Effect of deep muscle stimulation combined with exercise therapy on neck and shoulder myofascial pain syndrome_West China Medical Journal

Authors：

LI Qiuyan ¹ ,  WU Ping ¹ , LIU Shaxin ² , HE Chengqi ²

1. Department of Rehabilitation Medicine, the First People’s Hospital of Shuangliu District, West China (Airport) Hospital, Sichuan University, Chengdu, Sichuan 610200, P. R. China;
2. West China School of Medicine / Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

WU Ping, Email: 1204555081@qq.com

Keywords：

Myofascial pain syndrome; deep muscle stimulation; exercise therapy; shear wave velocity

DOI：

10.7507/1002-0179.202310154

Video：

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Objective To explore the effect of deep muscle stimulation (DMS) combined with exercise therapy on morphological changes of the trapezius muscle assessed by musculoskeletal ultrasound and the function for patients with neck and shoulder myofascial pain syndrome (MPS). Methods One hundred and twenty patients with neck and shoulder MPS admitted to the First People’s Hospital of Shuangliu District, Chengdu between August 2021 and December 2022 were randomly selected and divided into 4 groups. There were 30 cases in each group. Group A received modulated middle frequency electrotherapy, group B received modulated middle frequency electrotherapy combined with DMS, group C received modulated middle frequency electrotherapy combined with exercise therapy, and group D received modulated middle frequency electrotherapy, DMS combined with exercise therapy. Before treatment and after 4 weeks of treatment, shear wave elastography was used to detect the shear wave velocity (SWV) of the four groups, high frequency ultrasound was used to detect the muscle thickness of the trapezius muscle. The Visual Analogue Scale (VAS) scores, Neck Disability Index (NDI), modified Barthel Index (MBI), Instrumental Activities of Daily Living Scale (IADL), World Health Organization Quality of Life-BREF (WHOQOL-BREF), Self-rating Anxiety Scale (SAS), and Self-rating Anxiety Scale (SDS) were also assessed to compare the therapeutic effects among the four groups of patients under different intervention methods. Results Before treatment, there was no significant difference in trapezius muscle SWV, trapezius muscle thickness, VAS, NDI, MBI, IADL, WHOQOL-BREF, SAS or SDS among the four groups (P>0.05). After 4 weeks of treatment, there were significant differences in trapezius muscle SWV, VAS, NDI, WHOQOL-BREF in the physiological domain and psychological domain, SAS and SDS among the four groups (P<0.05), and the improvements of trapezius muscle SWV, WHOQOL-BREF in the physiological domain and psychological domain, and SDS in group D were more obvious than those in other groups (P<0.05). After 4 weeks of treatment, there was no significant difference in MBI, IADL, or WHOQOL-BREF in the society domain and environmental domain among the four groups (P>0.05). Conclusion DMS combined with exercise therapy can significantly improve trapezius muscle elasticity, psychological state and quality of life of patients with neck and shoulder MPS.

Citation： LI Qiuyan, WU Ping, LIU Shaxin, HE Chengqi. Effect of deep muscle stimulation combined with exercise therapy on neck and shoulder myofascial pain syndrome. West China Medical Journal, 2024, 39(6): 878-883. doi: 10.7507/1002-0179.202310154 Copy

