M.Tech. (Chiropractic) / Myofascial trigger points are very common and can become a painful part of most people’s life at one time or another. According to Travell and Simons (1999), active upper trapezius myofascial trigger points are common in patients presenting with neck pain. Myofascial pain syndrome is a regional muscle disorder that is one of the most common causes of persistent pain in the head, face and neck regions (Rachlin, 2002). The PAIN®GONE pen is a device that produces a high voltage, low frequency pulse for only a brief period of time. The electrical stimulation activates endorphins in the hypothalamus which plays a role in pain relief (Puskas, 2004). The technical system of the device is clinically proven and uses Transcutaneous Electric Nerve Stimulation (TENS), based on the pain gate control theory of Melzack and Wall (1965). The purpose of this study was to determine the efficacy of treating active upper trapezius trigger points with PAIN®GONE therapy combined with cervical spine chiropractic adjustments.This study consisted of two groups, the PAIN®GONE therapy group (Group 1) with fifteen participants and the placebo PAIN®GONE therapy group (Group 2) with fifteen participants. The participants were between the ages of 18 and 40 years of age. Prior to becoming a participant of this study, individuals were assessed according to the inclusion and exclusion criteria, a case history, physical examination, cervical regional examination and upper trapezius muscle palpation to assess for upper trapezius myofascial trigger points. Treatment was applied to the cervical spine by Chiropractic adjustments, and to the upper active trapezius myofascial trigger points via PAIN®GONE therapy or placebo PAIN®GONE therapy, from which the subjective and objective data were based.Each participant was treated six times over a period of three weeks. Prior to the initiation of treatment, each participant was requested to complete a Vernon-Mior Neck Pain and Disability Index questionnaire and Numerical Pain Rating Scale. Algometer readings were obtained for the active upper trapezius myofascial trigger points. The Cervical Range of Motion (CROM) goniometer was used to obtain numerical values for the participant’s active cervical spine ranges of motion in flexion, extension, lateral flexion androtation. Both groups, received treatment to the active upper trapezius trigger points and Chiropractic adjustments to the cervical spine for a total of six treatment sessions. Both subjective and objective data readings were obtained before the 1st, 4th and 7th final consultation...

M. Tech. / Background: No substantiated theory exists by which chiropractic adjustments are known to correct myofascial trigger points (MTrPs). Myofascial trigger points are theorized to be either a primary muscle dysfunction or a secondary manifestation to central/ peripheral neurological mechanisms. Chiropractic adjustments are theorized to exert their therapeutic influence either primarily through biomechanical effects and/ or via neurophysiological mechanisms. Objective: The objective of this study was to investigate the effects of chiropractic adjustments on chronic, active rhomboid MTrPs, by comparing the clinical effects attained with rhomboid attachment-segment (C7-T5) relative to rhomboid innervation-segment (C4 and/ or C5) chiropractic adjustments. Setting: University of Johannesburg Chiropractic Day Clinic in Johannesburg, Gauteng. Participants: Thirty female subjects selected from the general population (from 18 to 40 years) were randomly divided into two different treatment groups of 15 each. Methods: The subjective information required the completion of the Subjective Pain and Discomfort Questionnaire, including the Numerical Pain Rating Scale (NPRS). The objective measures collected were pressure-pain threshold (PPT) and range of motion measurements using the algometer and digital inclinometer, respectively. Additionally, the change in the number of active MTrPs over the treatment period was recorded. All measurements were recorded at the first, third and fifth consultations, over a 3 to 4 week period. The data gathered were then statistically analyzed with the use of a 95% confidence interval. The nonparametric Friedman and Wilcoxon Signed Rank tests were used for the intragroup comparisons, and the Mann Whitney- U test was used for the intergroup comparisons. Interventions: Treatment group 1 received upper-thoracic/ attachment- segment chiropractic adjustments, and treatment group 2 received mid-cervical/ innervation-segment chiropractic adjustments. The research project was carried out so that both groups received 5 treatment sessions over 3 to 4 weeks. Results: There were no statistically significant results obtained for intergroup comparisons. Attachment-segment chiropractic adjustments revealed statistically significant changes in NPRS values (p=0.000), PPT values (p=0.000), cervical spine right lateral flexion range (p=0.004), thoracic spine extension (p=0.005) and left rotation range (p=0.003) over time. Innervationsegment chiropractic adjustments revealed statistically significant changes in NPRS values v ii (p=0.001), cervical spine right rotation (p=0.003), thoracic spine flexion (p=0.001) right lateral flexion (p=0.001) and left rotation (p=0.005) over time. Conclusions: This study does not suggest that attachment-segment or innervation-segment chiropractic adjustments possess greater clinical efficacy relative to one another in terms of improving the clinical picture associated with chronic, active rhomboid MTrP activity. In a further study, a larger sample size will be necessary to identify subtle changes in measurement parameters.

