Effect of high-power pain threshold ultrasound versus extracorporeal shock wave on upper trapezius myofascial trigger points.

Abstract

The aim of the study is to investigate effect of high-power pain threshold ultrasound versus extracorporeal shock wave on myofascial trigger points. Methods: this randomized single blinded controlled trial included a sample of 60 subjects (age 20 to 26) years old with upper trapezius myofascial trigger points. Subjects randomly allocated into 3 groups; Extracorporeal shock wave (ESWT) group (n=20) which received low level energy ESWT plus neck stretching, strengthening exercise, High Power Pain threshold Ultrasound (HPPT) group (n=20) received high power-pain threshold ultrasound with intensity range from 0.5 to 2 Watt/cm² plus neck stretching, strengthening exercise and control group (n=20) received neck stretching, strengthening exercise, Arabic Neck Disability Index and Pressure algometer was used to measure neck functional disability (ANDI) and Pressure pain threshold (PPT). Results: within group study showed statistically significant improvement in ANDI and PPT in both ESWT group and HPPT group as p value was (P<0.0001), While between group analysis comparison demonstrated a statistically significant improvement in ESWT group compared to the HPPT group regarding the value of NDI and PPT (P<0.000). Conclusion: in young adult with upper trapezius myofascial trigger points, ESWT plus exercise produce better improvement in ANDI and PPT compared to HPPT Ultrasound.

Efficacy of Extracorporeal Shockwave Therapy on Pain and Function in Myofascial Pain Syndrome

“…The assessed outcome variables were as follows: (1) pain reported on a VAS or Numeric Pain Rating Scale in all studies, except in four trials 19,27,28,31 (2) the PPT, which was measured in 19 trials; and (3), and functionality (18 trials). The secondary variables were the quality of life, measured with the SF-36 in three studies, 17,21,34 and the ROM, measured in five studies 18,24,31,33,34 …”

“…In terms of the treated area, 22 studies were carried out on patients with cervical and shoulder complaints, three studies were conducted on the leg/foot region, 25,27,28 and two trials were conducted on the lumbar spine region. 22,30 On the duration of pain, eight studies reported no data on this variable, 19,20,23,28,32,33,38 five studies reported between zero days and 3 mos of pain duration, 18,24,29,33,34 and 14 studies reported that their sample had a duration of pain longer than 3 mos.…”

“…The secondary variables were the quality of life, measured with the SF-36 in three studies, 17,21,34 and the ROM, measured in five studies. 18,24,31,33,34 The follow-up periods differed among the studies. An immediate postintervention assessment was conducted in all the trials except that of Moghtaderi et al 40 at 3-9 wks after the intervention in four studies 17,25,29,30,39 and after 10-24 wks in 10 trials.…”

“…The characteristics of the included studies are shown in Supplementary Appendix 2 (Supplemental Digital Content 3, http://links.lww.com/PHM/C68). Of the 27 RCTs included, 12 compared ESWT against a control ESWT, [17][18][19][20][21][22][23][24][25][26][27][28] and 18 compared ESWT, [17][18][19][20][21][22]26,[29][30][31][32][33][34][35][36][37][38][39] with other interventions. Most of the trials included two arms, except for six trials, which were three-armed studies.…”

“…The protocols and parameters for the application of ESWT were heterogeneous. Eighteen studies used radial ESWT, [17][18][19][20][21]26,[28][29][30][31][33][34][35][36][37][38][39] with a dose range of 1.2 to 4 bar or 0.056 to 0.2 mJ/mm 2 ; the number of pulses applied to the TPs ranged between 300 and 1500, and the frequency ranged from 1 to 20 Hz. On the other hand, nine trials used focused ESWT, 19,[22][23][24][25]27,[32][33][34] with a dose range of 0.056 to 0.26 mJ/mm 2 ; the number of pulses applied to the TPs ranged between 400 and 700, and the frequency ranged from 1 to 10 Hz.…”