A Clinical Study Of Manual Manipulation Of Myofascial Trigger Points In The Treatment Of Frozen Shoulder Periarthritis

Periarthritis of shoulder is a group of diseases caused by shoulder pain and dysfunction caused by soft tissue injury and degeneration around the shoulder joint.The disease usually occurs at the age of 40?60 years,and women are more prone to the disease than men.Clinical divided into early freezing,freezing period,convalescence period.Massage therapy by stages,periarthritis of shoulder belongs to the injury tendon disease,"injury tendon" refers to the related musculoskeletal system soft tissue injury.One of the major characteristics of the massage treatment of tendon diseases is to perceive the development of the disease through palpation of the hand,and to perform the toning technique on the basis of the perception of acute tendon and clonic tendon performance.Modern massage combines the understanding of traditional Chinese medicine with modern medical anatomy to form a variety of manipulative treatment procedures for periarthritis of shoulder.Feel the development of the disease through the palpation of the handObjectives:In this study,a randomized controlled clinical trial was conducted to investigate the clinical effect of the trigger point of muscle fascia by manually poking in the treatment of frozen periarthritis of shoulder,the pressing-motion massage therapy and basic manipulation as the controls.Methods:A total of 90 patients with frozen periarthritis of shoulder from the massage clinic in Beijing Massage Hospital,who met the inclusion criteria,were randomly divided into observation group,pressing-motion group and basic group with 30 cases in each group.The observation group was treated with manipulation at the trigger point of muscle fascia.First,heavy method was used to quickly pull the trigger point from inside to outside along the muscle fiber vertical direction for 2?3mins,then slowly pull the trigger point vertically for 3?4mins,and then adjust the Angle of about 45° for 2?3mins.Finally,gentle massage was used to relax for 2?3mins.The pressing-motion group was treated with pressing-motion therapy,local points according to Jinggen,Jianzhen,subacromial pain point,biceps brachii long head tendon pain point,combined with the distal press Zhongping,so that patients do shoulder joint movement in all directions;Basic groupwas given to conventional manipulation treatment,around the shoulder joint line take knead,dial knead,and point according to Tianzong,Jianzhen,ChiZe,Jianyu,Quchi and other points.Subjects in each group were treated twice a week,10?15min each time,8 times as a course of treatment,a total of 1 course of treatment.For the three groups,respectively before treatment,1,2 and 4 weeks of treatment,VAS score was performed.For the three groups before and 4 weeks of treatment,Oxford shoulder questionnaire score(OSS)was performed.Finally,SPSS statistical software was used for data analysis.Results:1.General data analysisThere was no statistical difference in the general information(gender,age and course of disease)of the three groups.Before treatment,there was no statistically significant difference in VAS score and OSS score among the three groups(P<0.05)with comparability.2.Result analysis of efficacy indexes2.1 Comparison of VAS scores and OSS scores in the group after treatment2.1.1 Among the three groups,VAS scores at 1,2 and 4 weeks of treatment were compared,P=0.000(P<0.05),indicating that the observation group,the pressing-motion group and the basic group were all effective in aspect of relieving pain.2.1.2 Among the three groups,Comparison of OSS scores have Statistic difference before treatment and 4 weeks of treatment,P=0.000(P<0.05),indicating that the shoulder function of the observation group,the pressing-motion group and the basic group were improved.2.2 Comparison of VAS scores and OSS scores between groups after treatment2.2.1 Comparison of VAS scores among the three groups at 1,2,and 4 weeks of treatment,respectively,Comparison of overall VAS scores among the three groups has Statistic difference P=0.000(P<0.05).The pairwise comparison results showed that there were statistically significant differences between the observation group and the pressing-motion group,and between the observation group and the basic group(P=0.000,P<0.05).Pairwise comparison between the pressing-motion group and the basic group have no statistically difference(P=0.478,P>0.05).2.2.2 Comparison of OSS scores among groups.At 4 weeks of treatment,the mean OSS scores were 28.13±1.94 in the observation group;the mean is 28.77±2.81 in the pressing-motion group;the mean is 32.23±2.54 in the basic group.Comparison between the three groups was P=0.000(P<0.05),indicating that the observation group was better than the pressing-motion group and the basic group in aspect of improving the shoulder function.Conclusion:Manually poking the myofascial trigger point,pressing-motion therapy and basic manipulation all have curative effect on frozen periarthritis of shoulder,and manually poking the myofascial trigger point has better curative effect on aspcet of relieving pain and improving shoulder function than pressing-motion therapy and basic manipulation.Manually poking the myofascial trigger point can be used as one of the effective methods to treat periarthritis of shoulder.