A critical overview of the current myofascial pain literature – February 2019

Dommerholt, Jan; Chou, Li-Wei; Finnegan, Michelle; Hooks, Todd

doi:10.1016/j.jbmt.2019.02.017

Cited by 9 publications

(9 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Young hip patients report more insomnia and anxiety than age-matched controls, 21 and baseline psychological impairment is associated with worse postoperative outcomes. 25 Extra-articular myofascial-based therapies such as manual release, dry needling, and trigger point injections 4,24 may be useful adjuncts to facilitate progress with strengthening, movement pattern normalization, and long-term functional improvement. The variability in PT-led intervention highlights the need for better systematic research into the nonsurgical treatment protocols for FAI.…”

Section: Discussionmentioning

confidence: 99%

Short-term Clinical Outcomes of Hip Arthroscopy Versus Physical Therapy in Patients With Femoroacetabular Impingement: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Schwabe

Clohisy

Cheng

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Both physical therapy (PT) and surgery are effective in treating femoroacetabular impingement (FAI), but their relative efficacy has not been well established until recently. Several randomized controlled trials (RCTs) comparing the early clinical outcomes of these treatments have been published, with contradictory results. Purpose/Hypothesis: The purpose of this study was to perform a meta-analysis of RCTs that compared early patient-reported outcomes (PROs) of hip arthroscopy versus PT in patients with symptomatic FAI. The hypothesis was that surgical treatment of FAI leads to better short-term outcomes than PT. Study Design: Systematic review; Level of evidence, 1. Methods: In March 2019, a systematic review was performed to identify RCTs comparing hip arthroscopy and PT in patients with symptomatic FAI. A total of 819 studies were found among 6 databases; of these, 3 RCTs met eligibility (Griffin et al, 2018; Mansell et al, 2018; and Palmer et al, 2019). All 3 RCTs reported international Hip Outcome Tool--33 (iHOT-33) scores, and 2 reported Hip Outcome Score (HOS)–Activities of Daily Living (ADL) and HOS-Sport results. In a random-effects meta-analysis, between-group differences in postintervention scores were assessed according to intention-to-treat and as-treated approaches. Quality was assessed with CONSORT, CERT, TiDieR, and the Cochrane Collaboration tool. Results: The 3 RCTs included 650 patients with FAI; the mean follow-up ranged from 8 to 24 months. All studies reported PRO improvement from baseline to follow-up for both PT and surgery. The quality of the Griffin and Palmer studies was good, with minimal bias. In the Mansell study, a 70% crossover rate from PT to surgery increased the risk of bias. The meta-analysis demonstrated improved iHOT-33 outcomes with surgery compared with PT for intention-to-treat (mean difference [MD], 11.3; P = .046) and as-treated (MD, 12.6; P = .007) analyses. The as-treated meta-analysis of HOS-ADL scores favored surgery (MD, 12.0; P < .001), whereas the intention-to-treat analysis demonstrated no significant difference between groups for HOS-ADL (MD, 3.9; P = .571). Conclusion: In patients with FAI, the combined results of 3 RCTs demonstrated superior short-term outcomes for surgery versus PT. However, PT did result in improved outcomes and did not appear to compromise the surgical outcomes of patients for whom therapy failed and who progressed to surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Short-term Clinical Outcomes of Hip Arthroscopy Versus Physical Therapy in Patients With Femoroacetabular Impingement: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Schwabe

Clohisy

Cheng

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…In computer workers, this may lead to so-called work-related musculoskeletal disorders (WRMD, similar to PRMD) and has been evidenced to be related to the so-called Cinderella hypothesis. 43,44 The Cinderella hypothesis states that the development of muscular pain and repetitive strain injury is due to an overuse of fibers belonging to low threshold motor units. In our study, piano performance presented upper trapezius fatigue after 2 and 4 hours of rehearsals.…”

Section: Effects Of Type and Reps On The Frequency Component Of The E...mentioning

confidence: 99%

Effects of Rehearsal Time and Repertoire Speed on Upper Trapezius Activity in Conservatory Piano Students

