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Changzern Hong - One of the best experts on this subject based on the ideXlab platform.
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Remote therapeutic effectiveness of acupuncture in treating Myofascial Trigger Point of the upper trapezius muscle.
American journal of physical medicine & rehabilitation, 2011Co-Authors: Li-wei Chou, Changzern Hong, Mu-jung Kao, Yueh-ling Hsieh, Hsin-shui Chen, Ting-i HanAbstract:Chou L-W, Hsieh Y-L, Chen H-S, Hong C-Z, Kao M-J, Han T-I: Remote therapeutic effectiveness of acupuncture in treating Myofascial Trigger Point of the upper trapezius muscle. Am J Phys Med Rehabil 2011;90:1036Y1049. Objective: This study aimed to investigate the remote effect of acupuncture (AcP) on the pain intensity and the irritability of the Myofascial Trigger Point in the upper trapezius muscle. Design: Forty-five patients were equally divided into three groups: patients in the placebo control group received sham AcP, those in the simple needling group were treated using simple needling, and those in the modified AcP received AcP with the rapid Bscrewed in and out[ into multiple sites to elicit local twitch responses. The acuPoints of Wai-guan and Qu-chi were treated. The outcome assessments included changes in subjective pain intensity, pressure pain threshold, range of motion, and mean amplitude of endplate noise in the Myofascial Trigger Point region. Results: Immediately after acupuncture, all measured parameters improved significantly in the simple needling and modified AcP groups, but not in the placebo control group. There were significantly larger changes in all parameters in the modified AcP group than that in the simple needling group. Conclusions: The Myofascial Trigger Point irritability could be suppressed after a remote acupuncture treatment. It appears that needling to the remote AcP Points with multiple needle insertions of modified AcP technique is a better technique than simple needling insertion of simple needling technique in terms of the decrease in pain intensity and prevalence of endplate noise and the increase in pressure pain threshold in the needling sites (represented either AcP Points and or Myofascial Trigger Points). We have further confirmed that the reduction in endplate noise showed good correlation with a decreased in pain.
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Remote effects of dry needling on the irritability of the Myofascial Trigger Point in the upper trapezius muscle.
American journal of physical medicine & rehabilitation, 2010Co-Authors: Chien Tsung Tsai, Lin Fen Hsieh, Ta Shen Kuan, Mu-jung Kao, Li-wei Chou, Changzern HongAbstract:ABSTRACTTsai C-T, Hsieh L-F, Kuan T-S, Kao MJ, Chou L-W, Hong C-Z: Remote effects of dry needling on the irritability of the Myofascial Trigger Point in the upper trapezius muscle.Objective:To investigate the remote effect of dry needling on the irritability of a Myofascial Trigger Point in the uppe
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remote influences of acupuncture on the pain intensity and the amplitude changes of endplate noise in the Myofascial Trigger Point of the upper trapezius muscle
Archives of Physical Medicine and Rehabilitation, 2009Co-Authors: Li-wei Chou, Mu-jung Kao, Yueh-ling Hsieh, Changzern HongAbstract:Abstract Chou L-W, Hsieh Y-L, Kao M-J, Hong C-Z. Remote influences of acupuncture on the pain intensity and the amplitude changes of endplate noise in the Myofascial Trigger Point of the upper trapezius muscle. Objective To investigate the remote effect of acupuncture on the pain intensity and the endplate noise (EPN) recorded from a Myofascial Trigger Point (MTrP) of the upper trapezius muscle. Design Randomized controlled trial. Setting University hospital. Participants Patients (N=20) with active MTrPs in upper trapezius muscles and no experience in acupuncture therapy. Interventions Patients were divided into 2 groups. Those in the control group received sham acupuncture, and those in the acupuncture group received modified acupuncture therapy with needle insertion into multiple loci to elicit local twitch responses. The acupuncture Points of Wai-guan and Qu-chi were treated. Main Outcome Measures Subjective pain intensity (numerical pain rating scale) and mean EPN amplitude in the MTrP of the upper trapezius muscle. Results The pain intensity in the MTrP was significantly reduced after remote acupuncture (from 7.4±0.8 to 3.3±1.1; P P >.05). The mean EPN amplitude was significantly lower than the pretreatment level after acupuncture treatment (from 21.3±9.5μV to 9.5±3.5μV; P P >.05). The change in the pain intensity was significantly correlated with the change of EPN amplitude ( r = 0.685). Conclusions Both subjective changes in the pain intensity and objective changes of the EPN amplitude in the MTrP region of the upper trapezius muscle were found during and after acupuncture treatment at the remote ipsilateral acupuncture Points. This study may further clarify the physiological basis of the remote effectiveness of acupuncture therapy for pain control.
