본문 바로가기
KERD
논문KCI 등재

Combined Effects of Extracorporeal Shockwave Therapy and Integrated Neuromuscular Inhibition on Myofascial Trigger Points of Upper Trapezius: A Randomized Controlled Trial

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

주제분류재활의학

초록

Objective To investigate the combined effect of extracorporeal shockwave therapy (ESWT) and integrated neuromuscular inhibition (INI) on myofascial trigger points in the upper trapezius. Methods Sixty subjects aged 18–24 years old with active myofascial trigger points in the upper trapezius were studied. Participants were assigned randomly to either group A who received ESWT one session/week, group B who received INI three sessions/week, or group C who received ESWT in addition to INI. All groups completed 4 weeks of intervention. The following main outcome measures were evaluated at baseline and after 4 weeks of intervention: pain intensity, functional disability, pressure pain threshold (PPT), sympathetic skin response (SSR), and neuromuscular junction response (NMJR). Results Within-group analysis revealed a significant decline in visual analog scale (VAS), Arabic neck disability index (ANDI), and NMJR and incline in PPT and SSR latency post-intervention (p<0.001). Multiple comparison analysis showed a substantial difference between the groups, while the major changes favored group C (p<0.05). Conclusion Combined treatment with ESWT and INI for treating myofascial trigger points in the upper trapezius is more effective than using only one of the two approaches in terms of clinical, functional, and neurophysiological aspects.

Abstract

Objective To investigate the combined effect of extracorporeal shockwave therapy (ESWT) and integrated neuromuscular inhibition (INI) on myofascial trigger points in the upper trapezius. Methods Sixty subjects aged 18–24 years old with active myofascial trigger points in the upper trapezius were studied. Participants were assigned randomly to either group A who received ESWT one session/week, group B who received INI three sessions/week, or group C who received ESWT in addition to INI. All groups completed 4 weeks of intervention. The following main outcome measures were evaluated at baseline and after 4 weeks of intervention: pain intensity, functional disability, pressure pain threshold (PPT), sympathetic skin response (SSR), and neuromuscular junction response (NMJR). Results Within-group analysis revealed a significant decline in visual analog scale (VAS), Arabic neck disability index (ANDI), and NMJR and incline in PPT and SSR latency post-intervention (p<0.001). Multiple comparison analysis showed a substantial difference between the groups, while the major changes favored group C (p<0.05). Conclusion Combined treatment with ESWT and INI for treating myofascial trigger points in the upper trapezius is more effective than using only one of the two approaches in terms of clinical, functional, and neurophysiological aspects.

참고문헌 (44)

