Quantitative Ultrasound Assessment of Myofascial Pain Syndrome Affecting the Trapezius: A Reliability Study

Kumbhare, Dinesh; Shaw, Saurabh Bhaskar; Grosman‐Rimon, Liza; Noseworthy, Michael D.

doi:10.1002/jum.14308

Cited by 19 publications

(31 citation statements)

References 35 publications

(85 reference statements)

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“…The trapezius muscle was chosen for study since it is a common site for MTrPs, given the high load cervical muscles carry as well as the general increase sedentariness that perpetuates poor posture and cervical muscle strain, leading to trigger point presentation. Furthermore, the trapezius muscle has been used frequently in previously published work, which analyze motor unit parameters, power spectrum, and amplitude measurements [ 2 , 38 , 39 ].…”

Section: Methods and Designmentioning

confidence: 99%

Quantitative response of healthy muscle following the induction of capsaicin: an exploratory randomized controlled trial

Evans

Behr

Masani

et al. 2020

Trials

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Background Myofascial pain syndrome (MPS) is a prevalent chronic pain disorder primarily characterized by myofascial trigger points (MTrPs). There is limited knowledge on the pathophysiology and mechanisms underlying MTrP and its development. Research has previously demonstrated the identification of MTrPs using ultrasound and vibration sonoelastography, although there is some contradictory evidence regarding if MTrPs present as hyper or hypoechoic regions. Electromyography (EMG) investigations of MTrP have demonstrated that MTrPs are usually located proximal to innervation zones where the peak surface EMG signals are obtained from. Central sensitization has been proposed as the primary mechanism underlying MTrP development. Central sensitization is associated with hyperexcitability of neuronal responses to normal or noxious stimuli. There is a need for a study that measures ultrasound image textural changes and motor unit activity responses in the muscle following sensitization. The purpose of this study is to determine whether sensitizing healthy muscle using capsaicin induces a regional change in image texture variables within the specific and surrounding muscles, as well as the motor unit frequency and amplitude changes that accompany them. This is an exploratory trial that aims to provide preliminary evidence on whether central sensitization is a direct cause of taut band and MTrP development. Methods Ethical approval was obtained from the University Health Network (UHN) Research Ethics Board. This proposed study is a single centered, factorial, randomized placebo-controlled trial with two independent variables, depth of capsaicin application and dose of capsaicin, for a total of six treatment arms and three control treatment groups. Discussion This will be the first study that assesses the B-mode ultrasound image texture of induced sensitized muscles and will provide more evidence on muscle motor unit activity and regional changes of central sensitization. Findings from this study may support one of few hypotheses proposed delineating the involvement of central sensitization in the development of trigger points. Trial registration National Institutes of Health ClinicalTrials.gov NCT03944889. Registered on May 07, 2019

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Section: Methods and Designmentioning

confidence: 99%

Quantitative response of healthy muscle following the induction of capsaicin: an exploratory randomized controlled trial

Evans

Behr

Masani

et al. 2020

Trials

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“…Meet criteria for MTrP detection as agreed upon in the literature (Kumbhare et al, 2017; Rivers et al, 2015).…”

Section: Methodsmentioning

confidence: 99%

Effect of aerobic exercise in the treatment of myofascial pain: a systematic review

et al. 2018

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Myofascial pain is prevalent chronic pain disorder that is comorbid with many conditions. Strengthening and stretching exercises are capable of inducing hypoalgesic effects in people with myofascial pain syndrome. The goal of this systematic review was to summarize the effects of aerobic exercise on the management of myofascial pain. A comprehensive database search was conducted. A total of 1,331 articles were identified for review. One article was eligible for inclusion after full screening. Risk of bias was assessed using the Downs and Black quality assessment questionnaire (1998). Mean difference scores were calculated for continuous variables. The identified study had a low risk of bias. It was a randomized controlled trial assessing the influence of an 8-week water aerobic exercise program on myofascial pain in breast cancer patients. Visual analogue scale pain intensity ratings and the number of myofascial trigger points present in the neck and shoulder/axillary area of participants significantly decreased in the exercise group compared to those in the control group. Pain pressure thresholds significantly increased in muscle areas of the cervical spine in the water exercise group. Aerobic exercise presents a potential treatment modality for managing myofascial pain. Additional research is necessary.

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“…Furthermore, the trapezius muscle has been used frequently in previously published work, which analyze motor unit parameters, power spectrum and amplitude measurements. [31,32,33] sEMG Analysis After the identification for electrode placement and the captured baseline ultrasonic images, the area will be cleaned with alcohol and water. The Delsys Galelio sensor will be placed directly on the identified area.…”

Section: Measurement Of Motor Unit Activity Using Emgmentioning

confidence: 99%

Quantitative Response of Healthy Muscle Following the Induction of Capsaicin: An Exploratory Randomized Controlled Trial

Evans

Behr

Masani

et al. 2019

Preprint

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Background: Myofascial pain syndrome (MPS) is a prevalent chronic pain disorder primarily characterized by myofascial trigger points (MTrP). There is limited knowledge on the pathophysiology and mechanisms underlying MTrP and its development. Research has previously demonstrated the identification of MTrPs using ultrasound and vibration sonoelastography, although there is some contradictory evidence regarding if MTrPs present as hyper or hypoechoic regions. Electromyography (EMG) investigations of MTrP have demonstrated that MTrP are usually located proximal to innervation zones where the peak surface EMG signals are obtained from. Central sensitization has been proposed as the primary mechanism underlying MTrP development. Central sensitization is associated with hyperexcitability of neuronal responses to normal or noxious stimuli. There is a need for a study that measures ultrasound image textural changes and motor unit activity responses in the muscle following sensitization. The purpose of this study is to determine whether sensitizing healthy muscle using capsaicin induces a regional change in image texture variables within the specific and surrounding muscles, as well as the motor unit frequency and amplitude changes that accompany them.This is an exploratory trial that aims to provide preliminary evidence on whether central sensitization is a direct cause of taut band and MTrP development. Methods: The study conforms to the Consolidated Standards of Reporting Trials recommendations. Ethical approval will be sought from the University Health Network (UHN) Research Ethics Board. This proposed study is a single centered, factorial, randomized placebo-controlled trial with two independent variables, depth of capsaicin application and dose of capsaicin, for a total of four treatment arms and two control treatment groups. Discussion: This will be the first study that assesses the B-mode ultrasound image texture of induced sensitized muscles, and will provide more evidence on muscle motor unit activity and regional changes of central sensitization. Findings from this study may support one of few hypotheses proposed delineating the involvement of central sensitization in the development of trigger points.

show abstract

Quantitative Ultrasound Assessment of Myofascial Pain Syndrome Affecting the Trapezius: A Reliability Study

Cited by 19 publications

References 35 publications

Quantitative response of healthy muscle following the induction of capsaicin: an exploratory randomized controlled trial

Quantitative response of healthy muscle following the induction of capsaicin: an exploratory randomized controlled trial

Effect of aerobic exercise in the treatment of myofascial pain: a systematic review

Quantitative Response of Healthy Muscle Following the Induction of Capsaicin: An Exploratory Randomized Controlled Trial

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