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The Myofascial Trigger Point region: correlation between the degree of irritability and the prevalence of endplate noise.
American journal of physical medicine & rehabilitation, 2007Co-Authors: Ta Shen Kuan, Yueh-ling Hsieh, Shu Min Chen, Jo Tong Chen, Wei Chang Yen, Changzern HongAbstract:Kuan T-S, Hsieh Y-L, Chen S-M, Chen J-T, Yen W-C, Hong C-Z: The Myofascial Trigger Point region: correlation between the degree of irritability and the prevalence of endplate noise. Am J Phys Med Rehabil 2007;86:183‐189. Objective: This study was designed to investigate the correlation between the irritability of the Myofascial Trigger Point (MTrP) and the prevalence of endplate noise (EPN) in the MTrP region of human skeletal muscle. Design: Twenty normal subjects with latent MTrPs and 12 patients with active MTrPs in the upper trapezius muscles were recruited for this study. The patients reported the subjective pain intensity of the active MTrP (0‐10). The MTrP and an adjacent non-MTrP site were confirmed and marked for the measurement of pressure pain threshold (with a pressure algometer) and the prevalence of EPN (with electromyographic recordings). Results: The prevalence of EPN in the MTrP regions was significantly higher (P 0.01) in the active MTrPs than in the latent ones. However, no EPN could be found in the non-MTrP region near either the active or the latent MTrPs. The pain intensity and the pressure pain threshold were highly correlated with the prevalence of EPN in the MTrP region (r 0.742 and 0.716, respectively). Conclusions: The irritability of an MTrP is highly correlated with the prevalence of EPN in the MTrP region of the upper trapezius muscle. The assessment of EPN prevalence in an MTrP region may be applied to evaluate the irritability of that MTrP.
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Dry needling to a key Myofascial Trigger Point may reduce the irritability of satellite MTrPs.
American journal of physical medicine & rehabilitation, 2007Co-Authors: Yueh-ling Hsieh, Ta Shen Kuan, Mu-jung Kao, Shu Min Chen, Jo Tong Chen, Changzern HongAbstract:Hsieh Y-L, Kao M-J, Kuan T-S, Chen S-M, Chen J-T, Hong C-Z: Dry needling to a key Myofascial Trigger Point may reduce the irritability of satellite Myofascial Trigger Points. Am J Phys Med Rehabil 2007;86:397‐403. Objective: To investigate the changes in pressure pain threshold of the secondary (satellite) Myofascial Trigger Points (MTrPs) after dry needling of a primary (key) active MTrP. Design: Single blinded within-subject design, with the same subjects serving as their own controls (randomized). Fourteen patients with bilateral shoulder pain and active MTrPs in bilateral infraspinatus muscles were involved. An MTrP in the infraspinatus muscle on a randomly selected side was dry needled, and the MTrP on the contralateral side was not (control). Shoulder pain intensity, range of motion (ROM) of shoulder internal rotation, and pressure pain threshold of the MTrPs in the infraspinatus, anterior deltoid, and extensor carpi radialis longus muscles were measured in both sides before and immediately after dry needling. Results: Both active and passive ROM of shoulder internal rotation, and the pressure pain threshold of MTrPs on the treated side, were significantly increased (P 0.01), and the pain intensity of the treated shoulder was significantly reduced (P 0.001) after dry needling. However, there were no significant changes in all parameters in the control (untreated) side. Percent changes in the data after needling were also analyzed. For every parameter, the percent change was significantly higher in the treated side than in the control side. Conclusions: This study provides evidence that dry needle‐evoked inactivation of a primary (key) MTrP inhibits the activity in satellite MTrPs situated in its zone of pain referral. This supports the concept that activity in a primary MTrP leads to the development of activity in satellite MTrPs and the suggested spinal cord mechanism responsible for this phenomenon.
Josué Fernández-carnero - One of the best experts on this subject based on the ideXlab platform.
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Post-needling soreness after Myofascial Trigger Point dry needling: Current status and future research.
