 female) with mean age of 35.8 years. Three weekly dry needling treatments of a single active MTrP Primary Outcomes: Baseline and post treatment evaluations of pain using the verbal analogue scale, the Brief Pain Inventory and the status of the MTrP as determined by digital palpation. Trigger points were rated: active (spontaneously painful), latent (requiring palpation to reproduce the characteristic pain) and resolved (no palpable nodule). Secondary Outcomes: Profile of Mood States, Oswestry Disability Index, Short Form 36, Cervical Range of Motion. Primary outcomes: 41 subjects had a change in trigger point status from active to latent or resolved; and 11 had no change (p < .001). Reduction in all pain scores was significant (p<.001). Secondary outcomes: significant improvement in post-treatment cervical rotational asymmetry in subjects with unilateral/bilateral MTrPs (p=.001, p=21, respectively); in pain pressure threshold in subjects with unilateral/bilateral MTrPs, (p=.006, p=.012), respectively; improvement in the SF-36 mental health and physical functioning subscales (p=.019, p=.03) respectively; decrease in the Oswestry disability scale (p=.003). Dry needling reduces pain and changes MTrP status. Change in trigger point status is associated with a statistically and clinically significant reduction in pain. Reduction in pain is associated with improved mood, function and level of disability.