Additional Effect of Static Ultrasound and Diadynamic Currents on Myofascial Trigger Points in a Manual Therapy Program for Patients With Chronic Neck Pain: A Randomized Clinical Trial.

OBJECTIVE: To assess the additional effect of static ultrasound and diadynamic currents on myofascial trigger points in a manual therapy program to treat individuals with chronic neck pain. DESIGN: A single-blind randomized trial was conducted. Both men and women, between ages 18 and 45, with chronic neck pain and active myofascial trigger points in the upper trapezius were included in the study. Subjects were assigned to 3 different groups: group 1 (n = 20) was treated with manual therapy; group 2 (n = 20) was treated with manual therapy and static ultrasound; group 3 (n = 20) was treated with manual therapy and diadynamic currents. Individuals were assessed before the first treatment session, 48 hours after the first treatment session, 48 hours after the tenth treatment session, and 4 weeks after the last session. RESULTS: There was no group-versus-time interaction for Numeric Rating Scale, Neck Disability Index, Pain-Related Self-Statement Scale, pressure pain threshold, cervical range of motion, and skin temperature (F-value range, 0.089-1.961; P-value range, 0.106-0.977). Moreover, we found no differences between groups regarding electromyographic activity (P > 0.05). CONCLUSION: The use of static ultrasound or diadynamic currents on myofascial trigger points in upper trapezius associated with a manual therapy program did not generate greater benefits than manual therapy alone.

Reliability of different methodologies of infrared image analysis of myofascial trigger points in the upper trapezius muscle.

BACKGROUND: Infrared thermography is recognized as a viable method for evaluation of subjects with myofascial pain. OBJECTIVE: The aim of the present study was to assess the intra- and inter-rater reliability of infrared image analysis of myofascial trigger points in the upper trapezius muscle. METHOD: A reliability study was conducted with 24 volunteers of both genders (23 females) between 18 and 30 years of age (22.12 ± 2.54), all having cervical pain and presence of active myofascial trigger point in the upper trapezius muscle. Two trained examiners performed analysis of point, line, and area of the infrared images at two different periods with a 1-week interval. The intra-class correlation coefficient (ICC(2,1)) was used to assess the intra- and inter-rater reliability. RESULTS: With regard to the intra-rater reliability, ICC values were between 0.591 and 0.993, with temperatures between 0.13 and 1.57 °C for values of standard error of measurement (SEM) and between 0.36 and 4.35 °C for the minimal detectable change (MDC). For the inter-rater reliability, ICC ranged from 0.615 to 0.918, with temperatures between 0.43 and 1.22 °C for the SEM and between 1.19 and 3.38 °C for the MDC. CONCLUSION: The methods of infrared image analyses of myofascial trigger points in the upper trapezius muscle employed in the present study are suitable for clinical and research practices.

Reliability of different methodologies of infrared image analysis of myofascial trigger points in the upper trapezius muscle

BACKGROUND: Infrared thermography is recognized as a viable method for evaluation of subjects with myofascial pain. OBJECTIVE: The aim of the present study was to assess the intra- and inter-rater reliability of infrared image analysis of myofascial trigger points in the upper trapezius muscle. METHOD: A reliability study was conducted with 24 volunteers of both genders (23 females) between 18 and 30 years of age (22.12±2.54), all having cervical pain and presence of active myofascial trigger point in the upper trapezius muscle. Two trained examiners performed analysis of point, line, and area of the infrared images at two different periods with a 1-week interval. The intra-class correlation coefficient (ICC2,1) was used to assess the intra- and inter-rater reliability. RESULTS: With regard to the intra-rater reliability, ICC values were between 0.591 and 0.993, with temperatures between 0.13 and 1.57 °C for values of standard error of measurement (SEM) and between 0.36 and 4.35 °C for the minimal detectable change (MDC). For the inter-rater reliability, ICC ranged from 0.615 to 0.918, with temperatures between 0.43 and 1.22 °C for the SEM and between 1.19 and 3.38 °C for the MDC. CONCLUSION: The methods of infrared image analyses of myofascial trigger points in the upper trapezius muscle employed in the present study are suitable for clinical and research practices. .

Evaluation of myofascial trigger points using infrared thermography: a critical review of the literature.

OBJECTIVE: The aim of this study was to review recent studies published on the use of infrared thermography for the assessment of myofascial trigger points (MTrPs). METHODS: A search of the MEDLINE, CINAHL, PEDro, and SciELO databases was carried out between November 2012 and January 2013 for articles published in English, Portuguese, or Spanish from the year 2000 to 2012. Because of the nature of the included studies and the purpose of this review, the analysis of methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. RESULTS: The search retrieved 11 articles, 2 of which were excluded based on language (German and Chinese). Three were duplicated in different databases, 1 did not use infrared thermography for diagnostic purposes, and the other did not use infrared thermography to measure the skin temperature. Thus, the final sample was made up of 4 observational investigations: 3 comparative studies and 1 accuracy study. CONCLUSION: At present, there are few studies evaluating the accuracy and reliability of infrared thermography for the diagnosis and assessment of MTrPs. Of the few studies present, there is no agreement on skin temperature patterns in the presence of MTrPs.

Effects of physical activity programmes in the workplace (PAPW) on the perception and intensity of musculoskeletal pain experienced by garment workers.

OBJECTIVE: The physical activity programmes in the workplace (PAPW) are applied to minimize the prevalence, incidence and intensity of pain. This study evaluated the perception of pain and quantifies its intensity among garment workers before and after performing a PAPW. PARTICIPANTS: We included 61 workers of a clothing company, who were classified randomly into experimental group (n = 44) 28.7 ± 8.8 years old and a control group (n = 17) 27.8 ± 7.4 years (20-43 years). METHODS: The Trigger Points test questionnaire was used to assess pain perception and quantify its intensity. The PAPW was conducted in 15-minute sessions per day, consisting of stretching exercises (40%), muscular endurance (40%), self-massage relaxation and massage techniques (10%), and group dynamics (10%). RESULTS: The garment workers who participated in the PAPW showed a significant reduction of pain felt in the neck and wrists, and also a reduction in pain intensity in shoulders, arms, fingers and wrists that are most often strained during sewing. CONCLUSIONS: Our findings suggest that PAPW that target muscle groups that are more tense in sewing tasks, may be considered by companies for supporting adaptation to the work environment and improving health by reducing muscle and joint pain.