Journal of Bodywork and Movement Therapies, 2018Co-Authors: Aitor Martín-pintado-zugasti, Robert D Gerwin, Orlando Mayoral Del Moral, Josué Fernández-carneroAbstract:Abstract Post-dry needling soreness is a common complication of Myofascial Trigger Point (MTrP) dry needling treatment. The prevention, management and relevance of this complication remain uncertain. This paper examines the current state of knowledge and suggests directions for further studies in this area. MTrPs are hypersensitive nodules in skeletal muscles' taut bands, present in several pain conditions. Dry needling has been recommended for relieving MTrP pain. MTrP dry needling procedures have shown to be associated with post-needling soreness, which is thought to be a consequence of the neuromuscular damage, and hemorrhagic and inflammatory reaction generated by the needle. Postneedling soreness is a very frequent effect after deep dry needling, usually lasting less than 72 h. It may not be especially distressing for most patients. However, patients presenting with higher levels of post-needling soreness, not perceiving dry needling effectiveness in the first session, or not having high Myofascial pain intensity before treatment, could be the most likely to find post-needling soreness more distressing, functionally limiting and to abandon treatment. Future research should assess the clinical relevance of post-needling soreness. Post-needling soreness should be considered when investigating dry needling effectiveness since it could overlie the original Myofascial pain and influence the patients’ pain ratings.
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Postneedling soreness after deep dry needling of a latent Myofascial Trigger Point in the upper trapezius muscle: Characteristics, sex differences and associated factors
Journal of back and musculoskeletal rehabilitation, 2016Co-Authors: Aitor Martín-pintado-zugasti, Ángel L. Rodríguez-fernández, Josué Fernández-carneroAbstract:BACKGROUND: Postneedling soreness is considered the most frequent secondary effect associated to dry needling. A detailed description of postneedling soreness characteristics has not been previously reported. OBJECTIVE: (1) to assess the intensity and duration of postneedling soreness and tenderness after deep dry needling of a trapezius latent Myofascial Trigger Point (MTrP), (2) to evaluate the possible differences in postneedling soreness between sexes and (3) to analyze the influence on postneedling soreness of factors involved in the dry needling process. METHODS:Sixty healthy subjects (30 men, 30 women) with latent MTrPs in the upper trapezius muscle received a dry needling intervention in the MTrP. Pain and pressure pain threshold (PPT) were assessed during a 72 hours follow-up period. RESULTS: Repeated measures analysis of covariance showed a significant effect for time in pain and in PPT. An interaction between sex and time in pain was obtained: women exhibited higher intensity in postneedling pain than men. The pain during needling and the number of needle insertions significantly correlated with postneedling soreness. CONCLUSIONS: Soreness and hyperalgesia are present in all subjects after dry needling of a latent MTrP in the upper trapezius muscle. Women exhibited higher intensity of postneedling soreness than men.
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Ischemic Compression After Dry Needling of a Latent Myofascial Trigger Point Reduces Postneedling Soreness Intensity and Duration.
PM & R : the journal of injury function and rehabilitation, 2015Co-Authors: Aitor Martín-pintado-zugasti, Daniel Pecos-martín, Alicia Portillo-aceituno, Ángel L. Rodríguez-fernández, Isabel M. Alguacil-diego, Tomás Gallego-izquierdo, Josué Fernández-carneroAbstract:Abstract Objective To investigate the effect of ischemic compression (IC) versus placebo and control on reducing postneedling soreness of 1 latent Myofascial Trigger Point and on improving cervical range of motion (CROM) in asymptomatic subjects. Design A randomized, double-blind, placebo-controlled trial with 72-hour follow-up. Setting A university community. Participants Asymptomatic volunteers (N = 90: 40 men and 50 women) aged 18 to 39 years (mean ± standard deviation [SD]: 22 ± 3 years). Intervention All subjects received a dry needling application over the upper trapezius muscle. Participants were then randomly divided into 3 groups: a treatment group who received IC over the needled trapezius muscle, a placebo group who received sham IC, and a control group who did not receive any treatment after needling. Main Outcome Measures Visual analog scale (VAS; during needling, at posttreatment and 6, 12, 24, 48, and 72 hours) and CROM (at preneedling, postneedling, and 24 and 72 hours). Results Subjects in the IC group showed significantly lower postneedling soreness than the placebo and the control group subjects immediately after treatment (mean ± standard deviation [SD]: IC, 20.1 ± 4.8; placebo, 36.7 ± 4.8; control, 34.8 ± 3.6) and at 48 hours (mean ± SD: IC, 0.6 ± 1; placebo, 4.8 ± 1; control, 3.8 ± 0.7). In addition, subjects in the dry needling+IC group showed significantly lower postneedling soreness duration ( P = .026). All subjects significantly improved CROM in contralateral lateroflexion and both homolateral and contralateral rotations, but only the improvements found in the IC group reached the minimal detectable change. Conclusions IC can potentially be added immediately after dry needling of Myofascial Trigger Point in the upper trapezius muscle because it has the effect of reducing postneedling soreness intensity and duration. The combination of dry needling and IC seems to improve CROM in homolateral and contralateral cervical rotation movements.
