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首页> 外文期刊>Journal of bodywork and movement therapies >Changes in pain and pressure pain sensitivity after manual treatment of active trigger points in patients with unilateral shoulder impingement: a case series.
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Changes in pain and pressure pain sensitivity after manual treatment of active trigger points in patients with unilateral shoulder impingement: a case series.

机译：手动治疗单侧肩膀撞击患者主动触发点后疼痛和压力疼痛敏感性的变化：一个病例系列。

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The aim of this case series was to investigate changes in pain and pressure pain sensitivity after manual treatment of active trigger points (TrPs) in the shoulder muscles in individuals with unilateral shoulder impingement. Twelve patients (7 men, 5 women, age: 25 +/- 9 years) diagnosed with unilateral shoulder impingement attended 4 sessions for 2 weeks (2 sessions/week). They received TrP pressure release and neuromuscular interventions over each active TrP that was found. The outcome measures were pain during arm elevation (visual analogue scale, VAS) and pressure pain thresholds (PPT) over levator scapulae, supraspinatus infraspinatus, pectoralis major, and tibialis anterior muscles. Pain was captured pre-intervention and at a 1-month follow-up, whereas PPT were assessed pre- and post-treatment, and at a 1-month follow-up. Patients experienced a significant (P < 0.001) reduction in pain after treatment (mean +/- SD: 1.3 +/- 0.5) with a large effect size (d > 1). In addition, patients also experienced a significant increase in PPT immediate after the treatment (P < 0.05) and one month after discharge (P < 0.01), with effect sizes ranging from moderate (d = 0.4) to large (d > 1).A significant negative association (r(s) = -0.525; P = 0.049) between the increase in PPT over the supraspinatus muscle and the decrease in pain was found: the greater the decrease in pain, the greater the increase in PPT. This case series has shown that manual treatment of active muscle TrPs can help to reduce shoulder pain and pressure sensitivity in shoulder impingement. Current findings suggest that active TrPs in the shoulder musculature may contribute directly to shoulder complaint and sensitization in patients with shoulder impingement syndrome, although future randomized controlled trials are required.
机译：本案例系列的目的是研究对单侧肩部撞击患者的肩部肌肉主动触发点（TrPs）进行手动治疗后疼痛和压力疼痛敏感性的变化。十二名被诊断为单侧肩部撞击的患者（7名男性，5名女性，年龄：25 +/- 9岁）参加了4个疗程，共2周（每周2个疗程）。他们在发现的每个活动TrP上接受TrP压力释放和神经肌肉干预。结果测量指标是手臂抬高时的疼痛（视觉模拟评分，VAS）和提肌上的肩，骨，上棘下肌，胸大肌和胫前肌的压力疼痛阈值（PPT）。在干预前和1个月的随访中记录了疼痛，而在治疗前和后以及1个月的随访中评估了PPT。治疗后患者的疼痛显着减轻（P <0.001）（平均+/- SD：1.3 +/- 0.5），效果大小大（d> 1）。此外，患者在治疗后即刻（P <0.05）和出院后一个月（P <0.01）的PPT也显着增加，其影响范围从中度（d = 0.4）到大（d> 1）。发现上棘上肌的PPT增加与疼痛减轻之间存在显着的负相关性（r（s）= -0.525; P = 0.049）：疼痛减轻越大，PPT的增加越大。该案例系列表明，手动治疗活动性肌肉TrP可以帮助减轻肩部疼痛和对肩膀撞击的压力敏感性。目前的研究结果表明，尽管需要将来的随机对照试验，但肩部肌肉组织中活跃的TrPs可能直接导致肩部撞击综合征患者的肩部不适和过敏。

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