M. Tech. / OBJECTIVE: The aim of the study was to explore whether dry needle therapy delivered to latent myofascial trigger points of the biceps brachii muscle had an immediate effect on muscle activity and strength . DESIGN: One hundred participants with latent myofascial trigger points of the biceps brachii muscle and who were suitable for the study were drawn from the community. They were al located in to either a controlor treatment group so that each group contained fifty participants . The control and treatment group were divided in such a way to ensure that the two groups were comparable with one another un terms of age and gender. The International Physical Activity Questionnaire was completed by each participant to ensure that the two groups were also comparable with one another in terms of the total amount of physical activity performed per week. The results of this study were statistically analysed by STATKON at the University of Johannesburg.

M.Tech. / This study was conducted to investigate the efficacy of Chiropractic cervicothoracic spinal adjustment therapy in the treatment of active Trapezius myofascial trigger point dysfunction. Thirty participants were recruited and placed into one of two groups. Participants were between the ages of 18 and 30 years and selected based on the inclusion criteria being met. Participants had to present with active upper Trapezius trigger points and a restriction of the cervicothoracic junction. The experimental group received a Chiropractic adjustment to the cervicothoracic junction and the control group received detuned ultrasound as their respective treatments. The participants were treated six times over a 3-week period and measurements were taken on the first, fourth and seventh visits. A case history, physical examination and cervical regional examination were conducted at the first visit. Objective measurements included pressure algometry readings of Trapezius trigger points 1 and 2 and cervical spine goniometry readings. Subjective measurements included the Vernon Mior Pain Disability Index and the Numerical Pain Rating Scale. The results were interpreted by Statcon at the University of Johannesburg. The data was analysed using the Mann Whitney test and the Friedman test. According to the tests, the experimental group improved significantly in both the objective and subjective measurements over the seven visits. The control group showed an increase in the objective measurements and a decrease in the subjective measurements over the seven visits. This was found to be statistically insignificant. This study concluded that a Chiropractic adjustment to the cervicothoracic junction is effective in the treatment of upper Trapezius trigger points

M.Tech. / The term „myofascial‟ is derived from the word „myo‟ meaning muscle and „fascia‟ meaning connective tissue. Myofascial pain syndrome is a regional pain syndrome characterized by the presence of myofascial trigger points (Mense and Simons, 2001). The most crucial component of myofascial pain is muscle shortening from contracture (or „spasm‟). In fact, myofascial pain does not exist without muscle shortening. Prolonged shortening not only causes pain in the muscle but also physically pulls on tendons, thereby straining them and distressing the bone and joints they insert into and act upon (Gunn, 2002). Trigger points are most often discussed in the setting of myofascial pain syndromes, in which widespread or regional muscular pain is associated with hyperalgesia, psychological disturbance and significant restriction of daily activities (Huguenin, 2004).

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005. / The aim of this study was to evaluate the Myofascial Diagnostic Scale, for its inter-examiner reliability and to assess its reliability and validity as an assessment tool in the diagnosis and treatment of Myofascial Pain Syndrome. / M

A dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology: Chiropractic, Durban Institute of Technology, 2003. / The purpose of this study was to determine the relative effectiveness of a home programme of ischaemie compression, sustained stretch and a combination of the two, in terms of subjective and objective clinical findings for the treatment of Myofascial Pain Syndrome. / M

Résumé<p><p>Ce travail de thèse contribue à déterminer chez l’humain, le rôle de différentes structures fasciales (expansions aponévrotiques, tissu conjonctif aréolaire, fascia profond et paratendon) disposées en parallèle ou en série avec leur tendon respectif. <p><p>La première partie de ce travail est consacrée à l’étude de l’expansion aponévrotique du biceps brachial. Deux protocoles ont été développés sur spécimens cadavériques frais. Un premier, anatomique, a permis de mettre en évidence des caractéristiques individuelles telles que la longueur et la largeur sans lien avec le sexe et la latéralité. D’autre part, une partie profonde de l’expansion aponévrotique du biceps brachial a été observée de façon constante. <p>Le second, biomécanique, nous a permis d’étudier les mouvements de flexion du coude et de supination de l’avant-bras ainsi que les bras de leviers instantanés du muscle biceps brachial avec et sans la présence de son expansion aponévrotique. Les résultats nous indiquent que cette structure limite la flexion du coude ainsi que la supination de l’avant-bras, tout en maintenant une rythmicité entre la flexion et la supination. D’autre part, elle permet d’augmenter le bras de levier musculaire du muscle biceps brachial en flexion et en supination.<p><p>Dans la seconde partie de ce travail, notre étude in-vitro s’est intéressée à la contribution relative des structures tendineuses et fasciales sur l'avantage mécanique musculaire lors d’une plastie du ligament croisé antérieur aux tendons des muscles droit interne et demi-tendineux. Les résultats suggèrent que la voie myofasciale des muscles droit interne et du demi-tendineux semble cruciale pour la transmission de force permettant le déplacement du segment jambier. <p><p>Malgré les limitations inhérentes aux études sur préparations anatomiques, ce travail contribue à une meilleure connaissance de certaines structures fasciales, dont les implications cliniques devraient être prises en considération.<p><p> / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished