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Original ResearchdCME Ischemic Compression After Dry Needling of a Latent Myofascial Trigger Point Reduces Postneedling Soreness Intensity and Duration
2015Co-Authors: Aitor Martín-pintado-zugasti, Daniel Pecos-martín, Alicia Portillo-aceituno, Josué Fernández-carneroAbstract:Objective: To investigate the effect of ischemic compression (IC) versus placebo and control on reducing postneedling soreness of 1 latent Myofascial Trigger Point and on improving cervical range of motion (CROM) in asymptomatic subjects. Design: A randomized, double-blind, placebo-controlled trial with 72-hour follow-up. Setting: A university community.
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Effects of spray and stretch on postneedling soreness and sensitivity after dry needling of a latent Myofascial Trigger Point.
Archives of physical medicine and rehabilitation, 2014Co-Authors: Aitor Martín-pintado Zugasti, Ángel L. Rodríguez-fernández, Francisco García-muro, Almudena López-lópez, Orlando Mayoral, Juan Mesa-jiménez, Josué Fernández-carneroAbstract:Objectives: To investigate (1) the effect of spray and stretch versus control on reducing postneedling soreness of 1 latent Myofascial Trigger Point (MTrP) and (2) whether higher levels of psychological distress are associated with increased postneedling pain intensity. Design: A 72-hour follow-up, single-blind randomized controlled trial. Setting: University community. Participants: Healthy volunteers (NZ70; 40 men, 30 women) aged 18 to 36 years (mean age, 21� 4y) with latent MTrP in 1 upper trapezius muscle. Intervention: Allsubjectsreceivedadryneedlingapplicationovertheuppertrapeziusmuscle.Then,participantswererandomlydividedinto2groups: an interventiongroup, whichreceived spray and stretchover theneedled trapezius muscle,and a controlgroup, which did not receive any intervention. Main Outcome Measures: Visual analog scale (at postneedling, posttreatment, and 6, 12, 24, 48, and 72h after needling), pressure pain threshold (at preneedling, postneedling, and 24 and 48h after needling). Psychological distress was evaluated by using the Symptom Checklist-90-Revised. Results: Repeated-measures analysis of variance demonstrated a significant interaction between group and time (F3,204.8Z3.19; P .05). Repeated measures of covariance showed that none of the psychological covariates affected these results. Somatization, anxiety, interpersonal sensitivity, and hostility were significantly correlate d( P
Yueh-ling Hsieh - One of the best experts on this subject based on the ideXlab platform.
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Remote therapeutic effectiveness of acupuncture in treating Myofascial Trigger Point of the upper trapezius muscle.
American journal of physical medicine & rehabilitation, 2011Co-Authors: Li-wei Chou, Changzern Hong, Mu-jung Kao, Yueh-ling Hsieh, Hsin-shui Chen, Ting-i HanAbstract:Chou L-W, Hsieh Y-L, Chen H-S, Hong C-Z, Kao M-J, Han T-I: Remote therapeutic effectiveness of acupuncture in treating Myofascial Trigger Point of the upper trapezius muscle. Am J Phys Med Rehabil 2011;90:1036Y1049. Objective: This study aimed to investigate the remote effect of acupuncture (AcP) on the pain intensity and the irritability of the Myofascial Trigger Point in the upper trapezius muscle. Design: Forty-five patients were equally divided into three groups: patients in the placebo control group received sham AcP, those in the simple needling group were treated using simple needling, and those in the modified AcP received AcP with the rapid Bscrewed in and out[ into multiple sites to elicit local twitch responses. The acuPoints of Wai-guan and Qu-chi were treated. The outcome assessments included changes in subjective pain intensity, pressure pain threshold, range of motion, and mean amplitude of endplate noise in the Myofascial Trigger Point region. Results: Immediately after acupuncture, all measured parameters improved significantly in the simple needling and modified AcP groups, but not in the placebo control group. There were significantly larger changes in all parameters in the modified AcP group than that in the simple needling group. Conclusions: The Myofascial Trigger Point irritability could be suppressed after a remote acupuncture treatment. It appears that needling to the remote AcP Points with multiple needle insertions of modified AcP technique is a better technique than simple needling insertion of simple needling technique in terms of the decrease in pain intensity and prevalence of endplate noise and the increase in pressure pain threshold in the needling sites (represented either AcP Points and or Myofascial Trigger Points). We have further confirmed that the reduction in endplate noise showed good correlation with a decreased in pain.
