Tyrimo problema: miofascijinis skausmo sindromas, sukeltas aktyvių miofascijinių trigerinių, taškų vargina lėtiniais raumenų skausmais, sutrikdo judesių amplitudę, miegą ir gyvenimo kokybę. Latentiniai miofascijiniai trigeriniai taškai bet kuriuo metu, paveikti bet kokio mechaninio stimulo gali tapti aktyviais. Gydant ir taip šalinant latentinius miofascijinius trigerinius taškus užkertamas kelias aktyvių miofascijinių trigerinių taškų formavimuisi ir tuo pačiu miofascijinio skausmo sindromo atsiradimui. Tyrimo objektas: kaklo judesių amplitudės ir miofascijinių trigerinių taškų sukelto skausmo pokyčiai taikant miofascijinių trigerinių taškų terapiją ir tempimo pratimus. Tyrimo tikslas: nustatyti miofascijinių trigerinių taškų terapijos ir tempimo pratimų poveikį skausmui ir kaklo judesių amplitudei. Tyrimo uždaviniai: 1. Nustatyti išeminės kompresijos poveikį galvos sukamojo ir trapecinio viršutinės dalies raumenų miofascijinių trigerinių taškų sukeltam skausmui ir kaklo judesių amplitudei. 2. Nustatyti išeminės kompresijos ir tempimo pratimų poveikį galvos sukamojo ir trapecinio viršutinės dalies raumenų miofascijinių trigerinių taškų sukeltam skausmui ir kaklo judesių amplitudei. 3. Palyginti išeminės kompresijos taikomos atskirai ir kartu su tempimo pratimais veiksmingumą mažinant galvos sukamojo ir trapecinio viršutinės dalies raumenų miofascijinių trigerinių taškų sukeltą skausmą ir didinant kaklo judesių amplitudę. 4. Nustatyti miofascijinių trigerinių taškų sukelto... [toliau žr. visą tekstą] / Problem of study: Myofascial pain syndrome, caused by active myofascial trigger points, causes chronic muscle pain, restricts range of motion, decreases sleep and quality of life. Latent myofascial trigger points at any time can transforme into active myofascial trigger points, when a mechanical stimulus appears. Treating and eliminating latent myofascial trigger points prevent latent myofascial trigger points from transforming into active myofascial trigger points, and hence, prevent the development of myofascial pain syndrome. Object of study: changes of cervical range of motion and myofascial trigger points pain after application of myofascial trigger point therapy and streching exercises. Aim of study: to determine the impact of myofascial trigger point therapy and streching exercises for MTrPs pain and cervical range of motion. Goals of study: 1. To determine the change of sternocleidomastoid and upper trapezius muscles myofascial trigger points pain and cervical range of motion, when ischemic compression is applied. 2. To determine the change of sternocleidomastoid and upper trapezius muscles myofascial trigger points pain and cervical range of motion, when ischemic compression and streching exercises are applied. 3. To compare the effectiveness of ischemic compression and streching exercises on sternocleidomastoid and upper trapezius muscles myofascial trigger points pain and cervical range of motion. 4. To determine the relation beatween myofascial trigger points pain... [to full text]

