Article

OBJECTIVE: To evaluate the role of ultrasonography for detecting local twitch
responses (LTRs) of myofascial trigger points (MTrPs) in deeply located
lower-back muscles. DESIGN: Case-control study. Active MTrP was diagnosed in all
patients based on the criteria proposed by Travell and Simons in their
upper-trapezius or lower-back muscles. One investigator administered trigger
point injections while observing LTRs on ultrasonography. The other investigator
observed LTRs visually during the procedure. SETTING: University rehabilitation
hospital. PARTICIPANTS: Patients (n=41; mean age, 51.8 +/- 11.8y) with MTrPs in
the upper-trapezius muscles and patients (n=62; mean age, 56.8 +/- 11.9y) with
MTrPs in the erector spinae or quadratus lumborum were recruited from April 29 to
October 31, 2010. INTERVENTIONS: Ultrasound-guided trigger point injection. MAIN
OUTCOME MEASURES: LTR detection rate according to the depth of MTrPs; subjective
pain intensity using a visual analog scale before and immediately after the
trigger point injection. RESULTS: In upper-trapezius muscles, all LTRs were
detected by means of both ultrasonographic and visual inspection. In the
lower-back muscles, many LTRs were detected only on ultrasonography during the
trigger point injection. For deep muscles, ultrasound helped identify LTRs that
were not detected by using visual assessment. Pain was alleviated more
significantly in the group with LTRs during trigger point injections compared
with the group without LTRs. CONCLUSIONS: These findings suggest that
ultrasonography was useful for detecting LTRs of MTrPs, especially for LTRs in
the deep muscles. Ultrasound guidance may improve the therapeutic efficacy of
trigger point injection for treating MTrPs in the deep muscles.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS