The effectiveness of manual versus algometer pressure release techniques for treating active myofascial trigger points of the upper trapezius

Taleb, Walaa Abu; Youssef, Aliaa Rehan; Saleh, Amir

doi:10.1016/j.jbmt.2016.02.008

Cited by 24 publications

(22 citation statements)

References 30 publications

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“…In this study there were no significant changes in the PPT following the sham treatment in the control group, whereas there was a significant decrease in the group that received the manual PR technique, which led the authors to conclude that the reduction in tenderness was due to a change in tissue sensitivity, rather than an unintentional reduction of pressure by the examiner. Similar results were found by Taleb et al [13], who compared manual pressure…”

Section: Discussionsupporting

confidence: 90%

Is Instrumental Compression Equally Effective and Comfortable for Physiotherapists and Physiotherapy Students than Manual Compression? A Comparative Cross-Sectional Study

Pérez-Palomares

Sánchez

Serrano-Herrero

et al. 2021

IJERPH

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The objective of this work is to compare the homogeneity of instrumental and manual compression during the simulation of a pressure release technique, measured with a dynamometer, as well as to evaluate the comparative degree of comfort by physiotherapists and physiotherapy students when performing this technique. Methods: A comparative cross-sectional study was carried out with physiotherapists (lecturers with clinical experience) and 4th year students of the Physiotherapy Degree at Universidad San Jorge. The amount of pressure performed and how it was maintained during 80 s with both techniques was analysed using a digital dynamometer. The degree of comfort was evaluated using a modified numeric rating scale, with higher values representing a higher degree of discomfort. Results: A total of 30 subjects participated. Significant differences were found between the techniques in terms of maintaining a constant pressure level for 80 s (p = 0.043). A statistically significant difference was found between both techniques in the period from 45 to 80 s. Regarding the degree of discomfort, the value obtained from the students’ responses was 4.67 (1.35) for the manual technique and 1.93 (0.88) for the instrumental technique. In the case of physiotherapists, the comfort was 4.87 (2.13) for the manual technique and 3.33 (1.54) for the instrumental technique. Conclusion: The sustained manual compression necessary in manual pressure release techniques in the treatment of myofascial trigger points can be performed with assistive tools that guarantee a uniform compression maintained throughout the development of the technique and are more comfortable for physiotherapists.

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Section: Discussionsupporting

confidence: 90%

Is Instrumental Compression Equally Effective and Comfortable for Physiotherapists and Physiotherapy Students than Manual Compression? A Comparative Cross-Sectional Study

Pérez-Palomares

Sánchez

Serrano-Herrero

et al. 2021

IJERPH

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“…Massage techniques are direct interventions in which, allegedly, plastic deformation of the tissue causes elongation and restoration of optimal sarcomere length, as well as reactive hyperaemia and cessation of the release of noxious substances. 37,43 In addition, because of the stimulation of mechanoreceptors, there could be a simultaneous activation of nociceptive impulses in the dorsal horn of the spinal cord, which could play a role in the descending pain modulation. 26 Finally, stretch interventions are aimed at lengthening the muscle to its full range of movement.…”

Section: Discussionmentioning

confidence: 99%

Comparative Effectiveness of Manual Therapy Interventions on Pain and Pressure Pain Threshold in Patients With Myofascial Trigger Points

