Beneficial Effects of Dry Needling for Treatment of Chronic Myofascial Pain Persist for 6 Weeks After Treatment Completion.
Beneficial Effects of Dry Needling for Treatment of Chronic Myofascial Pain Persist for 6 Weeks After Treatment Completion.
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DOI：
10.1016/j.pmrj.2016.06.006
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发表时间：
2017-02
期刊：
影响因子：
--
通讯作者：
Shah JP
中科院分区：
文献类型：
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作者：
Gerber LH;Sikdar S;Aredo JV;Armstrong K;Rosenberger WF;Shao H;Shah JP
干针是一种有效的治疗方法，可以在短期内减少与肌筋膜触发点(AMTrPs)相关的疼痛。这种治疗的益处的持续时间尚未得到充分评估。这项研究试图确定a-MTrp的干针疗法是否在治疗6周后持续有效。大学前瞻性研究的随访：45名颈痛受试者(13名男性)在完成3次糖尿病肾病治疗的3个月后，在上斜方肌出现a-MTrP，并在治疗后6周进行评估。无主要结果：言语类比量表(VAS)、简明疼痛问卷(BPI)和MTrP状态的评分从基线到随访的变化。MTrp分级为：活动期(自发疼痛)、潜伏期(仅受压时疼痛)和未触及的结节。应答者：MTrP状态从活跃变为潜伏或未触及结节(已消失)的患者。疼痛压力阈值(PPT)、情绪状态评分、嗅觉障碍指数(ODI)、SF-36、颈椎活动度。疼痛测量在治疗后6周仍有显著改善(p<；.003)，SF-36身体功能评分(.01)和ODI(p=.002)也是如此。单侧MTrP患者的侧弯和PPT持续改善(p=.002)。持续6周MTrP反应的受试者数量显著(p<；.001)。有反应者和无反应者相比，VAS和BPI的变化有统计学意义(p=0.006，p=0.03)，但PPT没有统计学意义。基线VAS较高的患者对糖尿病肾病无反应的风险较高，VAS较基线下降较大的患者持续有效的可能性较高。VAS在基线水平降低一个单位，成为应答者的几率是无应答者的6.3倍(p=.008)。糖尿病肾病完成后疼痛评分持续下降，VAS下降幅度更大。基线VAS较高的患者对糖尿病肾病的反应较小。对于显著减轻疼痛的早期干预可能与持续的临床反应有关。
Dry needling is an effective treatment for reducing pain associated with active myofascial trigger points (aMTrPs) in the short term. The duration of the benefits of this treatment have not been fully assessed. This study attempts to determine whether the benefits of dry needling (DN) of a-MTrPs are sustained 6 weeks post-treatment. Follow-up of a prospective study University Forty-five subjects (13 males) with cervical pain > 3 months and a-MTrPs in the upper trapezius who completed 3 DN treatments, evaluated 6-weeks post-treatment. None Primary Outcomes: Changes from baseline to follow-up in scores for the verbal analogue scale (VAS), Brief Pain Inventory (BPI), and MTrP status. MTrPs were rated: active (spontaneously painful), latent (painful only on compression) and non-palpable nodule. Responders: patients whose MTrP status changed from active to latent or non-palpable nodule (resolved). Pain pressure threshold (PPT), Profile of Mood States, Oswestry Disability Index (ODI), SF-36, Cervical Range of Motion. Pain measures remained significantly improved 6 weeks post-treatment (p<.003), as did the SF-36 physical functioning score (.01) and ODI (p=.002). Side bending and PPT for subjects with unilateral MTrPs had sustained improvement (p=.002). The number of subjects with sustained MTrP response at 6 weeks was significant (p<.001). Comparing responders to non-responders, change in VAS and BPI were statistically significant (p = .006, p=.03), but PPT was not. Patients with higher baseline VAS have higher risk of not responding to DN, those with a greater drop in VAS from baseline have a higher probability of sustained response. One unit decrease in VAS at baseline results in a 6.3-fold increase in the odds of being a responder versus a non-responder (p = .008). There is sustained reduction of pain scores after completion of DN, which is more likely with a greater drop in VAS. Patients with higher baseline VAS are less likely to respond to DN. Early intervention toward significant pain reduction is likely to be associated with sustained clinical response.