• Journal of Oral Medicine and Pain
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• 제45권4호
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• pp.110-114
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• 2020

Myofascial pain (MFP) is one of the most common causes of persistent orofacial pain. Patients with chronic myofascial orofacial pain may present with diffuse heterotopic pain, complicating the correct diagnosis. Treatment of chronic MFP should focus on the elimination of aetiologic factors. This article describes two cases of chronic MFP of the masticatory muscles, whose symptoms were exacerbated after masseteric nerve neurectomy. The patients had suffered from irrelevant treatment which did not resolve the symptom. Their symptom was managed by conventional treatment protocol. These cases emphasize the importance of correct diagnosis and evidence-based approach.

• 대한임상전기생리학회지
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• 제8권1호
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• pp.23-29
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• 2010

Purpose : This study is to offer clinical primary data that examines the change of imaging structure and the quantitative evaluation of muscle activity on myofascial trigger points. This study examines neuromuscular physiological characteristic by comparing the differences in physical findings, pressure pain threshold, imaging, and electrophysiological characteristics in latent and active myofascial trigger points muscle and normal muscle through the following experimental procedures. Methods : The participants for the study were thirty-three adults in their twenties. We divided three groups into normal, latent and active myofascial trigger points groups by physical findings. We analyzed the results of measured pressure pain, threshold for pain, ultrasound imaging perform for structure characteristic of muscle, surface EMG according to type of muscle contraction for function of muscle contraction. Results : Significant differences were indicated in pressure pain threshold (p<0.05). Significant differences were discovered in the ultrasound imaging analysis. There were increases in muscle Echogenicity white area index (p<0.001). There were significant differences that decrease in %MVIC (p<0.05), increase in MDF (p<0.05). Conclusion : From these results, active rnyotascial trigger points muscle showed quality deterioration on ultrasound imaging and decreased function of muscle contraction, increased motor unit action potential of II type fiber, and electrophysiologically. Imaging structure and neuromuscular physiological characteristic can be diagnostic and quantitative analytical techniques for myofascial pain syndrome and a primary factor that reflected in physical therapy intervention.

• Physical Therapy Rehabilitation Science
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• 제13권3호
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• pp.294-303
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• 2024

Objective: The objective of this study is to evaluate the effects of radial shock wave therapy (RSWT) targeting multiple myofascial trigger points (MTrPs) along myofascial chains on shoulder pain, function, range of motion, and muscle strength in patients with bicipital tendinopathy. While traditional treatments primarily focus on a single MTrP, this study aims to achieve better clinical improvement by simultaneously treating multiple MTrPs along the myofascial chains. Design: A randomized controlled trial. Methods: Twenty-eight patients with bicipital tendinopathy were randomly assigned to either an experimental group (n=14) or a control group (n=14). The experimental group received RSWT targeting multiple MTrPs along myofascial chains, while the control group received RSWT focused on a single MTrP in the biceps brachii. Both groups underwent three treatment sessions over a nine-day period, with one session every three days. Outcomes, including shoulder pain, function, range of motion, and muscle strength, were measured before and after treatment to assess therapeutic effects. Results: Both groups showed significant improvements in shoulder pain, function, range of motion, and muscle strength (p<0.05). However, the experimental group demonstrated significantly greater improvements in all outcome measures compared to the control group (p<0.05). Conclusions: RSWT targeting multiple MTrPs along myofascial chains showed significantly greater effects in relieving shoulder pain, improving function, enhancing range of motion, and strengthening muscles in patients with bicipital tendinopathy compared to treatment targeting a single MTrP. Therefore, this study proposes that a comprehensive treatment strategy considering the entire myofascial pathway may be more effective in the rehabilitation of patients with bicipital tendinopathy.