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remote influences of acupuncture on the pain intensity and the amplitude changes of endplate noise in the Myofascial Trigger Point of the upper trapezius muscle
Archives of Physical Medicine and Rehabilitation, 2009Co-Authors: Li-wei Chou, Mu-jung Kao, Yueh-ling Hsieh, Changzern HongAbstract:Abstract Chou L-W, Hsieh Y-L, Kao M-J, Hong C-Z. Remote influences of acupuncture on the pain intensity and the amplitude changes of endplate noise in the Myofascial Trigger Point of the upper trapezius muscle. Objective To investigate the remote effect of acupuncture on the pain intensity and the endplate noise (EPN) recorded from a Myofascial Trigger Point (MTrP) of the upper trapezius muscle. Design Randomized controlled trial. Setting University hospital. Participants Patients (N=20) with active MTrPs in upper trapezius muscles and no experience in acupuncture therapy. Interventions Patients were divided into 2 groups. Those in the control group received sham acupuncture, and those in the acupuncture group received modified acupuncture therapy with needle insertion into multiple loci to elicit local twitch responses. The acupuncture Points of Wai-guan and Qu-chi were treated. Main Outcome Measures Subjective pain intensity (numerical pain rating scale) and mean EPN amplitude in the MTrP of the upper trapezius muscle. Results The pain intensity in the MTrP was significantly reduced after remote acupuncture (from 7.4±0.8 to 3.3±1.1; P P >.05). The mean EPN amplitude was significantly lower than the pretreatment level after acupuncture treatment (from 21.3±9.5μV to 9.5±3.5μV; P P >.05). The change in the pain intensity was significantly correlated with the change of EPN amplitude ( r = 0.685). Conclusions Both subjective changes in the pain intensity and objective changes of the EPN amplitude in the MTrP region of the upper trapezius muscle were found during and after acupuncture treatment at the remote ipsilateral acupuncture Points. This study may further clarify the physiological basis of the remote effectiveness of acupuncture therapy for pain control.
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The Myofascial Trigger Point region: correlation between the degree of irritability and the prevalence of endplate noise.
American journal of physical medicine & rehabilitation, 2007Co-Authors: Ta Shen Kuan, Yueh-ling Hsieh, Shu Min Chen, Jo Tong Chen, Wei Chang Yen, Changzern HongAbstract:Kuan T-S, Hsieh Y-L, Chen S-M, Chen J-T, Yen W-C, Hong C-Z: The Myofascial Trigger Point region: correlation between the degree of irritability and the prevalence of endplate noise. Am J Phys Med Rehabil 2007;86:183‐189. Objective: This study was designed to investigate the correlation between the irritability of the Myofascial Trigger Point (MTrP) and the prevalence of endplate noise (EPN) in the MTrP region of human skeletal muscle. Design: Twenty normal subjects with latent MTrPs and 12 patients with active MTrPs in the upper trapezius muscles were recruited for this study. The patients reported the subjective pain intensity of the active MTrP (0‐10). The MTrP and an adjacent non-MTrP site were confirmed and marked for the measurement of pressure pain threshold (with a pressure algometer) and the prevalence of EPN (with electromyographic recordings). Results: The prevalence of EPN in the MTrP regions was significantly higher (P 0.01) in the active MTrPs than in the latent ones. However, no EPN could be found in the non-MTrP region near either the active or the latent MTrPs. The pain intensity and the pressure pain threshold were highly correlated with the prevalence of EPN in the MTrP region (r 0.742 and 0.716, respectively). Conclusions: The irritability of an MTrP is highly correlated with the prevalence of EPN in the MTrP region of the upper trapezius muscle. The assessment of EPN prevalence in an MTrP region may be applied to evaluate the irritability of that MTrP.
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Dry needling to a key Myofascial Trigger Point may reduce the irritability of satellite MTrPs.