Pavon

Redondo

Vizcaíno

et al. 2022

The Clinical Journal of Pain

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Objectives: Myofascial trigger points (MTPs) are one of the most important causes of musculoskeletal pain. Evidence has suggested a positive effect of manual therapy in the treatment of MTPs. However, a comprehensive review comparing the effect of different manual therapy techniques are lacking. Thus, we conducted a network meta-analysis of randomized controlled trials to determine the type of manual therapy technique that has the greatest positive influence in patients with MTPs.Materials and Methods: PubMed, Web of Science, Cochrane Library, and Scopus databases were searched to identify direct and indirect evidence comparing the effectiveness of different types of manual therapy interventions on pain intensity and pressure pain threshold (PPT) in patients with MTPs. Risk of bias was assessed using the Cochrane RoB2 tool. A pairwise meta-analysis for direct and indirect comparisons between intervention and control/nonintervention groups was carried out.Results: A total of 37 studies were eligible for analysis. Combined interventions had the highest effect size for pain (−1.40; 95% CI, −2.34, −0.47), and the highest probability to be the best intervention and the highest Surface Under the Cumulative Ranking (64.7% and 87.9%, respectively). Afferent reduction techniques, understood as the interventions aimed to restore muscle spindles helping to dictate sarcomere length and tone in MTPs, had the highest effect size for PPT (0.93; 95% CI, 0.47, 1.39), and the highest probability to be the best intervention and the highest Surface Under the Cumulative Ranking (34.7% and 71.2%, respectively). The results were consistent in sensitivity analyses, with minimal inconsistencies between direct and indirect results.Discussion: Manual therapy interventions should be considered an effective strategy for pain and PPT in patients with MTPs. The results suggest that among the different manual therapy modalities, combined and afferent reduction techniques are the most effective for pain and PPT, respectively.

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“…The variance was expressed with 95% confidence intervals (95% CI). As our interest was understanding the treatment effect against a placebo control, the PPT values derived from different intervention arms of the same RCT study [ 32 , 33 , 34 ] were merged using well-established methods [ 35 ]. A global PPT value for active and latent TrPs was obtained by calculating the weighted mean and SD using the values reported in individual studies.…”

Section: Methodsmentioning

confidence: 99%

Pressure Pain Threshold of the Upper Trapezius Trigger Point: A Systematic Review with Meta-Analysis of Baseline Values and Their Modification after Physical Therapy

Geri¹,

Botticchio

Rossettini

et al. 2022

JCM

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Background: Myofascial trigger points (TrP) are diagnosed upon the presence of clinical signs among which hypersensitivity is considered one of the most important. The detection of the pressure pain threshold (PPT) is used to quantify the degree of hypersensitivity. However, there is a lack of normative data about how hypersensitive a TrP is. Therefore, the objective was to quantify the PPT for myofascial TrP in the upper trapezius muscle and its modification after manual or instrumental physical therapy interventions. Methods: A systematic review and meta-analysis were conducted among three databases (MEDLINE, Cochrane Library, and PEDro). Two independent reviewers conducted the electronic search and assessed the methodological quality of the included studies. Results: Eleven studies with a high-risk bias indicated that the PPT at TrP sites was 105.11 kPa lower (95% CI: −148.93; −61.28) at active TrP sites (Chi-squared = 1.07, df = 1 (p = 0.30), I2 = 7%) compared to the PPT of the upper trapezius muscles of healthy subjects. In addition, the PPT of TrP was also lower than the reference values coming from the pain-free population. Moreover, the PPT increased after both manual and instrumental treatment by 28.36 kPa (95% CI: 10.75; 45.96) and 75.49 kPa (95% CI: 18.02; 132.95), respectively. Conclusions: The results of the present study show that TrP has a decreased PPT when compared to healthy muscles and that physical therapy may increase the PPT. However, the clinical relevance of this decreased PPT needs to be further elucidated. Further, the high risk of bias in all the retrieved studies undermines the validity of the results.

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The effectiveness of manual versus algometer pressure release techniques for treating active myofascial trigger points of the upper trapezius

Cited by 24 publications

References 30 publications

Is Instrumental Compression Equally Effective and Comfortable for Physiotherapists and Physiotherapy Students than Manual Compression? A Comparative Cross-Sectional Study

Is Instrumental Compression Equally Effective and Comfortable for Physiotherapists and Physiotherapy Students than Manual Compression? A Comparative Cross-Sectional Study

Comparative Effectiveness of Manual Therapy Interventions on Pain and Pressure Pain Threshold in Patients With Myofascial Trigger Points

Pressure Pain Threshold of the Upper Trapezius Trigger Point: A Systematic Review with Meta-Analysis of Baseline Values and Their Modification after Physical Therapy

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