• 대한정형도수물리치료학회지
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• 제11권2호
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• pp.49-61
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• 2005

Summary of Background Data: Myofascial pain syndrome (MPS) is a common painful muscle disorder caused by trigger points occurring in myofascial. MPS is a major cause of chronical pain and is the subject of further clinical examination. Purpose: To uncover effective intramuscular stimulation therapy (IMS), the patients' actively participation stretching exercise and stabilizing around shoulder girdle where trigger point provoking myofascial pain syndrome in usually occurred. Methods: 45 myofascial pain syndrome patients were randomly chosen and divided into 3 groups. The first group (G1) received only IMS therapy, The second group (G2) had both IMS and active stretching exercises administered and the final group (G3) was given IMS therapy and stabilizing exercises. Therapy intervention was given for 3 weeks, 3 times a week and then only stretching exercise for the second group and stabilizing exercise for the third group was given for another 3 weeks. The visual analogue scale was dine before the experiment, 3 weeks after the experiment and 6weeks after the experiment to measure subjective degrees of pain and pressure pain threshold to measure sensitivity improvement of trigger point and functional ability questionnaire to measure daily life performance. Results: There were no significant changes after 3 weeks but after 6 weeks, between GI and G2 and between G1 and G3 showed significant change of pain, pressure pain threshold and daily life performance. There were significant improvement of the measurement of degrees of pain, pressure pain threshold and improvement of daily life performance at different times for G1 showed change 3 weeks after the experiment, but there were no changes 6 weeks after the experiment. There were significant improvement of the measurement at different times for G2 and G3 showed change 3 weeks after the experiment and 6 weeks after the experiment. Conclusions: IMS therapy proved to be effective in inactivation of trigger points of the myofascial pain syndrome patients and stretching and stabilizing exercises beside it keep remedial value longer by improvement of pain and dysfunction that occurred by the trigger point.

• 대한임상전기생리학회지
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• 제1권2호
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• pp.61-68
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• 2003

The purpose of this study was to compare the application method of ultrasound on the alteration of pressure pain threshold of myofascial trigger points. We used thirty patients with mayofascial pain syndrome in upper trapezius. Participants classified according to each group in non noxious dose, noxious dose by the ultrasound. The test was measured continuously pre test, post-test by algometer. The following results were obtained; 1. Pressure pain threshold were significantly increased in non-noxious dose and noxious dose group(p<.001). 2. In noxious dose group, pressure pain threshold were more significantly increased than non-noxious dose group(p<.001). These results lead us to the conclusion that non-noxious dose and noxious dose were significantly increased pressure pain threshold of upper trapezius trigger points. Therefore, a further direction of this study will be to provide more evidence that noxious dose have more effect on pressure pain threshold of myofascial trigger points.

• The Journal of Korean Physical Therapy
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• 제22권5호
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• pp.49-56
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• 2010

Purpose: The aim of this study was to evaluate a possible role for cranial artery velocity in cervicogenic headache. Methods: We studied 13 patients with cervicogenic headaches (M=9, F=4, age=$24.50{\pm}3.50\;y$) these were compared to 20 normal subjects (M=10, F=10, age=$23.30{\pm}2.90\;y$). Cervicogenic headache patients were divided into two groups (a myofascial relaxation group, a placebo group). Pain levels were measured using a visual analog scale (VAS). Transcranial Doppler (TCD) ultrasound recordings were used to measure blood flow velocity in the cranial artery. Results: Cervicogenic headache patients exhibited a significantly lower blood flow velocity in the middle cerebral artery. The patients who received an intervention had a significantly higher blood flow velocity in the left middle cerebral artery, right vertebral artery and basilar artery. Compared to the placebo group, the myofascial relaxation group exhibited a significantly decreased level of pain. Conclusion: Cervicogenic headache is pain referred to the head from a source in the cervical spine. Manual therapy affect to cervical spine and soft tissue as well as the passage of these vessels and nerves to recover because it is thought to be able to help.