American journal of physical medicine & rehabilitation, 2007Co-Authors: Yueh-ling Hsieh, Ta Shen Kuan, Mu-jung Kao, Shu Min Chen, Jo Tong Chen, Changzern HongAbstract:Hsieh Y-L, Kao M-J, Kuan T-S, Chen S-M, Chen J-T, Hong C-Z: Dry needling to a key Myofascial Trigger Point may reduce the irritability of satellite Myofascial Trigger Points. Am J Phys Med Rehabil 2007;86:397‐403. Objective: To investigate the changes in pressure pain threshold of the secondary (satellite) Myofascial Trigger Points (MTrPs) after dry needling of a primary (key) active MTrP. Design: Single blinded within-subject design, with the same subjects serving as their own controls (randomized). Fourteen patients with bilateral shoulder pain and active MTrPs in bilateral infraspinatus muscles were involved. An MTrP in the infraspinatus muscle on a randomly selected side was dry needled, and the MTrP on the contralateral side was not (control). Shoulder pain intensity, range of motion (ROM) of shoulder internal rotation, and pressure pain threshold of the MTrPs in the infraspinatus, anterior deltoid, and extensor carpi radialis longus muscles were measured in both sides before and immediately after dry needling. Results: Both active and passive ROM of shoulder internal rotation, and the pressure pain threshold of MTrPs on the treated side, were significantly increased (P 0.01), and the pain intensity of the treated shoulder was significantly reduced (P 0.001) after dry needling. However, there were no significant changes in all parameters in the control (untreated) side. Percent changes in the data after needling were also analyzed. For every parameter, the percent change was significantly higher in the treated side than in the control side. Conclusions: This study provides evidence that dry needle‐evoked inactivation of a primary (key) MTrP inhibits the activity in satellite MTrPs situated in its zone of pain referral. This supports the concept that activity in a primary MTrP leads to the development of activity in satellite MTrPs and the suggested spinal cord mechanism responsible for this phenomenon.
Ta Shen Kuan - One of the best experts on this subject based on the ideXlab platform.
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Remote effects of dry needling on the irritability of the Myofascial Trigger Point in the upper trapezius muscle.
American journal of physical medicine & rehabilitation, 2010Co-Authors: Chien Tsung Tsai, Lin Fen Hsieh, Ta Shen Kuan, Mu-jung Kao, Li-wei Chou, Changzern HongAbstract:ABSTRACTTsai C-T, Hsieh L-F, Kuan T-S, Kao MJ, Chou L-W, Hong C-Z: Remote effects of dry needling on the irritability of the Myofascial Trigger Point in the upper trapezius muscle.Objective:To investigate the remote effect of dry needling on the irritability of a Myofascial Trigger Point in the uppe
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The Myofascial Trigger Point region: correlation between the degree of irritability and the prevalence of endplate noise.
American journal of physical medicine & rehabilitation, 2007Co-Authors: Ta Shen Kuan, Yueh-ling Hsieh, Shu Min Chen, Jo Tong Chen, Wei Chang Yen, Changzern HongAbstract:Kuan T-S, Hsieh Y-L, Chen S-M, Chen J-T, Yen W-C, Hong C-Z: The Myofascial Trigger Point region: correlation between the degree of irritability and the prevalence of endplate noise. Am J Phys Med Rehabil 2007;86:183‐189. Objective: This study was designed to investigate the correlation between the irritability of the Myofascial Trigger Point (MTrP) and the prevalence of endplate noise (EPN) in the MTrP region of human skeletal muscle. Design: Twenty normal subjects with latent MTrPs and 12 patients with active MTrPs in the upper trapezius muscles were recruited for this study. The patients reported the subjective pain intensity of the active MTrP (0‐10). The MTrP and an adjacent non-MTrP site were confirmed and marked for the measurement of pressure pain threshold (with a pressure algometer) and the prevalence of EPN (with electromyographic recordings). Results: The prevalence of EPN in the MTrP regions was significantly higher (P 0.01) in the active MTrPs than in the latent ones. However, no EPN could be found in the non-MTrP region near either the active or the latent MTrPs. The pain intensity and the pressure pain threshold were highly correlated with the prevalence of EPN in the MTrP region (r 0.742 and 0.716, respectively). Conclusions: The irritability of an MTrP is highly correlated with the prevalence of EPN in the MTrP region of the upper trapezius muscle. The assessment of EPN prevalence in an MTrP region may be applied to evaluate the irritability of that MTrP.
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Dry needling to a key Myofascial Trigger Point may reduce the irritability of satellite MTrPs.
