Myotonometry as a measure to detect myofascial trigger points: an inter-rater reliability study.

OBJECTIVE: Several diagnostic methods have been used in the identification of mechanical properties of skeletal muscle, including myofascial trigger points (MTrPs), however, they are not suitable for daily clinical use. Myotonometry offers an easy noninvasive alternative to assess these muscle properties. Nevertheless, previous research has not yet studied the mechanical properties of MTrPs by myotonometry. The purposes of this study were (1) to analyze the differences in the mechanical properties between latent MTrPs and their taut bands by myotonometry, (2) to investigate the inter-rater reproducibility of myotonometric measurements, and (3) to examine the association between myotonometry and passive isokinetic dynamometry. APPROACH: Fifty individuals (58% male; age 24.6 ± 7.9 years) with a latent medial MTrP of the right soleus muscle participated. The mechanical properties of this MTrP area of soleus muscle and its taut band area were measured using a myotonometer (MyotonPRO). Additionally, passive resistive torque and extensibility of triceps surae muscle were assessed using a Kin-Com dynamometer. MAIN RESULTS: Statistical analysis indicated higher values for the stiffness parameter in the taut band with respect to the MTrP (P < 0.05). The inter-rater reliability of the myotonometric measurements was good for all variables (ICC3,1 > 0.75). The standard error of measurement (SEM) and minimal detectable difference (MDD) indicated a small measurement error for frequency and stiffness variables (SEM% < 10%; MDD95% < 20%). Significant fair correlations between myotonometric parameters and passive isokinetic parameters ranged from -0.29 to 0.48 (P < 0.05). SIGNIFICANCE: The myotonometer was demonstrated to be a reliable tool and was able to quantify differences in the mechanical properties of myofascial tissues. The potential of this method for the assessment of myofascial pain syndromes requires further investigation.

Fisioterapia conservadora del síndrome de dolor miofascial / Conservative physical therapy in myofascial pain syndrome

Se describe brevemente la estrategia terapéutica el síndrome de dolor miofascial y se pasan revista a la mayoría de las técnicas de tratamiento conservador de los puntos gatillo miofasciales, las cuales se clasifican en manuales e instrumentales. Se concluye la necesidad de una mayor investigación de calidad en este terreno para disponer de un mayor nivel de evidencia científica sobre la eficacia de las técnicas descritas

Management strategies in myofascial pain syndrome are summarized and most of the conservative therapeutic techniques for myofascial trigger points are briefly described. These can be classified as manual or instrumental. It is concluded that more high quality research is needed to allow for a higher level of scientific evidence regarding the efficacy of techniques

Fisioterapia invasiva del síndrome de dolor miofascial / Invasive physical therapy in myofascial pain syndrome

El presente artículo se centra en la descripción del uso de la punción como parte integrante de la fisioterapia de los puntos gatillo miofasciales y del síndrome de dolor miofascial. Aparte de detallarse su importancia diagnóstica se pasa también revista a su uso terapéutico y se exponen diferentes clasificaciones de las variadas técnicas y modalidades de tratamiento existentes en este campo. También se pasa revista a los principales peligros, contraindicaciones y complicaciones inherentes a las técnicas invasivas de tratamiento de este síndrome. De la revisión de la literatura se destaca la falta de estudios que confirmen o descarten una eficacia de las técnicas invasivas superior al placebo, por lo que se concluye la necesidad de investigación de calidad en este terreno

The present paper focuses on describing the use of dry needling as an integral part of myofascial trigger points and myofascial pain syndrome treatment. It is shown its diagnostic importance as well as its therapeutic use and the different classifications of the treatment techniques in this field. The main dangers, contraindications and complications of the invasive treatment techniques of this syndrome are also described. Review of the literature shows the lack of studies that support or refute the effectiveness of invasive techniques beyond placebo. Therefore, it is concluded the necessity of high quality experimental research in this field