• The Korean Journal of Pain
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• 제14권1호
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• pp.32-36
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• 2001

Background: There is no reliable objective test for the diagnosis of myofascial pain syndromes. The aim of this study was to evaluate the usefulness of a pressure algometer for the diagnosis of the trigger points and for the evaluation of the treatment in myofascial pain syndromes (MPS). Methods: Twenty female patients with clinical MPS of shoulder were included in this study. Pressure pain thresholds were measured by a pressure algometer at three different sites including the trapezius, supraspinatus and infraspinatus before, and then the 1st, 3rd and 7th days after TPI. Results: Mean pressure pain thresholds were lower in patients with MPS in than normal volunteers in all the examined skeletal muscles. Mean pressure pain thresholds in patients with MPS were increased significantly after TPI in all the examined skeletal muscles. Conclusions: Pressure algometer can be used as relatively objective diagnostic tool for locating trigger points and to quantify the effect of TPI in MPS. However, more investigation is necessary.

• 대한물리의학회지
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• 제15권4호
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• pp.21-28
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• 2020

PURPOSE: The main purpose of this meta-analysis study was to identify the degree-of-effect size and the variables for the effects of manual physical therapy on myofascial pain syndrome. METHODS: This study collected six studies published between 2015.01.01 and 2019.12.31. The analysis result verified nine effect size data. The random-effect model was chosen because of the heterogeneity of the data. RESULTS: First, the full case showed the largest mean effect size of 2.297 (p < .001). Second, the size of the effect based on the fascial distortion model (FDM) intervention showed an effect size of 4.654 (p < .001). Third, the number of participants showed a 15 or less effect size of 2.612 (p > .058). The number of treatments showed a 10 less effect size of 2.844 (p > .129). The publication type showed a thesis effect size of 3.095 (p < .002). CONCLUSION: Manual physical therapy has a great effect on myofascial pain syndrome in the neck and shoulders, and that the effects differ according to the methods of intervention.

• The Journal of Korean Physical Therapy
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• 제32권4호
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• pp.222-227
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• 2020

Purpose: The primary purposes of this study were to identify the degree of the effect size and the variables related to it on the effects of physical therapy on myofascial pain syndrome. Methods: This study collected 15 studies published between 2008.01.01 and 2019.12.31. The Analysis results confirmed 57 effect size data. The random-effect model was chosen because of the heterogeneity of the data. Results: First, the full case showed the largest mean effect size of 2.03 (p<0.001). Second, the size of the effect, according to the handson intervention, was 2.74 (p<0.003). Third, the VAS showed an effect size of 2.30 (p<0.001). Fourth, the intervention period showed a 1- to 15-day effect size of 2.94 (p<0.001). The number of interventions showed a 6 to 10 effect size of 2.84 (p<0.006). The number of participants showed a 10 or less effect size of 2.66 (p<0.001). Finally, the 'Trim and Fill' result confirmed that the calibration effect size was 0.93 (p<0.001). Conclusion: Physical therapy had a great effect on myofascial pain syndrome in the neck and shoulders, and that the effect differed according to the methods of the intervention and the methods of evaluation.

• The Korean Journal of Pain
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• 제29권2호
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• pp.136-140
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• 2016

Myofascial pain syndrome (MPS) is one of the common musculoskeletal conditions of the shoulder which may develop sensory-motor and autonomic dysfunctions at the various level of the neuromuscular system. The pain and dysfunction caused by MPS were primarily treated with physical therapy and pharmacological agents in order to achieve painfree movements. However, in recent years intramuscular electrical stimulation (IMES) with conventional electrode placement was used by researchers to maximise therapeutic values. But, in this study an inverse electrode placement was used to deliver electrical impulses intramuscularly to achieve neuro-modulation at the various level of the nervous system. Nine patients with MPS were treated with intramuscular electrode stimulation using inversely placed electrodes for a period of three weeks. All nine subjects recovered from their shoulder pain and disability within the few weeks of intervention. So, this inverse electrode placement may be more appropriate for chronic pain management.