A síndrome dolorosa miofascial (SDM) é uma disfunção musculoesquelética não articular caracterizada por pontos-gatilho miofasciais. Estes pontos, identificados por meio da palpação, são descritos como bandas tensas na fibra muscular, podendo apresentar dor referida à compressão. Sabe-se que os pontos-gatilho miofasciais provocam hiperatividade simpática regional de temperatura local devido à atividade vasoconstritora cutânea. Para documentação objetiva por imagem desta alteração funcional, a termografia tem sido proposta como método auxiliar diagnóstico. O objetivo deste estudo foi correlacionar os exames clínico e termográfico dos pontos-gatilho nos músculos da mastigação masseter e temporal parte anterior. A amostra constituiu-se por 26 mulheres voluntárias com 41 ± 15 anos. Os resultados demonstraram correlação diretamente proporcional entre algometria e termografia na avaliação do ponto-gatilho miofascial, onde, quanto menor a força aplicada, menor a temperatura local (p<0,001). As áreas com dor referida apresentaram níveis de limiar de dor à pressão (1.28±0.45 kgf) menores quando comparados às áreas de dor local (1.73±0,59 kgf; p<0.001). Sendo assim, a imagem termográfica de um ponto-gatilho apresentou-se hiporradiante quando comparada à região de ausência de ponto-gatilho (&#916;T>0,4ºC; p<0.001). Além disso, a avaliação termográfica dos pontos-gatilho nos músculos masseter e temporal pelo gradiente térmico (&#916;T e &#916;&#952;) apresentou maior sensibilidade e especificidade em comparação com a temperatura absoluta (T), mesmo quando corrigidos estes valores para a temperatura ambiente e temperatura timpânica da voluntária durante o exame (&#952;). A termografia isoladamente identificou pontos-gatilho com sensibilidade de 62,5% e especificidade de 71,31%. Os autores concluíram que a termografia é um método de imagem não invasivo, com potencial de identificação de pontos-gatilho miofasciais na região facial. / Myofascial pain syndrome is a myalgic dysfunction characterized by myofascial trigger points (MTP). The taut band is a constant feature of a trigger point characterized by referred pain when stimulated. It is known that the myofascial trigger points cause regional sympathetic hyperactivity in local temperature due to the cutaneous vasoconstrictor activity. For detection of functional changes, thermography may be used as an auxiliary diagnostic imaging. The aim of this study was to correlate clinical and thermographic myofascial trigger points in the masticatory muscles masseter and temporalis. Twenty six women volunteers were included, having a mean age of 41 ± 15 years. The results showed directly proportional relationship by algometry and thermography in the assessment of MTP, where smaller the force applied, lower the local temperature will be (p<0.001). Moreover, when the soreness was evaluated and local vasomotor response, the temperature decreases as the worst local situation. PPT (pressure pain threshold) levels measured at the points of referred pain in MTP (1.28±0.45 kgf) were significantly lower than the areas of local pain in MTP (1.73±0,59 kgf; p<0.001). Thus, the thermographic image of a MTP presented colder than the area without trigger point (&#916;T>0,4ºC; p<0.001). In the thermographic assessment of MTP in the masseter and temporalis muscles, the results suggest that the parameters of thermal asymmetry (&#916;T and &#916;&#952;) show greater sensitivity and specificity in comparison to local absolute temperature values (T), even when corrected for the volunteer\'s core temperature and the temperature of the room during the exam (&#952;). Thermography can identify trigger points (referred pain) with sensitivity of 62,50% and specificity of 71,31%. The authors concluded that thermography is a noninvasive imaging method with potential for screening patients with MTP in the facial region.

Thesis (M.Thec.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 110 leaves ; ill. ; 30 cm / According to Wood (1998), patellofemoral pain syndrome (PFPS) refers to a syndrome that comprises of the following signs and symptoms: anterior knee pain, inflammation, imbalance, instability, or any combination thereof. Prevailing literature suggests that the presence of myofascial trigger points (MFTP’s) in quadriceps femoris (QF) muscle could result in a combination of the following signs and symptoms: - Retro- or peripatella pain, - Weakness of the quadriceps muscle (Chaitow and DeLany, 2002) - Loss of full lengthening (Travell and Simons, 1983:248-250) The aetiology of PFPS is poorly understood (Kannus et al. 1999). The current trend in literature suggests an extensor mechanism dysfunction as the most probable aetiology (Galantly et al., 1994; Juhn, 1999). There appears to be a clinical overlap between the two syndromes, in terms of an extensor mechanism dysfunction and of signs and symptoms. The aim of this investigation was to evaluate the role of active myofascial trigger points in the vastus lateralis (VL) muscle as perpetuating, causative or concomitant factors in the alteration of VL/VM Total Work (TW) in PFPS in distance runners.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 x, 80 leaves / 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.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban University of Technology, 2007 121 leaves / Ankle sprains account for 85% of all injuries to the ankle (Garrick, 1997). Inversion sprains result from a twisting of a weight-bearing foot into a plantarflexed and inverted position leading to lateral ankle ligament injury. Louwerens and Snijders (1999) state that there are multiple factors involved in ankle sprains or lateral ankle instability. These include injury to the lateral ankle ligaments, proprioceptive dysfunction and decrease of central motor control. Other factors that still need further research include the role of the fibularis muscles, the influence of foot geometry and the role of subtalar instability in ankle sprains (Louwerens and Snijders, 1999). This study focused on the fibularis muscles. Fibularis longus and brevis muscles are found in the lateral compartment of the leg and function to evert/pronate the foot and plantarflex the ankle. Fibularis tertius is found in the anterior compartment and its function is to evert and dorsiflex the foot. Myofascial trigger points in these three muscles refer pain primarily over the lateral malleolus of the ankle, above, behind and below it (Travell and Simons, 1993 2: 371). This is the exact area where ankle sprain patients experience pain. Travel and Simons (1993 2:110) state that a once off traumatic occurrence can activate myofascial trigger points. When considering the mechanism of injury of a lateral ankle sprain, the importance of the fibularis muscles becomes obvious. When the ankle inverts during a lateral ankle sprain, these muscles are forcefully stretched whilst trying to contract to bring about their normal action. Therefore these muscles are often injured from traction when the foot inverts (Karageanes, 2004). It stands to reason that as a result of this mechanism of injury myofascial trigger points may develop in the fibularis muscles. It was hypothesised that fibularis muscle trigger points would prove to be more prevalent in the injured leg when compared to the uninjured leg. To further investigate this hypothesis, an analytical, cross sectional study (phase 1) was done on 44 participants between the ages of 15 and 50. Consecutive convenience sampling was used and participants were screened according to phase 1’s inclusion and exclusion criteria. According to Travel et al. (1999 1: 19) myofascial trigger points (whether active or latent) can cause significant motor dysfunction. Trevino, et al. (1994) stated that fibularis muscle weakness is thought to be a source of symptoms after an inversion sprain. Treatment for ankle sprains involves minimising swelling and bruising and encouraging adequate ankle protection in the acute phase. The patient is advised to rest for up to 72 hours to allow the ligaments to heal (Ivins, 2006). After the acute phase has passed, rehabilitation is focused on. This includes improving the ankle range of motion and proprioception. Attention is also given to strengthen the muscles, ligaments and tendons around the ankle joint. In the recommended treatment protocol however, no mention is made of evaluating the musculature around the ankle joint for myofascial trigger points and or treating these points. McGrew and Schenck (2003) noted that if the musculature and neural structures surrounding the ankle joint were affected during an ankle sprain injury, and were left unresolved, they would lead to chronic instability. It was hypothesised that lateral ankle pain due to inversion ankle sprain injuries may be due to referred pain from the fibularis muscle trigger points. Patients treated with dry needling of the fibularis muscle trigger points would therefore show a greater improvement in terms of subjective and objective clinical findings when compared to a placebo treatment (detuned ultrasound) applied to the fibularis muscle trigger points.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic,Durban Institute of Technology, 2005 xxi, 132, 34 leaves ; ill. ; 30 cm / To assess and quantify the number, severity and specific location of myofascial trigger points within the shoulder rotator muscle group. To assess the internal/external ratio of the dominant shoulder in throwing athletes using a Cybex 700 dynamometer, after intervention and to establish a comparable clinical profile of the participants.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xv, 81 leaves ; 30 cm / The purpose of this study was to investigate the association between active Myofascial Trigger Points in the dominant shoulder external rotator muscle group in overhead throwing athletes and an altered internal/external rotation peak torque and single repetition work ratio of the involved shoulder.