American journal of physical medicine & rehabilitation, 2007Co-Authors: Yueh-ling Hsieh, Ta Shen Kuan, Mu-jung Kao, Shu Min Chen, Jo Tong Chen, Changzern HongAbstract:Hsieh Y-L, Kao M-J, Kuan T-S, Chen S-M, Chen J-T, Hong C-Z: Dry needling to a key Myofascial Trigger Point may reduce the irritability of satellite Myofascial Trigger Points. Am J Phys Med Rehabil 2007;86:397‐403. Objective: To investigate the changes in pressure pain threshold of the secondary (satellite) Myofascial Trigger Points (MTrPs) after dry needling of a primary (key) active MTrP. Design: Single blinded within-subject design, with the same subjects serving as their own controls (randomized). Fourteen patients with bilateral shoulder pain and active MTrPs in bilateral infraspinatus muscles were involved. An MTrP in the infraspinatus muscle on a randomly selected side was dry needled, and the MTrP on the contralateral side was not (control). Shoulder pain intensity, range of motion (ROM) of shoulder internal rotation, and pressure pain threshold of the MTrPs in the infraspinatus, anterior deltoid, and extensor carpi radialis longus muscles were measured in both sides before and immediately after dry needling. Results: Both active and passive ROM of shoulder internal rotation, and the pressure pain threshold of MTrPs on the treated side, were significantly increased (P 0.01), and the pain intensity of the treated shoulder was significantly reduced (P 0.001) after dry needling. However, there were no significant changes in all parameters in the control (untreated) side. Percent changes in the data after needling were also analyzed. For every parameter, the percent change was significantly higher in the treated side than in the control side. Conclusions: This study provides evidence that dry needle‐evoked inactivation of a primary (key) MTrP inhibits the activity in satellite MTrPs situated in its zone of pain referral. This supports the concept that activity in a primary MTrP leads to the development of activity in satellite MTrPs and the suggested spinal cord mechanism responsible for this phenomenon.
Ángel L. Rodríguez-fernández - One of the best experts on this subject based on the ideXlab platform.
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Postneedling soreness after deep dry needling of a latent Myofascial Trigger Point in the upper trapezius muscle: Characteristics, sex differences and associated factors
Journal of back and musculoskeletal rehabilitation, 2016Co-Authors: Aitor Martín-pintado-zugasti, Ángel L. Rodríguez-fernández, Josué Fernández-carneroAbstract:BACKGROUND: Postneedling soreness is considered the most frequent secondary effect associated to dry needling. A detailed description of postneedling soreness characteristics has not been previously reported. OBJECTIVE: (1) to assess the intensity and duration of postneedling soreness and tenderness after deep dry needling of a trapezius latent Myofascial Trigger Point (MTrP), (2) to evaluate the possible differences in postneedling soreness between sexes and (3) to analyze the influence on postneedling soreness of factors involved in the dry needling process. METHODS:Sixty healthy subjects (30 men, 30 women) with latent MTrPs in the upper trapezius muscle received a dry needling intervention in the MTrP. Pain and pressure pain threshold (PPT) were assessed during a 72 hours follow-up period. RESULTS: Repeated measures analysis of covariance showed a significant effect for time in pain and in PPT. An interaction between sex and time in pain was obtained: women exhibited higher intensity in postneedling pain than men. The pain during needling and the number of needle insertions significantly correlated with postneedling soreness. CONCLUSIONS: Soreness and hyperalgesia are present in all subjects after dry needling of a latent MTrP in the upper trapezius muscle. Women exhibited higher intensity of postneedling soreness than men.
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Ischemic Compression After Dry Needling of a Latent Myofascial Trigger Point Reduces Postneedling Soreness Intensity and Duration.
PM & R : the journal of injury function and rehabilitation, 2015Co-Authors: Aitor Martín-pintado-zugasti, Daniel Pecos-martín, Alicia Portillo-aceituno, Ángel L. Rodríguez-fernández, Isabel M. Alguacil-diego, Tomás Gallego-izquierdo, Josué Fernández-carneroAbstract:Abstract Objective To investigate the effect of ischemic compression (IC) versus placebo and control on reducing postneedling soreness of 1 latent Myofascial Trigger Point and on improving cervical range of motion (CROM) in asymptomatic subjects. Design A randomized, double-blind, placebo-controlled trial with 72-hour follow-up. Setting A university community. Participants Asymptomatic volunteers (N = 90: 40 men and 50 women) aged 18 to 39 years (mean ± standard deviation [SD]: 22 ± 3 years). Intervention All subjects received a dry needling application over the upper trapezius muscle. Participants were then randomly divided into 3 groups: a treatment group who received IC over the needled trapezius muscle, a placebo group who received sham IC, and a control group who did not receive any treatment after needling. Main Outcome Measures Visual analog scale (VAS; during needling, at posttreatment and 6, 12, 24, 48, and 72 hours) and CROM (at preneedling, postneedling, and 24 and 72 hours). Results Subjects in the IC group showed significantly lower postneedling soreness than the placebo and the control group subjects immediately after treatment (mean ± standard deviation [SD]: IC, 20.1 ± 4.8; placebo, 36.7 ± 4.8; control, 34.8 ± 3.6) and at 48 hours (mean ± SD: IC, 0.6 ± 1; placebo, 4.8 ± 1; control, 3.8 ± 0.7). In addition, subjects in the dry needling+IC group showed significantly lower postneedling soreness duration ( P = .026). All subjects significantly improved CROM in contralateral lateroflexion and both homolateral and contralateral rotations, but only the improvements found in the IC group reached the minimal detectable change. Conclusions IC can potentially be added immediately after dry needling of Myofascial Trigger Point in the upper trapezius muscle because it has the effect of reducing postneedling soreness intensity and duration. The combination of dry needling and IC seems to improve CROM in homolateral and contralateral cervical rotation movements.
