Clinical Study Of The Effects Of Therapeutic Ultrasound Combined With Traditional Chinese Massage On Myofascial Pain Syndrome

Partâ… Reliability and validity of the hand-held pressure algometer as a measuring instrument of pressure pain threshold and the characteristics of pressure pain threshold in healthy ChineseObjectives: To evaluate the test-retest and inter-rater reliability of the hand-held pressure algometer as a measuring instrument of pressure pain threshold (PPT), and to characterize the pressure pain threshold in healthy Chinese .Methods: A total of 37 healthy subjects were recruited for reliability test. Three raters measured PPT at 12 body sites of the subjects. Each rater conducted three trials on each site. In the validity test, 10 patients with active trigger points in the upper trapezius were recruited and measured by one rater using the pressure algometer for PPT, the visual analogue scale (VAS) was also used to evaluate the pain intensity induced by the trigger point. The intraclass correlation coefficient and Spearman correlation coefficient were calculated to reflect the reliability and validity. And mean value of the three trails by one rater was used to compare the pressure pain threshold over different sites and between individuals. Results: The test-retest and inter-rater reliabilities were both high (ICC>0.95), with the measurements by one rater were more reliable than measurements by multiple raters. The inter-rater reliability of PPT measurement obtained by using the mean value of 3 trials was higher than any of the 3 trials alone. The PPT values of the trigger points were significantly lower than those of the normal points, and there was a significantly negative correlation between the PPT values of the trigger points and the VAS scores. The inter-individual differences were significant (P<0.05) and females exhibited lower PPT in every sites than males (P<0.05). PPT varied among different sites on one side (P<0.05), but showed no significant difference between the antimere sites (P>0.05). PPT value obtained from the paraspinal muscle was higher and that from the mastoid was lower than those from the other sites.Conclusions: The intra- and inter-rater PPT measurements in healthy subjects obtained with the hand-held pressure algometer were highly reliable. The algometer was valid for quantifying myofascial trigger point sensitivity. On the individual level, due to the considerable variation found in the PPT results, cautions were advised both in selecting the reference point and interpreting the results when using it as a method for clinical pain assessment. Analyzing the factors influencing the measurements and establishing the normal range of pressure pain threshold in Chinese should be approached in the near future.Partâ…¡Clinical study of the effects of therapeutic ultrasound combined with traditional Chinese massage on myofascial pain syndromeObjectives: To observe the clinical effects of therapeutic ultrasound combined with traditional Chinese massage in treatment of myofascial pain syndrome. .Methods: A total of 42 patients with myofascial pain syndrome and have active myofascial trigger points on one side of the upper trapezius were randomly divided into a therapy group and a control group, with 21 patients in each. For those in the therapy group, 10 minutes of ultrasound at the therapeutic intensity (1W/cm2, 100% duty cycle) was applied to the active myofascial trigger points before traditional Chinese massage once daily for 5 days. For the control group, only traditional Chinese massage was used. Visual analogue scale (VAS), pressure pain threshold (PPT), active range of motion (AROM), Pittsburgh sleep quality index (PSQI), 12-item short form of health survey questionnaire (SF-12) were recorded before the first treatment and immediate after the first and fifth treatment and one month later after the last treatment.Results: AROM measurements showed statistically significant increases after the first ultrasound therapy (P<0.05) in the therapy group, while the PPT values did not when compared with pretreatment (P>0.05). For both groups, VAS scores were decreased significantly (P<0.05), PPT values and AROM were significant improved (P<0.05) after the fifth treatment, and the results of the therapy group were better than those of the control group. A follow-up observation after 1 month found that VAS and PSQI scores of both groups remained significantly lower when compared with pretreatment scores (P<0.05), meanwhile, the AROM and SF-12 scores also showed significant improvement (P<0.05).Conclusions: Therapeutic ultrasound administered in combination with traditional Chinese massage seems to be better than traditional Chinese massage in reducing the active myofascial trigger point sensitivity and improving the quality of life in patients with MPS.