• 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.

• The Korean Journal of Pain
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• 제29권1호
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• pp.12-17
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• 2016

Background: The study aimed to determine if ultrasonography of masseter can be used to evaluate the outcome of transcutaneous electrical nerve stimulation (TENS) in subjects with temporomandibular disorders (TMDs) such as myositis and myofascial pain. Methods: Fifteen TMD subjects with myofascial pain/myositis who satisfied the RDC/McNeil criteria were included in the study. All the subjects were administered TENS therapy for a period of 6 days (30 minutes per session). The mouth opening (in millimeters) and severity of pain (visual analogue scale score) and ultrasonographic thickness of the masseter (in millimeters) in the region of trigger/tender areas was assessed in all the subjects both prior and post TENS therapy. A comparison of the pre-treatment and post-treatment values of the VAS score, mouth opening and masseter thickness was done with the help of a t-test. Results: There was a significant reduction in the thickness of masseter muscle (P = 0.028) and VAS scores (P < 0.001) post TENS therapy. There was also a significant improvement in the mouth opening (P = 0.011) post TENS therapy. Conclusions: In the present study, ultrasonography was found to be an effective measuring tool in the assessment of TENS therapy in subjects with myositis and myofascial pain.

• 한국전문물리치료학회지
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• 제24권3호
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• pp.30-39
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• 2017

Background: Scapular posterior tilt (SPT) is important in the prevention of abnormal scapular movement and pain during elevation of the arm. However, previous studies have overlooked increased upper trapezius (UT) muscle activity interrupting the normal force couple of scapular motion and compensation of levator scapulae (LS) muscle activated simultaneously with UT during SPT exercise. Objects: The purpose of this study was to compare the effects of modified SPT with depression exercise versus SPT exercise on serratus anterior (SA), lower trapezius (LT), UT, and LS muscle activities and the clavicular tilt angle, in subjects with rounded shoulder posture (RSP) and myofascial pain in the UT muscle region. Methods: Eighteen subjects with RSP were recruited and randomly allocated to 2 groups; 9 in the SPT group and 9 in the SPT with depression group. All subjects met the specific RSP criteria and had myofascial pain of UT region. Depending on the allocated group, subjects performed the assigned SPT exercise and EMG data were recorded during the each exercise. Clavicular tilt angle was defined as the angle between the line joining the medial and lateral end of the clavicle and a horizontal line. Results: The SA muscle activity was significantly greater in SPT with depression than with SPT exercise (p<.05). The UT, LS muscle activity and the clavicular tilt angle was significantly lower in SPT with depression than with SPT exercise (p<.05). Conclusion: These findings were insightful because the potential risk of pain from overactivation of the UT and LS was considered, in contrast with SPT exercise. SPT with depression exercise can be implemented as an effective method to facilitate scapular muscle activity for stability and to prevent myofascial pain in the neck and shoulder.

• Journal of Oral Medicine and Pain
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• 제32권4호
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• pp.455-460
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• 2007

치아의 통증을 호소하는 환자 중 임상검사 및 방사선학적 검사소견에서 특기할 병적 소견이 관찰되지 않는 경우 비치성 치통을 의심해보아야 하며, 근육질환, 상악동염, 신경병성 통증, 신경혈관 질환 등의 원인으로 치통이 유발될 수 있다. 이러한 비치성 치통의 경우 진성 치통과 구별하기 위하여 철저한 병력 조사 및 전반적인 임상검사가 시행되어야 하며, 진단용 국소마취를 통하여 보다 정확한 진단을 확립할 수 있다. 이러한 비치성 치통의 가장 흔한 원인 중의 하나인 근막동통은 근육조직을 촉진 시 단단한 띠가 만져지는 것이 특징적이며 이것이 발통점으로 작용하여 근육이 뻣뻣한 느낌과 피로감, 연관통, 치아에 전이되는 통증, 근긴장성 두통, 통각과민 등의 증상을 유발할 수 있으며, 특히 교근은 상악 구치부 및 하악 구치부의 통증을 유발한다. 본 증례는 우측 교근부의 근막동통에 기인한 하악 우측 구치부의 치통 양상을 운동요법, 물리치료, 약물치료 등의 통상적이고 가역적인 근육질환의 치료법을 통해 증상의 호전을 보인 증례이다. 비치성 치통은 정확하게 진단되지 않을 경우 근관치료, 치주치료, 발치 등의 불필요한 치과치료가 시행될 수 있으며, 이러한 치료를 통하여도 환자의 통증은 경감되지 않기 때문에 치과치료가 시행되기 전에 반드시 정확한 감별진단이 필요하리라 사료된다.

