| ObjectiveThe myofascial pain trigger point theory was applied to the clinical treatment of patients with chronic pain in knee soft tissue sports injuries to compare the clinical efficacy of the Muscle Energy Technique(MET),the acupuncture technique and the combination of the two in the treatment of myofascial trigger point-induced chronic pain in knee soft tissue sports injuries.In addition to the basic VAS scores and Lysholm scales,the experimental outcome indicators were also used to measure the active knee mobility,the blood flow in the quadriceps muscle and the total amount of fluid in the knee joint by musculoskeletal ultrasound to investigate the effectiveness of Muscle Energy Technique in relieving the chronic pain of myofascial trigger point induced knee joint.We investigated the effectiveness of muscle energy techniques in relieving chronic pain,improving local blood supply,and eliminating joint effusion in soft tissue sports injuries,and explored the advantages and disadvantages of different types of treatments in relieving pain and improving joint mobility.MethodsA random number table method was used to randomly divide 45 patients who met the inclusion criteria into 3 groups: experimental group 1(MET group),experimental group 2(acupuncture + MET group),and control group(acupuncture group),with 15 patients in each group.In the control group,8 myofascial trigger points of the internal oblique femoral muscle,lateral femoral muscle and rectus femoris were used for acupuncture;in the experimental group 1,MET was used to inactivate the myofascial trigger points of the quadriceps and hamstring muscles;in the experimental group 2,acupuncture combined with MET was used.8 acupuncture interventions were performed twice a week;8 MET interventions were performed for 20 min each time,twice a week;the total experimental period was 4 weeks.Results(1)Changes in VAS scores in the experimental and control groups before and after treatmentWithin-group comparison: the changes in VAS pain scores in the resting state as well as in the exercise state in the control group,experimental group 1,and experimental group 2 at two time points before and after treatment were analyzed by independent samples t-test,which showed that the VAS pain scores in the control group,experimental group 1,and experimental group 2 at the end of treatment were statistically significant(p<0.01)in the resting state as well as in the exercise state,with statistically significant differences.Between-group comparison: the differences in the changes of VAS pain scores in resting state as well as in exercise state between experimental group 1,experimental group 2 and control group before and after treatment,the chi-square analysis of the data of the two groups showed that the volatility of the sample data of different groups in VAS scores in resting state and exercise state of the knee joint showed consistency(p>0.05),and the one-way ANOVA showed that: there was no significant change in VAS pain scores in resting state between experimental group and control group after treatment.There was no significant difference between the VAS pain scores of the experimental and control groups in the resting state after treatment(p>0.05),and there was a significant difference between the VAS pain scores of the experimental and control groups in the exercise state after treatment(p<0.05).(2)Changes in knee flexion active mobility AROM in the experimental and control groups before and after treatmentWithin-group comparison: The changes in AROM scores of knee active mobility in the control group,experimental group 1 and experimental group 2 at two time points before and after treatment were analyzed by independent sample t-test,which showed statistically significant changes in knee active mobility in the control group,experimental group 1 and experimental group 2 at the end of treatment(p<0.01).Comparison between groups: the differences in AROM changes before and after treatment in the control group,experimental group 1 and experimental group 2 were shown to be consistent by chi-square analysis of the volatility of the sample data of different groups of knee AROM(p>0.05),and by one-way ANOVA: there was no significant difference between the knee active flexion mobility AROM in the experimental and control groups before and after treatment(p>0.05).(3)Changes of knee joint Lysholm score scale before and after treatment in the experimental and control groupsWithin-group comparisons: Changes in the knee Lysholm scale in the control group,experimental group 1 and experimental group 2 at two time points before and after treatment were analyzed by independent samples t-test,which showed that there were statistically significant changes in the knee Lysholm scale in the control group,experimental group 1 and experimental group 2 at the end of treatment(p<0.01).Comparison between groups: the differences between the control group,experimental group 1 and experimental group 2 in the knee joint Lysholm score scale before and after treatment were shown to be consistent by ANOVA(p>0.05),and by one-way ANOVA: the differences between each experimental group and control group in the knee joint Lysholm score scale before and after treatment were shown to be consistent by ANOVA(p>0.05).Scale analysis results,none of them were significantly different(p>0.05).