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Based on the modern anatomy and physiology, the referred pain of myofascial trigger points of each muscle is integrated; compared with the twelve meridians as well as conception vessel and governor vessel, the similarity of their position and running course is observed. With the current research progress of myofascial trigger points and fasciology, based on the running course of referred pain of trigger points, combined with fascia mechanics, nerve and vascular, the location of acupoints and meridians, as well as the relationship between acupoints and meridians, are discussed.
Assuntos
Humanos , Pontos de Acupuntura , Meridianos , Músculos , Dor Referida , Pontos-GatilhoRESUMO
<p><b>OBJECTIVE</b>To study clinical treatment effects of inactivating myofascial trigger points with needling and muscle stretching for the treatment of knee osteoarthritis(OA).</p><p><b>METHODS</b>Retrospective analyses were made to investigate the clinical data of pain clinic outpatient in our hospital from 2010 to 2014, and 108 patients with knee OA, including 35 males and 73 females, were treated with acupuncturing of myofascial trigger points and stretching of muscles and structure around knee. The puncturing of trigger points, and the back and forth movement of needle were required to elicit local twitch response of muscle. After acupuncture treatment, muscle stretch around the knee joint was performed by a therapist. All patients must do homework of self stretching exercise. The extent of stretching should be to gradually increased under a tolerable pain. The ROM and walking pain VAS scores were measured before and after whole therapy and were statistically analyzed during 1 year of follow up.</p><p><b>RESULTS</b>All the patients were followed up, and 95 patients had no pain after 1 year. The VAS scores were improved from preoperative severe 7.6±0.5, moderate 4.9±0.7, to mild 1.9±0.6 and painless 0.3±0.2.</p><p><b>CONCLUSIONS</b>The walking pain of knee OA might be alleviated by the acupuncture and stretch to inactivate the myofascial trigger point.</p>
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Objective To observe electromyography (EMG) activity and kinematic characteristics of the dorsal and ventral muscles during extension-flexion of the trunk. Methods Ten healthy male subjects stood on a test platform, performing the front and back lifting and lowering. The EMG activity of 10 muscles (rectus abdominus, external oblique, gluteus medius, erector spinae, multifidus), the angular movement, the plantar center of pressure (COP) were recorded at the same time. The average amplitude of EMG, contribution ratio of muscles, and COP displacement were calculated, and statistical analyses of all the data were conducted. Results During front lifting and lowering, the activity of dorsal muscles was greater than that of ventral muscles under both loading and unloading, and the contribution ratio of dorsal muscles was increasing with loading. During back lifting and lowering, the activity of ventral muscles was slightly greater, but the contribution ratio of both dorsal and ventral muscles was very close. The contribution ratio of ventral muscles was increasing with loading, while the activity of dorsal muscles decreased. The activity of gluteus medius was increasing with loading, but the contribution ratio was basically consistent under both loading and unloading. Conclusions During extension-flexion of the trunk, muscle activation varies with the load size and trunk position. Under loading at front, dorsal muscles are working as an agonist, while ventral muscles as antagonist; under loading at back, ventral muscles become an agonist and dorsal muscles as a co-activator. The activity of gluteus medius might play a role of stabilization during front and back lifting and lowering.
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Objective To analyze how the athletes control postural balance through observing their joint angular motion change,center of pressure (COP) change and EMG activities of lower extremities for both athletes and beginners when performing the movement of white crane spreads its wings in Tai Chi Quan. Methods Twenty subjects were divided into 2 groups as 10 athletes and 10 beginners of Tai Chi Quan in each. When performing the movement of white crane spreads its wings, their EMG activities of 10 skeletal muscles, two-dimensional angular motion of 3 large joints in bilateral lower extremities, and COP displacements in lateral and anterior-posterior directions were recorded. Each performing trial took 8 seconds and repeated 5 times. All data were statistically processed for EMG, motion and balance analysis, and the EMG data were normalized to compare the differences between the athletes and beginners of Tai Chi Quan. Results The EMG activities of tibialis anterior(Ta), biceps femur(bF), gluteus medium(Gm) in support leg of athletes were significantly greater than those of the ipsilateral muscles in support leg of beginners, and the same was the EMG activities of gastrocnemius (G) and rectus femur(rF) in virtual leg of athletes compared with the beginners. The maximal average angular motion of 3 large joints and the coxa -joint motion of support leg in athletes were both significantly greater than that in beginners, but the anterior-posterior COP displacement in athletes was significantly smaller than that in beginners. Conclusions When performing the movement of white crane spreads its wings in Tai Chi Quan, athletes could oppose the COP change by enhancing muscle activities to maintain the postural balance, while beginners couldn’t make such active muscle activities against the uncontrolled anterior-posterior COP displacement. This may preliminarily explain the reason why Tai Chi Quan exercise can improve the muscle strength in lower extremities and enhance the ability of postural control.
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Objective To observe the electromyography (EMG) activities and kinematic characteristics of the back, abdomen and hip muscles under the static symmetric loading and unloading with the flexion and extension posture. Methods Six healthy male subjects stood on a specially designed testing platform, doing flexion/extension under symmetric loading and unloading, respectively. Each trial lasted 4 seconds and was repeated 3 times. The EMG activities of 10 muscles(rectus abdominis,obliquus externus abdominis,erector spinae,multifidus,gluteus Medius), the 3D angular movement, the plantar COP (center of pressure) were recorded during the trial.The normalized EMG, trunk angle and COP displacement were calculated, and statistical analyses of all data were made. Results Muscle activities of the back were greater (10.47~16.94) with flexion both under loading and unloading. Muscle activities of the abdomen were greater with extension under unloading, and those of the back (3.70~17.95) and hip (6.64~11.52) were increasing under loading, with muscle activities of the abdomen decreasing (10.66~4.18). The flashing trunk numbers was increased with the increase of loading, especially 1.55-time increase in the trunk angle. The COP displacement in anterior posterior direction was shifted greater than that in lateral direction, and this shift was more during flexion (14.60) than that during extension (7.65).Conclusions Extension increases the activities of back muscles, especially for multifidus, and it also increases the torso angular displacement and flashing trunk numbers, especially under loading.