Taut Bands in Myofascial Pain

肌筋膜疼痛中的绷紧带

• 批准号: 8122293
• 负责人: KAI-NAN AN
• 金额: $ 23.42万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8122293
• 关键词: Address; Affect; Aftercare; Agreement; Area; Attention; Biochemical; Biomechanics; Breast; Characteristics; Clinical; Communities; Consensus; Control Groups; Development; Diagnosis; Etiology; Fatigue; Future; Goals; High Prevalence; Hour; Image; Individual; Liver; Location; Magnetic Resonance Elastography; Manuals; Measurement; Measures; Mechanics; Methods; Motion; Muscle; Muscle Hypertonia; Myalgia; Myofascial Pain Syndromes; Myofascial Trigger Point; Nature; Outcome; Outcome Measure; Pain; Palpation; Pattern; Physical Examination; Physicians; Property; Published Comment; Recording of previous events; Research; Research Personnel; Symptoms; Syndrome; Techniques; Testing; Time; Tissues; Visual Analogue Pain Scale; Work; base; improved; in vivo; pressure; public health relevance; soft tissue; success; trapezius muscle; treatment effect; trigger point

DESCRIPTION (provided by applicant): Our preliminary study has, for the first time, imaged myofascial taut bands based on their stiffness values. This was accomplished using the Magnetic Resonance Elastography (MRE) technique. The goal of this application is to further test our hypothesis that MRE stiffness measurements of myofascial taut bands are reliable and sensitive to changes resulting from myofascial manual therapies. If the MRE technique is reliable and sensitive, it can be used to assess the efficacy of manual therapies in future studies. The current study will address the following specific aims: Specific Aim 1: To determine the reliability of MRE stiffness measurements of myofascial taut bands and their surrounding muscle tissue. Forty subjects with upper trapezius myofascial pain (as determined by clinical examination and history) and at least one taut band on MRE will be studied. An initial MRE examination will characterize the myofascial taut bands (location of the taut band in the MRE stiffness image, area of the taut band, and stiffness ratio between the taut band and the surrounding muscle tissue). Subjects will undergo a second MRE examination two hours later and the measures statistically compared to determine reliability. Pain will be quantified with an electroalgometer and pain VAS score before and after the second MRE; the change scores from this Aim will be used as a control group in Aim 2. Specific Aim 2: To determine the sensitivity of MRE stiffness measurements to change in a pain visual analog scale (VAS) as a result of Trigger-point Pressure Release therapy. Forty subjects with upper trapezius myofascial pain will be assessed using MRE. The overall muscle stiffness of the upper trapezius as well as the mechanical characterization of taut bands identified in MRE images (size and location of the taut band area and stiffness ratio) will be quantified. Tenderness will be evaluated by a physician using an electroalgometer and a pain VAS scale. Subjects will then be treated with a single treatment with TPR therapy. Pain will be reevaluated by the same individual and stiffness of the upper trapezius will be again measured with a second MRE. To test our hypothesis (that MRE taut band measurements are sensitive to changes resulting from therapy, as indicated by reduced pain score), associations between changes in pain VAS and changes in the MRE parameters of the taut bands will be statistically determined. PUBLIC HEALTH RELEVANCE: Myofascial pain syndrome is a painful and often disabling condition. The exact benefits of manual therapies for myofascial pain remain unknown largely because there are no proven methods of detecting and measuring stiff, painful areas in muscles. Magnetic Resonance Elastography is able to image and measure muscle stiffness and therefore is a promising technique to accurately detect changes in stiff taut bands and trigger points after manual therapy treatment.

描述（由申请人提供）：我们的初步研究首次根据肌筋膜拉紧带的刚度值对其进行了成像。这是使用磁共振弹性成像（MRE）技术完成的。本应用的目的是进一步检验我们的假设，即肌筋膜拉紧带的 MRE 硬度测量是可靠的，并且对肌筋膜手法治疗引起的变化敏感。如果 MRE 技术可靠且灵敏，则可以在未来的研究中用于评估手法治疗的疗效。当前的研究将解决以下具体目标： 具体目标 1：确定肌筋膜拉紧带及其周围肌肉组织的 MRE 硬度测量的可靠性。将研究 40 名患有上斜方肌筋膜疼痛（根据临床检查和病史确定）且 MRE 上至少有一条拉紧带的受试者。最初的 MRE 检查将表征肌筋膜拉紧带（拉紧带在 MRE 硬度图像中的位置、拉紧带的面积以及拉紧带与周围肌肉组织之间的刚度比）。两小时后，受试者将接受第二次 MRE 检查，并对测量结果进行统计比较以确定可靠性。在第二次 MRE 之前和之后，将使用电痛觉计和疼痛 VAS 评分对疼痛进行量化；该目标的变化分数将用作目标 2 中的对照组。 具体目标 2：确定 MRE 硬度测量值对触发点压力释放疗法导致的疼痛视觉模拟量表 (VAS) 变化的敏感性。将使用 MRE 评估 40 名患有上斜方肌肌筋膜疼痛的受试者。上斜方肌的整体肌肉硬度以及 MRE 图像中识别的拉紧带的机械特征（拉紧带面积的大小和位置以及刚度比）将被量化。医生将使用电痛觉计和疼痛 VAS 量表来评估压痛程度。然后受试者将接受 TPR 疗法的单次治疗。同一个人将重新评估疼痛，​​并使用第二次 MRE 再次测量上斜方肌的僵硬程度。为了检验我们的假设（MRE 拉紧带测量对治疗引起的变化敏感，如疼痛评分降低所示），将统计确定疼痛 VAS 变化与拉紧带 MRE 参数变化之间的关联。 公众健康相关性：肌筋膜疼痛综合征是一种痛苦且常常致残的疾病。徒手疗法治疗肌筋膜疼痛的确切益处仍然未知，很大程度上是因为没有经过验证的方法来检测和测量肌肉中僵硬、疼痛的区域。磁共振弹性成像能够成像和测量肌肉硬度，因此是一种很有前景的技术，可以准确检测手法治疗后僵硬绷紧带和触发点的变化。