  1. Klein R, "Straincounterstrain to treat restrictions of the mobility of the cervical spine in patients with neck pain : a shamcontrolled randomized trial", Complement Ther Med, 21, pp.1~7 (2013)
  2. Rachlin ES, "Myofascial pain and fibromyalgia:trigger point management" (2002), Mosby
  3. Martin-Herrero C, "Myofascial trigger points, pain, disability and quality of sleep in patients with chronic tensiontype headache: a pilot study", Rev Neurol, 55, pp.193~199 (2012)
  4. Nagrale AV, "The efficacy of an integrated neuromuscular inhibition technique on upper trapezius trigger points in subjects with non-specific neck pain : a randomized controlled trial", J Man Manip Ther, 18, pp.37~43 (2010)
  5. Abbaszadeh-Amirdehi M, "Neurophysiological and clinical effects of dry needling in patients with upper trapezius myofascial trigger points", J Bodyw Mov Ther, 21, pp.48~52 (2017)
  6. Unalan H, "Comparison of high-power pain threshold ultrasound therapy with local injection in the treatment of active myofascial trigger points of the upper trapezius muscle", Arch Phys Med Rehabil, 92, pp.657~662 (2011)
  7. Simons DG, "Review of enigmatic MTrPs as a common cause of enigmatic musculoskeletal pain and dysfunction", J Electromyogr Kinesiol, 14, pp.95~107 (2004)
  8. Hong CZ, "Pathophysiologic and electrophysiologic mechanisms of myofascial trigger points", Arch Phys Med Rehabil, 79, pp.863~872 (1998)
  9. Simons DG, "Endplate potentials are common to midfiber myofacial trigger points", Am J Phys Med Rehabil, 81, pp.212~222 (2002)
  10. Vernon H, "Chiropractic management of myofascial trigger points and myofascial pain syndrome : a systematic review of the literature", J Manipulative Physiol Ther, 32, pp.14~24 (2009)
  11. Sarrafzadeh J, "The effects of pressure release, phonophoresis of hydrocortisone, and ultrasound on upper trapezius latent myofascial trigger point", Arch Phys Med Rehabil, 93, pp.72~77 (2012)
  12. Cagnie B, "Physiologic effects of dry needling", Curr Pain Headache Rep, 17, pp.348~ (2013)
  13. Cagnie B, "Evidence for the use of ischemic compression and dry needling in the management of trigger points of the upper trapezius in patients with neck pain : a systematic review", Am J Phys Med Rehabil, 94, pp.573~583 (2015)
  14. Hong CZ, "Immediate effects of various physical medicine modalities on pain threshold of an active myofascial trigger point", J Musculoskelet Pain, 1, pp.37~53 (1993)
  15. Kietrys DM, "Effectiveness of dry needling for upper-quarter myofascial pain : a systematic review and meta-analysis", J Orthop Sports Phys Ther, 43, pp.620~634 (2013)
  16. Pecos-Martin D, "Effectiveness of dry needling on the lower trapezius in patients with mechanical neck pain : a randomized controlled trial", Arch Phys Med Rehabil, 96, pp.775~781 (2015)
  17. Kim DH, "The effects of myofascial trigger point injections on nocturnal calf cramps", J Am Board Fam Med, 28, pp.21~27 (2015)
  18. Ogden JA, "Shock wave therapy(Orthotripsy)in musculoskeletal disorders", Clin Orthop Relat Res, (387), pp.22~40 (2001)
  19. Gur A, "Comparison of the effectiveness of two different extracorporeal shock wave therapy regimens in the treatment of patients with myofascial pain syndrome", Turk J Rheumatol, 29, pp.186~193 (2014)
  20. Berta L, "Extracorporeal shock waves enhance normal fibroblast proliferation in vitro and activate mRNA expression for TGF-beta1 and for collagen types I and III", Acta Orthop, 80, pp.612~617 (2009)
  21. Ochiai N, "Extracorporeal shock wave therapy improves motor dysfunction and pain originating from knee osteoarthritis in rats", Osteoarthritis Cartilage, 15, pp.1093~1096 (2007)
  22. Sibby GM, "Effectiveness of integrated neuromuscular inhibitory technique and LASER with stretching in the treatment of upper trapezius trigger points", J Exerc Sci Physiother, 5, pp.115~121 (2009)
  23. Chaitow L, "Modern neuromuscular techniques" (1996), Churchill Livingstone
  24. Fleckenstein J, "Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: results of a cross-sectional, nationwide survey", BMC Musculoskelet Disord, 11, pp.32~ (2010)
  25. Gilani MH, "Comparison between effectiveness of ischemic compression and muscle energy technique in upper trapezius myofascial trigger points", ISRA Med J, 10, pp.230~234 (2018)
  26. Price DD, "The validation of visual analogue scales as ratio scale measures for chronic and experimental pain", Pain, 17, pp.45~56 (1983)
  27. Lluch E, "Effects of deep cervical flexor training on pressure pain thresholds over myofascial trigger points in patients with chronic neck pain", J Manipulative Physiol Ther, 36, pp.604~611 (2013)
  28. Takala EP, "Pressure pain threshold on upper trapezius and levator scapulae muscles. Repeatability and relation to subjective symptoms in a working population", Scand J Rehabil Med, 22, pp.63~68 (1990)
  29. Shaheen AA, "Cross-cultural adaptation, reliability, and validity of the Arabic version of neck disability index in patients with neck pain", Spine(Phila Pa 1976), 38, pp.E609~E715 (2013)
  30. Childs JD, "Neck pain : clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopedic Section of the American Physical Therapy Association", J Orthop Sports Phys Ther, 38, pp.A1~A34 (2008)
  31. Ramon S, "Update on the efficacy of extracorporeal shockwave treatment for myofascial pain syndrome and fibromyalgia", Int J Surg, 24, pp.201~206 (2015)
  32. Jagad BH, "Effects of ischemic compression on the trigger points in the upper trapezius muscle", Indian J Physiother Occup Ther, 7, pp.99~104 (2013)
  33. Lytras DE, "Effects of exercise and an integrated neuromuscular inhibition technique program in the management of chronic mechanical neck pain : a randomized controlled trial", J Manipulative Physiol Ther, 43, pp.100~113 (2020)
  34. Peters D, "Integrating complementary therapies in primary care: a practical guide for health professionals" (2002), Churchill Livingstone
  35. Mahajan R, "Comparative effectiveness of muscle energy technique and static stretching for treatment of subacute mechanical neck pain", Int J Health Rehabil Sci, 1, pp.16~21 (2012)
  36. Speed CA, "Extracorporeal shock-wave therapy in the management of chronic soft-tissue conditions", J Bone Joint Surg Br, 86, pp.165~171 (2004)
  37. Hye Min Ji, "Extracorporeal Shock Wave Therapy in Myofascial Pain Syndrome of Upper Trapezius", Annals of Rehabilitation Medicine, 36(5), pp.675~680 (2012), 대한재활의학회
  38. 홍진오, "Extracorporeal Shock Wave Therapy Versus Trigger Point Injection in the Treatment of Myofascial Pain Syndrome in the Quadratus Lumborum", Annals of Rehabilitation Medicine, 41(4), pp.582~588 (2017), 대한재활의학회
  39. Rahbar M, "Effectiveness of extracorporeal shock wave therapy versus standard care in the treatment of neck and upper back myofascial pain : a single blinded randomized clinical trial", Clin Rehabil, 35, pp.102~113 (2021)
  40. FatmaAlzahraa Hassan Kamel, "Efficacy of Extracorporeal Shockwave Therapy on Cervical Myofascial Pain Following Neck Dissection Surgery: A Randomized Controlled Trial", Annals of Rehabilitation Medicine, 44(5), pp.393~401 (2020), 대한재활의학회[DOI]
  41. Janig W, "Pain and the sympathetic nervous system", pp.17~89 (1990), Kluwer Academic Publishers
  42. Okuyucu EE, "Does transcutaneous nerve stimulation have effect on sympathetic skin response", J Clin Neurosci, 47, pp.160~162 (2018)
  43. Alghadir AH, "Efficacy of combination therapies on neck pain and muscle tenderness in male patients with upper trapezius active myofascial trigger points", Biomed Res Int, 2020, pp.9361405~ (2020)
  44. Nasb M, "Dry cupping, ischemic compression, or their combination for the treatment of trigger points:a pilot randomized trial", J Altern Complement Med, 26, pp.44~50 (2020)

