BACKGROUND Active myofascial trigger points(TrPs)often occur in the upper region of the upper trapezius(UT)muscle.These TrPs can be a significant source of neck,shoulder,and upper back pain and headaches.These TrPs an...BACKGROUND Active myofascial trigger points(TrPs)often occur in the upper region of the upper trapezius(UT)muscle.These TrPs can be a significant source of neck,shoulder,and upper back pain and headaches.These TrPs and their related pain and disability can adversely affect an individual’s everyday routine functioning,work-related productivity,and general quality of life.AIM To investigate the effects of instrument assisted soft tissue mobilization(IASTM)vs extracorporeal shock wave therapy(ESWT)on the TrPs of the UT muscle.METHODS A randomized,single-blind,comparative clinical study was conducted at the Medical Center of the Egyptian Railway Station in Cairo.Forty patients(28 females and 12 males),aged between 20-years-old and 40-years-old,with active myofascial TrPs in the UT muscle were randomly assigned to two equal groups(A and B).Group A received IASTM,while group B received ESWT.Each group was treated twice weekly for 2 weeks.Both groups received muscle energy technique for the UT muscle.Patients were evaluated twice(pre-and posttreatment)for pain intensity using the visual analogue scale and for pain pressure threshold(PPT)using a pressure algometer.RESULTS Comparing the pre-and post-treatment mean values for all variables for group A,there were significant differences in pain intensity for TrP1 and TrP2(P=0.0001)and PPT for TrP1(P=0.0002)and TrP2(P=0.0001).Also,for group B,there were significant differences between the pre-and post-treatment pain intensity for TrP1 and TrP2 and PPT for TrP1 and TrP2(P=0.0001).There were no significant differences between the two groups in the post-treatment mean values of pain intensity for TrP1(P=0.9)and TrP2(P=0.76)and PPT for TrP1(P=0.09)and for TrP2(P=0.91).CONCLUSION IASTM and ESWT are effective methods for improving pain and PPT in patients with UT muscle TrPs.There is no significant difference between either treatment method.展开更多
目的观察推拿按法对慢性激痛点模型大鼠骨骼肌超微结构的影响,探讨推拿按法对慢性激痛点的治疗作用。方法将健康雄性SD大鼠随机分为空白组、模型组、按法组、利多卡因组,每组6只。采用钝性打击结合离心运动方式建立慢性激痛点大鼠模型...目的观察推拿按法对慢性激痛点模型大鼠骨骼肌超微结构的影响,探讨推拿按法对慢性激痛点的治疗作用。方法将健康雄性SD大鼠随机分为空白组、模型组、按法组、利多卡因组,每组6只。采用钝性打击结合离心运动方式建立慢性激痛点大鼠模型。按法组大鼠予按法刺激局部激痛点,隔天治疗1次,每次7.5 min,共治疗7次;利多卡因组大鼠予0.5 mL的1%利多卡因注射液治疗,6 d 1次,共治疗3次。2周干预结束后,采用HE染色观察各组大鼠骨骼肌显微结构变化;采用透射电镜观察各组大鼠骨骼肌组织超微结构变化。结果(1)光镜下,模型组可见异常梭形形态肌纤维,表现为中间膨大,两端变窄,伴大量炎症细胞浸润和核内移现象;与模型组比较,按法组和利多卡因组均可见肌纤维粗细均匀、排列较整齐,炎症细胞减少。(2)电镜下,模型组肌原纤维排列紊乱,大量肌纤维断裂、破损,线粒体数量减少,结构异常,出现肿胀变圆、嵴结构减少或呈空泡状;按法组和利多卡因组表现接近,与模型组比较,肌原纤维排列趋于整齐,线粒体数量增多,结构恢复正常,呈细长杆状和卵圆形,或出现融合形态。各组肌节长度测量结果显示,模型组与空白组比较,肌节长度明显缩短,差异有显著统计学意义(P<0.01);模型组与按法组、利多卡因组比较,差异有统计学意义(P<0.05)。结论慢性激痛点病理特征为骨骼肌肌节挛缩、线粒体结构和数量受损。按法治疗能够舒张挛缩的肌节、促进线粒体的损伤修复,起到对慢性激痛点的去活化作用。展开更多
目的通过观察按法干预对激痛点骨骼肌细胞骨架α微管蛋白(α-tubulin)和微管相关蛋白4(microtubule-associated protein 4,MAP-4)的影响,探讨按法的舒筋解结作用。方法40只SPF级雄性大鼠随机分为空白组10只和激痛点造模大鼠30只,采用钝...目的通过观察按法干预对激痛点骨骼肌细胞骨架α微管蛋白(α-tubulin)和微管相关蛋白4(microtubule-associated protein 4,MAP-4)的影响,探讨按法的舒筋解结作用。方法40只SPF级雄性大鼠随机分为空白组10只和激痛点造模大鼠30只,采用钝性打击结合离心运动的方法建立大鼠激痛点模型,模型评价后将符合标准的20只大鼠随机分为模型组和按法组,每组10只。空白组和模型组不予按法干预,仅正常观察,按法组以自制按法刺激器干预14 d。干预结束后在激痛点局部取材,用Western blot和免疫荧光双染法检测α-tubulin和MAP-4。结果α-tubulin和MAP-4在肌细胞和细胞外基质均有一定的共表达,空白组α-tubulin和MAP-4主要分布在肌细胞膜与细胞质,分布连续性较好,模型组α-tubulin分布连续性和完整性欠佳,在肌细胞内表达减少,在细胞外基质表达增加,MAP-4在肌细胞和细胞外基质表达均增加,两者在按法组有一定改善。与空白组相比,模型组α-tubulin表达下降、MAP-4表达升高(P<0.05);与模型组相比,按法组α-tubulin表达升高、MAP-4表达下降(P<0.05)。结论按法的舒筋解结作用可能与抑制微管蛋白解聚并促进其合成有关。展开更多