(4)Changes in knee pain thresholds in the experimental and control groups before and after treatmentWithin-group comparison: The changes in myofascial trigger point pain thresholds in the two dimensions of perceived pain PPT and withstood pain MPT in the control,experimental 1 and experimental 2 groups before and after treatment at two time points were analyzed by independent sample t-test,which showed that the pain thresholds in the control,experimental 1 and experimental 2 groups showed statistically significant changes(p<0.01)at the end of treatment.Between-group comparison: The differences in pain threshold changes between experimental group 1,experimental group 2 and control group before and after treatment were analyzed by chi-squared analysis showing that knee pain thresholds,including PPT and MPT,showed significant(p<0.05)fluctuations in all of the sample data of different groups,implying that the fluctuations of sample data of different groups had significant differences,so the non-parametric test was selected to compare the differences between groups: There was a significant difference between the pain thresholds of each experimental and control group in the PPT dimension of perceived pain after treatment(p<0.01),and the pain scores of each experimental and control group in the MPT dimension of tolerated pain after treatment were similarly significantly different(p<0.01).(5)Changes in the total KE of intra-articular fluid in the knee before and after treatment in the experimental and control groups.Within-group comparison: The changes in the total amount of intra-articular fluid in the knee joint of the control group,experimental group 1 and experimental group 2at two time points before and after treatment were analyzed by independent sample t-test,which showed that the pain thresholds of the acupuncture group,experimental group 1 and experimental group 2 all showed significant changes(p<0.01)at the end of treatment,with statistically significant differences.Inter-group comparison: further comparison of experimental group 1,experimental group 2 and control group before and after treatment pain threshold change differences,by ANOVA showed that the total amount of internal effusion in different groups of sample data fluctuations all showed significant(p<0.05),so this group data should also be similarly selected for comparison of differences between groups using non-parametric test: after treatment each experimental group and control group in the change of intra-knee joint effusion There was no significant difference(p>0.05).(6)Changes in blood flow BF in the quadriceps muscle of the knee joint before and after treatment in the experimental and control groupsWithin-group comparison: The changes in blood flow in the quadriceps muscle of the knee joint in the control group,experimental group 1 and experimental group 2 at two time points before and after treatment were analyzed by independent sample t-test,which showed that there were statistically significant changes in blood flow in the quadriceps muscle of the acupuncture group,experimental group 1 and experimental group 2 at the end of treatment(p<0.01).Comparison between groups: further comparison of the differences in the changes in quadriceps blood flow between experimental group 1,experimental group 2 and control group before and after treatment,the results of ANOVA of the quadriceps blood flow in the knee joint showed that all the fluctuations in the sample data of the different groups did not show significance(p>0.05),and the ANOVA test could be used,and the one-way ANOVA showed that each experimental group and control group showed significant changes in the quadriceps blood flow in the knee joint after treatment.muscle blood flow showed significant differences(p<0.05).Conclusion(1)MET treatment can reduce VAS scores,improve joint mobility,and improve joint function in the short term,and is more effective than MET combined with acupuncture in improving VAS pain in the knee joint under sports conditions;and the improvement in trigger point pain tolerance threshold is much higher than that of acupuncture alone;(2)The combination of acupuncture MTrPs and MET therapy had significant therapeutic effects on the VAS score and functional improvement of the experimental patients in the short term,especially in improving myofascial trigger point pressure pain,pain tolerance threshold and local blood circulation of the quadriceps muscle of the knee joint,and the long-term effect was better than that of monotherapy,and the combination therapy showed better clinical application potential. |
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