관련 논문AI추천

Extracorporeal Shock Wave Therapy in Myofascial Pain Syndrome of Upper Trapezius한수정, Ho Jeong Kim, Hye Min Ji대한재활의학회 · Annals of Rehabilitation Medicine2012 · 제36권 제5호The Effect of Extracorporeal Shock Wave Therapy on Myofascial Pain Syndrome서정훈, 장기언, Jeong Hyeon Mun, Ji Soo Choi, Jong Hyun Jeon, Ju Youn Lee, Won Yong Park, Yun Jae Jung대한재활의학회 · Annals of Rehabilitation Medicine2012 · 제36권 제5호근막통증증후군 환자에게 통증점 체외충격파 치료가 경추의 가동 범위, 통증, 근육의 기계적 특성에 미치는 영향윤태림, 이준희, Koo-Young Jung한국전문물리치료학회 · 한국전문물리치료학회지2021 · 제28권 제1호체외충격파 치료와 기구보조연부조직가동술 기법이 근막통증증후군 환자의 위등세모근의 통증에 미치는 영향김종우, 임준영, 황병준대한정형도수물리치료학회 · 대한정형도수물리치료학회지2025 · 제31권 제2호Efficacy of Extracorporeal Shockwave Therapy on Cervical Myofascial Pain Following Neck Dissection Surgery: A Randomized Controlled TrialAshwag Alsharidah, FatmaAlzahraa Hassan Kamel, Islam Mohamed Hewidy, Maged Basha, Mohamed Ezzat, Nancy Hassan Aboelnour대한재활의학회 · Annals of Rehabilitation Medicine2020 · 제44권 제5호Effectiveness of intramuscular electrical stimulation using conventional and inverse electrode placement methods on pressure pain threshold and electromyographic activity of the upper trapezius muscle with myofascial trigger points: a randomized clinical trialArthur de Sá Ferreira, Fabio Vieira dos Anjos, Praveen Kumar Kandakurti, Ramprasad Muthukrishnan, Satheeskumar Durairaj, Sukumar Shanmugam대한통증학회 · The Korean Journal of Pain2025 · 제38권 제2호

이 간행물의 다른 논문 (8건)