1.	李亞茜, 王會, 周鴻. 剪切波彈性成像和表面肌電圖評估針刺聯合推拿治療頸肩肌筋膜疼痛綜合征的效果. 臨床超聲醫學雜志, 2020, 22(12): 893-897.
2.	Fleckenstein J, Zaps D, Rüger LJ, et al. Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: results of across-sectional, nationwide survey. BMC Musculoskelet Disord, 2010, 11: 32.
3.	Galasso A, Urits I, An D, et al. A comprehensive review of the treatment and management of myofascial pain syndrome. Curr Pain Headache Rep, 2020, 24(8): 43.
4.	馬明, 孫武東, 湯從智, 等. 深層肌肉刺激聯合本體感覺神經肌肉促進療法治療顳下頜關節紊亂病的療效觀察. 中華物理醫學與康復雜志, 2015, 37(11): 848-850.
5.	趙保禮, 趙智, 張立莊, 等. 筋膜松解術聯合核心肌群訓練治療非特異性下背痛的療效觀察. 中華物理醫學與康復雜志, 2020, 42(3): 239-241.
6.	葛瑞東, 白碩, 郭京偉, 等. 局部肌肉振動對男性慢性非特異性腰痛患者腰背肌疲勞的即刻效應. 中國康復醫學雜志, 2019, 34(3): 287-292.
7.	陳勤, 漆瀟, 張小君, 等. 半導體激光與 DMS 治療腰肌勞損 105 例臨床療效研究. 激光雜志, 2016, 37(8): 149-152.
8.	Fontana TL, Richardson CA, Stanton WR. The effect of weight-bearing exercise with low frequency, whole body vibration on lumbosacral proprioception: a pilot study on normal subjects. Aust J Physiother, 2005, 51(4): 259-263.
9.	傅彩峰, 高朝, 楚妍峰, 等. 超聲波聯合懸吊運動療法治療腰肌筋膜疼痛綜合征的臨床觀察. 中華物理醫學與康復雜志, 2016, 38(2): 153-155.
10.	Urits I, Charipova K, Gress K, et al. Treatment and management of myofascial pain syndrome. Best Pract Res Clin Anaesthesiol, 2020, 34(3): 427-448.
11.	Gezginaslan ?, Gümü? Atalay S. High-energy flux density extracorporeal shock wave therapy versus traditional physical therapy modalities in myofascial pain syndrome: a randomized-controlled, single-blind trial. Arch Rheumatol, 2019, 35(1): 78-89.
12.	中華醫學會. 臨床診療指南: 物理醫學與康復分冊. 北京: 人民衛生出版社, 2005: 105-108.
13.	Kim CM, Park JW. Meta-analysis of the effects of physical modality therapy and exercise therapy on neck and shoulder myofascial pain syndrome. Osong Public Health Res Perspect, 2020, 11(4): 251-258.
14.	Shah JP, Danoff JV, Desai MJ, et al. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil, 2008, 89(1): 16-23.
15.	蘇晗, 崔俊武, 王晶晶, 等. 肌筋膜疼痛綜合征的治療研究進展. 廣西醫學, 2021, 43(5): 621-624.
16.	韓曉閣. 深部肌肉刺激聯合 rTMS 對慢性肌筋膜疼痛綜合征患者神經生物標記物表達的影響. 中國疼痛醫學雜志, 2016, 22(9): 645-647.
17.	郄淑燕, 王叢笑, 孫曉靜, 等. 局部振動治療對頸肩痛患者肌肉物理特性及表面肌電信號的影響. 中華物理醫學與康復雜志, 2017, 39(1): 30-33.
18.	程凱, 魏光儀, 羅漢華, 等. 深層肌肉刺激治療腰臀肌筋膜炎的臨床療效研究. 頸腰痛雜志, 2021, 42(5): 751-752.
19.	玄其文, 顧偉. 運動療法治療肌筋膜疼痛綜合征的研究進展. 第二軍醫大學學報, 2021, 42(8): 911-915.
20.	蔡春水, 魏魯青, 尹杰, 等. 運動處方治療慢性頸肌筋膜疼痛綜合征的早期療效觀察. 中國矯形外科雜志, 2011, 19: 1964-1966.
21.	郭玲, 桑志成, 張丁丁, 等. 實時剪切波彈性成像技術檢測斜方肌非自主性緊張的可行性分析. 中華超聲影像學雜志, 2015(4): 333-336.
22.	Yamamoto A, Yamakoshi Y, Ohsawa T, et al. Shear wave velocity measurement of upper trapezius muscle by color Doppler shear wave imaging. J Med Ultrason (2001), 2018, 45(1): 129-136.
23.	Vuorenmaa AS, Siitama EMK, M?kel? KS. Inter-operator and inter-device reproducibility of shear wave elastography in healthy muscle tissues. J Appl Clin Med Phys, 2022, 23(9): e13717.
24.	Ta? S, Onur MR, Y?lmaz S, et al. Shear wave elastography is a reliable and repeatable method for measuring the elastic modulus of the rectus femoris muscle and patellar tendon. J Ultrasound Med, 2017, 36(3): 565-570.