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Effects of spray and stretch on postneedling soreness and sensitivity after dry needling of a latent Myofascial Trigger Point.
Archives of physical medicine and rehabilitation, 2014Co-Authors: Aitor Martín-pintado Zugasti, Ángel L. Rodríguez-fernández, Francisco García-muro, Almudena López-lópez, Orlando Mayoral, Juan Mesa-jiménez, Josué Fernández-carneroAbstract:Objectives: To investigate (1) the effect of spray and stretch versus control on reducing postneedling soreness of 1 latent Myofascial Trigger Point (MTrP) and (2) whether higher levels of psychological distress are associated with increased postneedling pain intensity. Design: A 72-hour follow-up, single-blind randomized controlled trial. Setting: University community. Participants: Healthy volunteers (NZ70; 40 men, 30 women) aged 18 to 36 years (mean age, 21� 4y) with latent MTrP in 1 upper trapezius muscle. Intervention: Allsubjectsreceivedadryneedlingapplicationovertheuppertrapeziusmuscle.Then,participantswererandomlydividedinto2groups: an interventiongroup, whichreceived spray and stretchover theneedled trapezius muscle,and a controlgroup, which did not receive any intervention. Main Outcome Measures: Visual analog scale (at postneedling, posttreatment, and 6, 12, 24, 48, and 72h after needling), pressure pain threshold (at preneedling, postneedling, and 24 and 48h after needling). Psychological distress was evaluated by using the Symptom Checklist-90-Revised. Results: Repeated-measures analysis of variance demonstrated a significant interaction between group and time (F3,204.8Z3.19; P .05). Repeated measures of covariance showed that none of the psychological covariates affected these results. Somatization, anxiety, interpersonal sensitivity, and hostility were significantly correlate d( P
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Effects of Burst-Type Transcutaneous Electrical Nerve Stimulation on Cervical Range of Motion and Latent Myofascial Trigger Point Pain Sensitivity
Archives of physical medicine and rehabilitation, 2011Co-Authors: Ángel L. Rodríguez-fernández, Víctor Garrido-santofimia, Javier Güeita-rodríguez, César Fernández-de-las-peñasAbstract:Abstract Rodriguez-Fernandez AL, Garrido-Santofimia V, Gueita-Rodriguez J, Fernandez-de-las-Penas C. Effects of burst-type transcutaneous electrical nerve stimulation on cervical range of motion and latent Myofascial Trigger Point pain sensitivity. Objective To assess the effects of a burst application of transcutaneous electrical nerve stimulation (TENS) on cervical range of motion and pressure Point sensitivity of latent Myofascial Trigger Points (MTrPs). Design A single-session, single-blind randomized trial. Setting General community rehabilitation clinic. Participants Individuals (N=76; 45 men, 31 women) aged 18 to 41 years (mean ± SD, 23±4y) with latent MTrPs in 1 upper trapezius muscle. Interventions Subjects were randomly divided into 2 groups: a TENS group that received a burst-type TENS (pulse width, 200μs; frequency, 100Hz; burst frequency, 2Hz) stimulation over the upper trapezius for 10 minutes, and a placebo group that received a sham-TENS application over the upper trapezius also for 10 minutes. Main Outcome Measures Referred pressure pain threshold (RPPT) over the MTrP and cervical range of motion in rotation were assessed before, and 1 and 5 minutes after the intervention by an assessor blinded to subjects' treatment. Results The analysis of covariance revealed a significant group × time interaction ( P 2 ; 95% confidence interval [CI], 0.1–0.4) and at 5 minutes (0.6kg/cm 2 ; 95% CI, 0.3–0.8) after treatment. A significant group × time interaction ( P =.01) was also found for cervical rotation in favor of the TENS group. Between-group differences were also small at 1 minute (2.0°; 95% CI, 1.0–2.8) and at 5 minutes (2.7°; 95% CI, 1.7–3.8) after treatment. Conclusions A 10-minute application of burst-type TENS increases in a small but statistically significant manner the RPPT over upper trapezius latent MTrPs and the ipsilateral cervical range of motion.
