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其刚度值对肌筋膜绷紧带进行成像。这是使用磁共振弹性图（MRE）技术完成的。该应用的目的是进一步检验我们的假设，即MRE僵硬绷紧条带的MRE刚度测量对肌筋膜手动疗法产生的变化可靠且敏感。如果MRE技术是可靠和敏感的，则可以用来评估手动疗法在未来的研究中的功效。当前的研究将解决以下特定目的：具体目的1：确定MRE刚度测量的肌筋膜绷紧条带及其周围的肌肉组织的可靠性。将研究有40名患有斜方肌上肌膜疼痛的受试者（由临床检查和病史确定）和MRE上至少一个紧绷的频带。最初的MRE检查将表征肌筋膜绷紧带（MRE刚度图像中拉紧带的位置，拉紧带的面积以及拉紧带和周围的肌肉组织之间的刚度比）。受试者将在两个小时后进行第二次MRE检查，并在统计上进行措施以确定可靠性。在第二次MRE之前和之后，将使用电表和疼痛VAS评分来量化疼痛；该目标的变化得分将在AIM 2中用作对照组。特定的目标2：确定MRE刚度测量对疼痛视觉模拟量表（VAS）变化的敏感性，这是由于触发点释放疗法而导致的。将使用MRE评估四十个患有斜方肌上肌疼痛的受试者。上斜方肌的整体肌肉刚度以及在MRE图像中鉴定出的绷紧带的机械表征（拉紧带面积的大小和位置和刚度比）将被量化。将使用电表和疼痛VAS量表的医生评估压痛。然后，将通过单一治疗TPR治疗对受试者进行治疗。相同的个体将重新评估疼痛，​​上斜方肌的刚度将再次用第二个MRE测量。为了检验我们的假设（如疼痛评分降低所示，MRE拉紧的带测量对治疗的变化很敏感），疼痛VAS的变化与紧绷带的MRE参数变化之间的关联将在统计上确定。 公共卫生相关性：肌膜疼痛综合征是一种痛苦且经常残疾的状况。手动疗法对肌筋膜疼痛的确切好处仍然未知，这主要是因为没有可靠的方法检测和测量肌肉中僵硬，疼痛的区域。磁共振弹性图能够形象和测量肌肉刚度，因此是一种有前途的技术，可以准确检测手动治疗后刚性拉紧带和触发点的变化。