Baeyens¹,

Díez²,

Serrien³

et al. 2022

Medical Problems of Performing Artists

View full text Add to dashboard Cite

BACKGROUND: Repetitive piano play may overload neck and shoulder muscles and tendons, leading to playing-related musculoskeletal disorders (PRMDs). METHODS: In this pilot study (EMG data of the extensor carpi radialis have been published separately), surface electromyography (sEMG) activity of the upper trapezius (UT) was captured in 10 conservatory piano students while playing a fast and a slow music score selected from the individual’s repertoire, each 3 minutes long. Measurements were made at baseline and again after 2 hrs and 4 hrs of rehearsal time of the piano études. The amplitude of the sEMG signal was processed by a smoothing algorithm, and the frequency component with a non-orthogonal wavelets procedure. Amplitude of the sEMG was expressed in percent of maximal voluntary contraction (%MVC) at baseline, and the frequency component using median frequency based on the frequency band powers. Statistical analysis encompassed repeated measures ANOVAs for the amplitude and frequency components of the sEMG signal (set at 5%). The students also rated the intensity of rehearsals using a visual analog scale (VAS). RESULTS: The median values for the %MVC presented a global mean for the left trapezius of 5.86 (CI90% 4.71, 6.97) and 5.83 for the right trapezius (CI90% 4.64, 7.05). The rehearsals at moderate intensity increased the amplitude of %MVC of the upper trapezius by around 50% and decreased the median frequency. CONCLUSIONS: Playing faster presented higher magnitudes of activity of the upper trapezius. The decrease in the median frequency in response to long rehearsals may be a sign of muscle fatigue.

show abstract

“…The clinical literature has for decades included descriptions of focal indurated and tender bands or "knots" commonly found within shortened or weak muscles. 20,66,71 Following unhabitual exercise or repetitive movement, these focal areas can become spontaneously painful and cause local and/or referred pain that typically resolves within a few days, but commonly recurs in a chronic pattern. 71 Remarkably, there has been a near complete lack of imaging methods or animal models to investigate the pathophysiological underpinnings of these clinical observations.…”

Section: Pain and The Brainmentioning

confidence: 99%

Reconnecting the Brain With the Rest of the Body in Musculoskeletal Pain Research

Langevin

2021

The Journal of Pain

View full text Add to dashboard Cite

A challenge in understanding chronic musculoskeletal pain is that research is often siloed between neuroscience, physical therapy/rehabilitation, orthopedics, and rheumatology which focus respectively on 1) neurally mediated effects on pain processes, 2) behavior and muscle activity, 3) tissue structure, and 4) inflammatory processes. Although these disciplines individually study important aspects of pain, there is a need for more cross-disciplinary research that can bridge between them. Identifying the gaps in knowledge is important to understand the whole body, especially at the interfaces between the silos-between brain function and behavior, between behavior and tissue structure, between musculoskeletal and immune systems, and between peripheral tissues and the nervous system. Research on "mind and body" practices can bridge across these silos and encourage a "whole person" approach to better understand musculoskeletal pain by bringing together the brain and the rest of the body. Perspective: Research on chronic musculoskeletal pain is limited by significant knowledge gaps. To be fully integrated, musculoskeletal pain research will need to bridge across tissues, anatomical areas, and body systems. Research on mind and body approaches encourages a "whole person" approach to better understand musculoskeletal pain.

show abstract

A critical overview of the current myofascial pain literature – February 2019

Cited by 9 publications

References 38 publications

Short-term Clinical Outcomes of Hip Arthroscopy Versus Physical Therapy in Patients With Femoroacetabular Impingement: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Short-term Clinical Outcomes of Hip Arthroscopy Versus Physical Therapy in Patients With Femoroacetabular Impingement: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Effects of Rehearsal Time and Repertoire Speed on Upper Trapezius Activity in Conservatory Piano Students

Reconnecting the Brain With the Rest of the Body in Musculoskeletal Pain Research

Contact Info

Product

Resources

About