Abstract.[Purpose] The purpose of this study was to identify which manual therapy technique was effective against muscle tenderness and stiffness of myofascial pain syndrome and then, based on the result, to determine the cause of myofascial pain syndrome.[Subjects] The subjects were 23 men and 67 women who had an average age of 65.5 ± 19.0 years. All subjects had normal results in imaging and neurological examinations but complained of chronic pain along with muscle tenderness and stiffness.[Methods] Using a muscle hardness meter, the muscle hardness of the tender, stiff muscles was measured before, immediately after, and 1 week after manual therapy. The subjects were divided into two groups according to the therapy given myotherapy/massage, to provide direct stimulus to the muscle, or joint facilitation/joint mobilization, to improve functional joint disorders. Statistical analysis was conducted using repeated measures ANOVA, and multiple comparisons were performed.[Results] A significant difference in muscle hardness was seen between pre-treatment and post-treatment. A significant difference in muscle hardness was seen between before and 1 week after manual therapy, but not between post-treatment and 1 week after. A significant difference was seen between the direct stimulus to muscle technique and the functional joint disorder technique. Post-treatment muscle hardness decreased more with direct muscle stimulus than with the functional joint disorder technique, and muscle stiffness was decreased even 1 week after treatment.[Conclusion] Manual therapy for muscle tenderness and stiffness of myofascial pain syndrome was effective at reducing muscle stiffness. Moreover, techniques that provide direct stimulus to the muscle are better at reducing voluntary muscle stiffness than techniques that improve functional joint disorders.

This study examined the validity of a practical evaluation method for pitting edema by comparing it to other methods, including circumference measurements and ultrasound image measurements. Fifty-one patients (102 legs) from a convalescent ward in Maruyama Hospital were recruited for study 1, and 47 patients (94 legs) from a convalescent ward in Morinaga Hospital were recruited for study 2. The relationship between the depth of the surface imprint and circumferential measurements, as well as the relationship between the depth of the surface imprint and the thickness of the subcutaneous soft tissue on an ultrasonogram, were analyzed using a Spearman correlation coefficient by rank. There was no significant relationship between the surface imprint depth and circumferential measurements. However, there was a significant relationship between the depth of the surface imprint and the thickness of the subcutaneous soft tissue as measured on an ultrasonogram (correlation coefficient 0.736). Our findings suggest that our novel evaluation method for pitting edema, based on a measurement of the surface imprint depth, is both valid and useful.

[Purpose] To develop and verify the reliability of a new practical evaluation method for pitting edema, which uses the depth of the surface imprint as an indicator. [Subjects] We included 26 inpatients (52 legs). [Methods] The subjects were diagnosed with edema, and we verified the inter- and intra-rater reliabilities of the edema gauge using intraclass correlation coefficients. [Results] For the first and second measurement values and the measured values between the examiners, the intraclass correlation coefficients were high. [Conclusion] Therefore, our findings suggest that the edema gauge, which measures the depth of the surface imprint, has sufficient intra- and inter-rater reliabilities.