M.Tech. / Problem Statement: Myofascial Pain Syndrome (MPS) is a painful and prevalent muscular condition that is characterized by the development of myofascial trigger points (TrP’s). These are locally tender when active and are able to refer pain through specific patterns to other areas of the body distal from the trigger point (Manga, 2008). Myofascial trigger points are a frequently overlooked and misunderstood source of the distressingly ever-present musculoskeletal aches and pains of mankind and many authors have found that the trapezius muscle is most often the muscle that has frequent myofascial trigger points (Travell and Simons, 1999). Much debate and discussion has arisen on the merits of the fanning dry needling technique compared to that of the static dry needling technique, but research evidence is very limited. Some practitioners prefer the static technique over the fanning technique as it reduces the presence and amount of post-needling soreness, as well as reduces the possibility of penetrating a blood vessel resulting in hemorrhaging. Other practitioners prefer the fanning technique as it increases the chances of locating the loci of the TrP, as well as increasing the chances of eliciting a local twitch response and possibly making this method more effective in deactivating a TrP than the static technique. Aim of Study: The aim of this study was to compare the effects of static myofascial dry needling to the effects of fanning myofascial dry needling of an active trigger point (TrP1) in the upper trapezius muscle in order to determine which of the two treatments is more effective with regards to decreasing neck pain and disability as well as increasing pressure pain threshold in patients with neck pain due to Trapezius Myofascial Pain Syndrome. Method: Forty participants underwent a general screening to determine whether they had active myofascial trigger points in the upper fibers of the trapezius muscle.

M.Tech. (Chiropractic) / PURPOSE: Shoulder pain has been identified to be one of the most common musculoskeletal problems found in a variety of different countries, showing characteristics of chronicity and recurrence. It is considered to be a main contributor towards nontraumatic upper limb pain. One of the identifiable causes of chronic or reoccuring shoulder pain may be attributed to myofascial pain syndrome which is caused by MTrP’s and produces symptoms that are similar to that of other shoulder pain syndromes. The infraspinatus muscle as an integral component of the rotator cuff complex is subject to high tension biomechanical strain as well as neuromuscular tension. While therapeutic interventions have been devised to treat varying degrees of biomechanical and neuomuscular tension, little evidence exists establishing which of these treatment regimes is most effective in treating myofascial trigger points. The purpose of this study was to compare different regional chiropractic adjustments relative to the attachment site and the innervation segment of the infraspinatus muscle and to identify the most effective treatment protocol with regard to chronic, active infraspinatus myofascial trigger point dysfunction. DESIGN: A selection of thirty participants were recruited for this study. The participants were divided into two groups of fifteen participants each. Group A received a chiropractic adjustment to the glenohumeral joint, the attachment site for infraspinatus muscle. Group B received a chiropractic adjustment to the cervical spine segments associated with the innervation to the infraspinatus muscle. Cervical spine restrictions specific to levels C4/C5 and/or C5/C6, and glenohumeral joint restrictions were determined using motion palpation techniques. All participants received a total of six treatments over a three-four week period. MEASUREMENTS: Subjective measurements were obtained by the Functional Rating Index Questionnaire and the Numerical Pain Rating Scale. Objective measurements were obtained using the hand-held pressure algometer and counting the number of active infrapsinatus myofascial trigger points. The data was collected on the first, fourth and seventh consultations. OUTCOME: With regards to the subjective readings, the results from the Functional Rating Index Questionnaire for the intragroup analysis indicated that the glenohumeral joint adjustment group showed the greatest improvement over time (15.5%). No statistically significant differences were noted for the intergroup analysis. The intragroup analysis of the Numerical Pain Rating Scale indicated that the glenohumeral joint adjustment group showed the greatest improvement over time (68.8%). The intergroup analysis indicated that there were no statistically significant differences. vii With regard to the objective measurements, the intragroup analysis of the pressure algometer readings indicated that the glenohumeral joint adjustment group showed the greatest improvement over time (21.7%). There were no statistically significant differences with the intergroup analysis. The intragroup and intergroup analysis of the number of active infraspinatus myofascial trigger point dysfunction showed no statistically significant differences between the groups or within each of the groups over time. CONCLUSION: The results showed that both treatment groups protocols were effective in reducing chronic, active infraspinatus myofascial trigger point dysfunction. Small differences were noted between the two treatment groups with regards to the subjective and objective findings. The glenohumeral joint adjustment group showed the greatest clinical and statistical improvements over the three-four week trial period.