Ultrasound and Laser as Stand‐Alone Therapies for Myofascial Trigger Points: A Randomized, Double‐Blind, Placebo‐Controlled Study

Physiotherapy Research International - Tập 19 Số 3 - Trang 166-175 - 2014
Andrea Manca1, Eloisa Limonta2, G. Pilurzi1,3, Francesca Ginatempo1, Edoardo Rosario de Natale1, Beniamina Mercante1, E. Tolu1, Franca Deriu1
1Department of Biomedical Sciences, University of Sassari, Sassari, Italy
2Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
3Department of Clinical and Experimental Medicine, University of Sassari, Italy

Tóm tắt

AbstractBackground and Purpose

Ultrasound (US) and low‐level laser therapy (LLLT) are commonly employed for myofascial trigger points (MTP) despite lack of evidence for usage as stand‐alone treatments. The aim of the study was to determine, on MTP of the upper trapezius muscle (uTM), the effects of US and LLLT per se, as delivered in accordance with the procedures reported by surveys about their usage among physiotherapists.

Methods

Design was set as a double‐blind, randomized, placebo‐controlled study. Sixty participants with at least one active MTP in uTM (28 women and 32 men; mean age 24.5 ± 1.44 years) were recruited and randomly assigned to one out of five groups: active US (n = 12), placebo US (n = 12), active LLLT (n = 11), placebo LLLT (n = 11) and no therapy (control, n = 14). The participants and outcome assessor were blinded to the group assignment and therapy delivered. Three outcome measures were assessed at baseline, after a 2‐week treatment and 12 weeks after the end of the intervention (follow‐up): pressure pain threshold, subjective pain on a numerical rating scale and muscle extensibility performing a cervical lateral flexion. All subjects assigned to the intervention groups were treated five times weekly for overall 10 treatments given. Two‐way ANOVA was used to compare differences before and after intervention and among groups at each time‐point.

Results

After the 2‐week intervention, all groups showed pressure pain threshold, numerical rating scale and cervical lateral flexion significant improvements (p < 0.05), which were confirmed at the follow‐up. When performing multiple comparisons, controls scored significantly less than both the active therapies and placebos, whereas no differences were detected between active therapies and placebos.

Conclusions

Ultrasound and LLLT provided significant improvements in pain and muscle extensibility, which were superior to no therapy but not to placebos, thus raising concerns about the suitability, both economically and ethically, of administering such common physical modalities as stand‐alone treatments in active MTP of the uTM. Copyright © 2014 John Wiley & Sons, Ltd.

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Physiotherapy Research International

Tập 19 Số 3

166-175

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