• The Journal of Korean Physical Therapy
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• 제31권1호
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• pp.24-30
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• 2019

Purpose: This study compared the effectiveness of three methods, fascial distortion model (FDM), myofascial release (MFR), self-myofascial release (SMR), on the neck range of motion and pain. Methods: In this study, the collected data were processed statistically using SPSS version 22.0 for Windows. Descriptive statistics were used to analyze the general characteristics of the subjects. Repeated measure ANOVA was conducted to analyze the range of motion of the neck of the group and VAS, and Contras was used to see the difference in significance over time. One-way ANOVA was used to compare the differences among the groups and a post-hoc test was used. The significance level (${\alpha}$) was 0.05. Results: In the range of motion, the flexion and extension of the neck, right rotation, and left rotation were significantly different in the SMR, FDM, and MFR groups. The right lateral flexion showed significant differences in the FDM, MFR, and SMR groups. The VAS was similar in the groups at 2 and 4 weeks, but there was a significant difference among the FDM, MFR, and SMR groups at 6 weeks. Conclusion: In this study, MFR and MSR as well as FDM were effective in controlling the range of motion and pain control of the neck. Further studies will be needed to determine the effects of long-lasting treatments other than pain control. These studies and the present study will be used as a basis for ongoing research into the duration and method of application for musculoskeletal therapies.

• Journal of Preventive Medicine and Public Health
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• 제30권4호
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• pp.779-790
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• 1997

본 연구는 목과 상지의 누적외상성장애를 호소하는 대상자들중에서 근막동통증후군으로 진단받은 환자군과 단순 증상호소군인 대조군사이에서 검사결과의 분석을 통하여 집단 검진시 고려해 볼 수 있는 검사항목을 찾고자하였다. 조사대상은 컴퓨터를 통한 자료검색 및 대화형태의 업무를 하는 여성 전화교환원 904명이었으며, 근막동통증후군으로 진단받은 105명의 환자군과 상지의 누적외상성장애의 증상만을 호소하는 550명의 대조군을 비교하여 다음과 같은 결론을 얻었다. 1. 신체계측과 악력 및 Pinch strength 측정결과, 키와 몸무게, 앉은 자세의 높이 등에서는 환자군과 대조군의 차이가 없었으나, 약력은 환자군의 우측손이 대조군보다 유의하게 낮았으며, Pinch strength는 두 군간의 유의한 차이는 없었다. 2. 시각적 상사척도는 환자군의 평균값이 $6.74{\pm}2.29$이며, 대조군은 $4.37{\pm}2.32$으로 나타나 두 군간 뚜렷한 차이를 보였다. 3. 근육효소검사에서는 비정상으로 분류된 이상자의 분포가 환자군과 대조군에서 유사한 분포를 보여 실제 진단과정에 미치는 영향은 미비한 것으로 나타났다. 4. 다중 로지스틱 회귀분석을 이용한 유의한 변수는 나이, 우측 상부승모근의 압통역치값과 시각적 상사척도로 나타났다. 5. 압통역치검사와 시각적 상사척도는 근막동통증후군의 진단에 객관적 검사로서 고려할 만한 검사로 나타났다.

• 대한물리의학회지
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• 제2권1호
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• pp.1-10
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• 2007

Purpose : To identify the effects of Hold-Relax of proprioceptive neuromuscular facilitation (PNF) on the functional improvement of patients with neck myofascial pain syndrome. Methode : The present research investigated 60 patients with neck myofascial syndrome, dividing them into a group doing Hold-Relax of proprioceptive neuromuscular facilitation and a group doing Stretching, This study examined degree of recovery from neck pain by comparing their neck myofascial pain syndrome before and after the treatment, and compared two groups to find difference in the degree of recovery from myofascial pain syndrome. Results : 1. For Hold-Relax of proprioceptive neuromuscular facilitation group, the pain rating score (PRS) were significantly decreased for six weeks treatment. 2. For Stretching group, the pain rating score (PRS) did not indicate significant decrease for six weeks treatment. 3. For Hold-Relax of proprioceptive neuromuscular facilitation group, range of motion of flexion, left rotation, right rotation indicated significant difference after pre test and after two week but no significant difference after four week. 4. For Stretching group, range of motion of flexion, left rotation, and right rotation except extension indicated significant difference after pre test and after two week but no significant difference after four week. Conclusion : The Hold-Relax of proprioceptive neuromuscular facilitation is considered to be effective in increasing joint range of motion of patient and decreasing pain. Accordingly physical therapists has to learn a wide range of patterns and to develop various treatment techniques.

• 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.

• 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.