文摘BACKGROUND Active myofascial trigger points(TrPs)often occur in the upper region of the upper trapezius(UT)muscle.These TrPs can be a significant source of neck,shoulder,and upper back pain and headaches.These TrPs and their related pain and disability can adversely affect an individual’s everyday routine functioning,work-related productivity,and general quality of life.AIM To investigate the effects of instrument assisted soft tissue mobilization(IASTM)vs extracorporeal shock wave therapy(ESWT)on the TrPs of the UT muscle.METHODS A randomized,single-blind,comparative clinical study was conducted at the Medical Center of the Egyptian Railway Station in Cairo.Forty patients(28 females and 12 males),aged between 20-years-old and 40-years-old,with active myofascial TrPs in the UT muscle were randomly assigned to two equal groups(A and B).Group A received IASTM,while group B received ESWT.Each group was treated twice weekly for 2 weeks.Both groups received muscle energy technique for the UT muscle.Patients were evaluated twice(pre-and posttreatment)for pain intensity using the visual analogue scale and for pain pressure threshold(PPT)using a pressure algometer.RESULTS Comparing the pre-and post-treatment mean values for all variables for group A,there were significant differences in pain intensity for TrP1 and TrP2(P=0.0001)and PPT for TrP1(P=0.0002)and TrP2(P=0.0001).Also,for group B,there were significant differences between the pre-and post-treatment pain intensity for TrP1 and TrP2 and PPT for TrP1 and TrP2(P=0.0001).There were no significant differences between the two groups in the post-treatment mean values of pain intensity for TrP1(P=0.9)and TrP2(P=0.76)and PPT for TrP1(P=0.09)and for TrP2(P=0.91).CONCLUSION IASTM and ESWT are effective methods for improving pain and PPT in patients with UT muscle TrPs.There is no significant difference between either treatment method.
文摘目的观察推拿按法对慢性激痛点模型大鼠骨骼肌超微结构的影响,探讨推拿按法对慢性激痛点的治疗作用。方法将健康雄性SD大鼠随机分为空白组、模型组、按法组、利多卡因组,每组6只。采用钝性打击结合离心运动方式建立慢性激痛点大鼠模型。按法组大鼠予按法刺激局部激痛点,隔天治疗1次,每次7.5 min,共治疗7次;利多卡因组大鼠予0.5 mL的1%利多卡因注射液治疗,6 d 1次,共治疗3次。2周干预结束后,采用HE染色观察各组大鼠骨骼肌显微结构变化;采用透射电镜观察各组大鼠骨骼肌组织超微结构变化。结果(1)光镜下,模型组可见异常梭形形态肌纤维,表现为中间膨大,两端变窄,伴大量炎症细胞浸润和核内移现象;与模型组比较,按法组和利多卡因组均可见肌纤维粗细均匀、排列较整齐,炎症细胞减少。(2)电镜下,模型组肌原纤维排列紊乱,大量肌纤维断裂、破损,线粒体数量减少,结构异常,出现肿胀变圆、嵴结构减少或呈空泡状;按法组和利多卡因组表现接近,与模型组比较,肌原纤维排列趋于整齐,线粒体数量增多,结构恢复正常,呈细长杆状和卵圆形,或出现融合形态。各组肌节长度测量结果显示,模型组与空白组比较,肌节长度明显缩短,差异有显著统计学意义(P<0.01);模型组与按法组、利多卡因组比较,差异有统计学意义(P<0.05)。结论慢性激痛点病理特征为骨骼肌肌节挛缩、线粒体结构和数量受损。按法治疗能够舒张挛缩的肌节、促进线粒体的损伤修复,起到对慢性激痛点的去活化作用。
文摘目的通过观察按法干预对激痛点骨骼肌细胞骨架α微管蛋白(α-tubulin)和微管相关蛋白4(microtubule-associated protein 4,MAP-4)的影响,探讨按法的舒筋解结作用。方法40只SPF级雄性大鼠随机分为空白组10只和激痛点造模大鼠30只,采用钝性打击结合离心运动的方法建立大鼠激痛点模型,模型评价后将符合标准的20只大鼠随机分为模型组和按法组,每组10只。空白组和模型组不予按法干预,仅正常观察,按法组以自制按法刺激器干预14 d。干预结束后在激痛点局部取材,用Western blot和免疫荧光双染法检测α-tubulin和MAP-4。结果α-tubulin和MAP-4在肌细胞和细胞外基质均有一定的共表达,空白组α-tubulin和MAP-4主要分布在肌细胞膜与细胞质,分布连续性较好,模型组α-tubulin分布连续性和完整性欠佳,在肌细胞内表达减少,在细胞外基质表达增加,MAP-4在肌细胞和细胞外基质表达均增加,两者在按法组有一定改善。与空白组相比,模型组α-tubulin表达下降、MAP-4表达升高(P<0.05);与模型组相比,按法组α-tubulin表达升高、MAP-4表达下降(P<0.05)。结论按法的舒筋解结作用可能与抑制微管蛋白解聚并促进其合成有关。
