The immediate effects of deep transverse friction massage, high- power pain threshold ultrasound and whole body vibration on active myofascial trigger points.

BACKGROUND: The most important clinical problem in myofascial pain syndrome (MPS) is trigger points (TrPs). The aim of the present study was to investigate the comparison of immediate effect of deep transverse friction massage (DTFM), high-power pain threshold ultrasound (HPPTUS), and whole body vibration (WBV) on treatment of active myofascial trigger points (MTrPs). MATERIALS AND METHODS: sixty six men with active TrPs of upper trapezius muscle were randomly divided into three equal groups: DTFM, HPPT US, and WBV. Pain intensity based on the Visual Analogue Scale (VAS), pressure pain threshold (PPT) and active contralateral lateral flexion range of motion (CLF ROM) of the neck were evaluated before and immediately after the interventions. RESULTS: The VAS, PPT and the active CLF ROM were substantially improved after intervention in all groups (P < 0.01). When the three groups were compared regarding VAS, participants in the WBV group reported significantly more reduction in pain (P < 0.01). On comparing the interventions, there were no significant differences in PPT values (P > 0.05). The CLF ROM value in HPPTUS and WBV groups have significant increase in comparison to the DTFM group. CONCLUSION: All three interventions can improve neck pain, PPT and ROM in participants with active TrPs in upper trapezius muscle, but due to the fact that the DTFM has more pressure on therapist fingers, and the HPPTUS technique requires proper interaction with the participants, WBV can be used as one of the effective intervention on active MTrPs of upper trapezius. CLINICAL TRIAL REGISTRATION NUMBER: IRCT20200518047498N1.

Effects of dry needling and stretching exercise versus stretching exercise only on pain intensity, function, and sonographic characteristics of plantar fascia in the subjects with plantar fasciitis: a parallel single-blinded randomized controlled trial.

OBJECTIVES: Plantar fasciitis is a common problem in the foot region which has negative considerable impact on foot function. METHODS: In this parallel blinded randomized controlled trial, a total of thirty-seven subjects with plantar fasciitis (forty feet) were enrolled randomly to either the control group (stretching exercise) or the experimental group (stretching exercise plus dry needling). All interventions lasted six weeks and both groups were followed for two weeks. Primary outcomes were first step pain, pain, and activity daily function subscales of the FAOS questionnaire and secondary outcomes were plantar fascia thickness, and echogenicity. RESULTS: The mixed model ANOVAs showed significant group × time interactions for all primary outcomes. In both groups, first step pain and both subscales of the FAOS questionnaire were improved compared to baseline measurements. There were considerable differences between the two groups and the experimental group experienced more improvements in primary outcomes compared to the control group. For secondary outcomes, plantar fascia thickness at insertion significantly decreased, and the echogenicity in the two regions significantly increased in the experimental group compared to the control group. CONCLUSION: These results suggest that the combination of dry needling and stretching exercises can be an effective conservative treatment for plantar fasciitis subjects.

The role of scapular kinematics in patients with different shoulder musculoskeletal disorders: A systematic review approach.

This study aimed to identify the role of the scapula in shoulder musculoskeletal disorders (SMDs) and provided a systematic review of available studies in the field of scapular three-dimensional kinematics. We systematically searched 5 international databases, including Scopus, EMBASE, PubMed, CINAHL, PEDro, and Cochrane Library from June to September 2015. Twenty studies met the inclusion criteria and were retrieved in full paper. The selected studies were critically appraised independently by two researchers. The patients with shoulder impingement syndrome (SIS) and shoulder instability had an increased protraction, lesser upward rotation (UR), and increased internal rotation (IR) during scapular plane elevation, whereas the patients with frozen shoulders had lesser protraction. Moreover, the patients with SIS had a greater scapular posterior tilt (PT) and external rotation during shoulder abduction. Increased scapular UR and PT with decreased scapular IR was seen in patients with stiffness of Latissimus Dorsi and fibromyalgia without any changes in the scapular IR. The results of this systematic review help the clinicians to have an insight about scapular kinematics as a predictive index for SMDs.