Thesis (M.Tech,: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 62, 19 leaves :|bill. ;|c30 cm / To document the relationship between total work and myofascial trigger points in the vastus lateralis and vastus medialis portion of the quadriceps femoris muscle, whilst providing baseline graphs of these muscles with the use of a Cybex 700 Isokinetic Dynanometer in long distance runners both with and without patellofemoral pain syndrome. Methods: A quantitative, non-intervention clinical exploratory study. Fifty participants were divided into two groups, Group A (40 symptomatics) and Group B (10 asymptomatics). Both groups were screened for vastus lateralis and vastus medialis trigger points. Subjective data was obtained from Group A only, using the Numerical Pain Rating Scale and the Patient Specific Functional Scale. Objective data was obtained from both groups using the algometer, Myofascial Diagnostic Scale, and the Cybex 700 Isokinetic Dynanometer. For descriptive analysis frequency tabulations, box and whisker plots were used to display distributions graphically. Comparisons of categorical and quantitative variables between independent groups were run using chi square and Mann-Whitney testing consecutively. Finally Spearman’s correlation, multivariate generalized linear modelling and repeated measures ANOVA were also used. All statistical analysis was completed at the 95% (p<0.05) level of confidence.

Thesis (M.Tech.: Chiropractic) - Dept. of Chiropractic, Durban Institute of Technology, 2003 1 v. (various pagings) / This study was a prospective, randomised, double blinded, placebo controlled, comparative clinical trial to establish the efficacy of therapeutic ultrasound and compare the effectiveness of the two waveforms of ultrasound in the treatment of myofascial pain syndrome.

Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2006. 88 leaves. / Myofascial pain syndrome is the second most common reason patients seek the help of health care workers. It costs billions of dollars each year in lost revenue due to loss of productivity and other costs. The treatment of myofascial pain syndrome has been extensively researched and it appears that dry needling and medicinal injections of trigger points are some of the most effective modalities. However, an unwanted side effect common to both these therapies is post-needling soreness. Despite being mentioned in passing by many authors, very little detail is available regarding post-needling soreness. It is unclear whether post-needling soreness arises from the trigger point itself, or whether the tissue damage caused by the needle insertion is responsible. Therefore, this study was aimed at investigating whether dry needling muscle tissue in asymptomatic subjects (i.e. subjects not suffering from myofascial pain syndrome) resulted in post-needling soreness. Two different dry needling techniques were also compared with a placebo group in order to determine which technique resulted in the least post-needling soreness. This study was designed as a prospective, randomised, placebo controlled experimental investigation. Sixty subjects were randomly allocated into three equal groups. Group one received the single needle insertion technique and the second group received the fanning dry needling technique. The last group formed the control group and the subjects were treated using the Park Sham Device (placebo needles). All the subjects were between the ages of 18 and 50 and were required to be asymptomatic in the low back region.