1. 李亞茜, 王會, 周鴻. 剪切波彈性成像和表面肌電圖評估針刺聯合推拿治療頸肩肌筋膜疼痛綜合征的效果. 臨床超聲醫學雜志, 2020, 22(12): 893-897.
2. Fleckenstein J, Zaps D, Rüger LJ, et al. Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: results of across-sectional, nationwide survey. BMC Musculoskelet Disord, 2010, 11: 32.
3. Galasso A, Urits I, An D, et al. A comprehensive review of the treatment and management of myofascial pain syndrome. Curr Pain Headache Rep, 2020, 24(8): 43.
4. 馬明, 孫武東, 湯從智, 等. 深層肌肉刺激聯合本體感覺神經肌肉促進療法治療顳下頜關節紊亂病的療效觀察. 中華物理醫學與康復雜志, 2015, 37(11): 848-850.
5. 趙保禮, 趙智, 張立莊, 等. 筋膜松解術聯合核心肌群訓練治療非特異性下背痛的療效觀察. 中華物理醫學與康復雜志, 2020, 42(3): 239-241.
6. 葛瑞東, 白碩, 郭京偉, 等. 局部肌肉振動對男性慢性非特異性腰痛患者腰背肌疲勞的即刻效應. 中國康復醫學雜志, 2019, 34(3): 287-292.
7. 陳勤, 漆瀟, 張小君, 等. 半導體激光與 DMS 治療腰肌勞損 105 例臨床療效研究. 激光雜志, 2016, 37(8): 149-152.
8. Fontana TL, Richardson CA, Stanton WR. The effect of weight-bearing exercise with low frequency, whole body vibration on lumbosacral proprioception: a pilot study on normal subjects. Aust J Physiother, 2005, 51(4): 259-263.
9. 傅彩峰, 高朝, 楚妍峰, 等. 超聲波聯合懸吊運動療法治療腰肌筋膜疼痛綜合征的臨床觀察. 中華物理醫學與康復雜志, 2016, 38(2): 153-155.
10. Urits I, Charipova K, Gress K, et al. Treatment and management of myofascial pain syndrome. Best Pract Res Clin Anaesthesiol, 2020, 34(3): 427-448.
11. Gezginaslan ?, Gümü? Atalay S. High-energy flux density extracorporeal shock wave therapy versus traditional physical therapy modalities in myofascial pain syndrome: a randomized-controlled, single-blind trial. Arch Rheumatol, 2019, 35(1): 78-89.
12. 中華醫學會. 臨床診療指南: 物理醫學與康復分冊. 北京: 人民衛生出版社, 2005: 105-108.
13. Kim CM, Park JW. Meta-analysis of the effects of physical modality therapy and exercise therapy on neck and shoulder myofascial pain syndrome. Osong Public Health Res Perspect, 2020, 11(4): 251-258.
14. Shah JP, Danoff JV, Desai MJ, et al. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil, 2008, 89(1): 16-23.
15. 蘇晗, 崔俊武, 王晶晶, 等. 肌筋膜疼痛綜合征的治療研究進展. 廣西醫學, 2021, 43(5): 621-624.
16. 韓曉閣. 深部肌肉刺激聯合 rTMS 對慢性肌筋膜疼痛綜合征患者神經生物標記物表達的影響. 中國疼痛醫學雜志, 2016, 22(9): 645-647.
17. 郄淑燕, 王叢笑, 孫曉靜, 等. 局部振動治療對頸肩痛患者肌肉物理特性及表面肌電信號的影響. 中華物理醫學與康復雜志, 2017, 39(1): 30-33.
18. 程凱, 魏光儀, 羅漢華, 等. 深層肌肉刺激治療腰臀肌筋膜炎的臨床療效研究. 頸腰痛雜志, 2021, 42(5): 751-752.
19. 玄其文, 顧偉. 運動療法治療肌筋膜疼痛綜合征的研究進展. 第二軍醫大學學報, 2021, 42(8): 911-915.
20. 蔡春水, 魏魯青, 尹杰, 等. 運動處方治療慢性頸肌筋膜疼痛綜合征的早期療效觀察. 中國矯形外科雜志, 2011, 19: 1964-1966.
21. 郭玲, 桑志成, 張丁丁, 等. 實時剪切波彈性成像技術檢測斜方肌非自主性緊張的可行性分析. 中華超聲影像學雜志, 2015(4): 333-336.
22. Yamamoto A, Yamakoshi Y, Ohsawa T, et al. Shear wave velocity measurement of upper trapezius muscle by color Doppler shear wave imaging. J Med Ultrason (2001), 2018, 45(1): 129-136.
23. Vuorenmaa AS, Siitama EMK, M?kel? KS. Inter-operator and inter-device reproducibility of shear wave elastography in healthy muscle tissues. J Appl Clin Med Phys, 2022, 23(9): e13717.
24. Ta? S, Onur MR, Y?lmaz S, et al. Shear wave elastography is a reliable and repeatable method for measuring the elastic modulus of the rectus femoris muscle and patellar tendon. J Ultrasound Med, 2017, 36(3): 565-570.

West China Medical Journal

Effect of deep muscle stimulation combined with exercise therapy on neck and shoulder myofascial pain syndrome

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