Novel method to measure active myofascial trigger point stiffness using ultrasound imaging

Jafari, Mehdi; Bahrpeyma, Farid; Mokhtari‐Dizaji, Manijhe; Nasiri, Azadeh

doi:10.1016/j.jbmt.2017.06.019

Cited by 22 publications

(45 citation statements)

References 20 publications

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“…In participants with myofascial trigger points, US-based SWEstiffness measurements were 89% higher directly over the trigger points compared with the adjacent fibers within the same muscle. 31 It is interesting to note that our results for SCM and UT SWE stiffness were 2 to 3 times higher than the values reported previously. 30 However, because of the current, less reliable values and the higher coefficient of variance for the SWE-stiffness measurements, further refinement of the technique is required.…”

Section: Discussioncontrasting

confidence: 74%

Sex Differences in Ultrasound-Based Muscle Size and Mechanical Properties of the Cervical-Flexor and -Extensor Muscles

Nagai

Schilaty

Krause

et al. 2020

Journal of Athletic Training

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Context Neck pain (NP), neck injuries, and concussions are more prevalent in female athletes than in their male counterparts. Females exhibit less neck girth, strength, and stiffness against a perturbation. As part of the clinical examination for individuals with NP, ultrasound (US)–based imaging of the cervical muscles has become common. Muscle size or thickness and stiffness can be measured with US-based B-mode and shear-wave elastography (SWE), respectively. Information on reliability, normative values, and sex differences based on US-based muscle size or thickness and stiffness in young and athletic individuals is limited. Objective To evaluate sex differences in US-based muscle size or thickness and biomechanical properties of the cervical-flexor and -extensor muscles. Design Cross-sectional study. Setting Laboratory. Patients or Other Participants A total of 13 women (age = 23.7 ± 1.9 years, height = 167.1 ± 6.1 cm, mass = 63.8 ± 5.6 kg) and 11 men (age = 25.6 ± 4.9 years, height = 178.7 ± 8.3 cm, mass = 78.9 ± 12.0 kg). Main Outcome Measure(s) The same examiner collected all measures, using US B-mode to scan the cross-sectional area and thickness of the longus colli (LC), sternocleidomastoid (SCM), cervical-extensor muscles, and upper trapezius (UT) muscle. The US SWE-mode was used to measure the stiffness of the SCM and UT. Independent t tests or Mann-Whitney U tests were calculated to determine sex differences. The intraclass correlation coefficient (ICC) measured intrarater test-retest reliability. Results Men had thicker SCMs than women (P = .01). No sex differences were present for longus colli cross-sectional area, cervical-extensor muscle thickness, or UT thickness (P > .05). In addition, no sex differences were evident for SCM (P = .302) or UT (P = .703) SWE stiffness. Reliability was good to excellent (ICC = 0.715–0.890) except for SCM SWE stiffness (ICC = 0.554). Conclusions The only sex difference was in SCM thickness. However, smaller SCMs in women did not result in less SCM SWE stiffness. We provided normative values for US-based imaging of the cervical-flexor and -extensor muscles in young and athletic men and women.

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Section: Discussioncontrasting

confidence: 74%

Sex Differences in Ultrasound-Based Muscle Size and Mechanical Properties of the Cervical-Flexor and -Extensor Muscles

Nagai

Schilaty

Krause

et al. 2020

Journal of Athletic Training

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“…Previous studies observed MTrPs using Bmode US are consistent describing MTrPs as hypoechoic regions [28], and using Doppler US found speci c puslatility index response in MTrPs [29]. Furthermore, one study conducted by Jafari et al [30] assessed MTrP stiffness by using elastography imaging to distinguish quantitatively MTrP from normal tissue, obtaining signi cative differences between MTrPs and the normal part of the muscle. The methodology assessed on this study could be applied to calculate the SR between a MTrP-control point and 2-control points (since it showed a good validity and reliability), its correlation with pain pressure thresholds and SR changes after treatment.…”

Section: Discussionmentioning

confidence: 86%

How Accurate Is Semi-quantitative Elastography for Calculating Strain Ratios? A Validity and Reliability Study

Valera‐Calero¹,

Fernández‐de‐las‐Peñas²,

Fernández-Rodríguez³

et al. 2021

Preprint

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Background: Elastography is a promising imaging technique for evaluating various musculoskeletal tissues which uses acoustic radiation force pulse sequences to generate shear waves, which propagate perpendicular to the ultrasound beam causing transient displacements to calculate the tissues stiffness. Objective: The aims were to assess the validity, inter-examiner reliability and stability of semi-quantitative elastography for calculating strain ratios (SR) in a homogeneous gel phantom in different locations within the image. Methods: A diagnostic accuracy study was performed in a homogeneous stiffness phantom. Two examiners (one novice and one experienced) performed 50 imaging captures in 5 series of 10 captures with 1-minute difference between captures and 30 minutes difference be-tween series. Each examiner assessed the SR in two locations. Difference between-examiners, stability of measurements, SR error and absolute error, mean error of the measurements and coefficient of variation were calculated. Results: The agreement between examiners, validity and stability of measurements were higher in the central area than the lateral limits of the images. Thus, the experience of the examiner showed to be relevant for the concordance of the measurements in the lateral limits of the images (SR difference of 0.13 ± 0.02; p<0.001), but not for the central area (SR difference of 0.00 ± 0.01; p>0.05). Conclusion: Semi-quantitative elastography seems to be an accurate tool for assessing stiffness differences within the same image. Further validity and reliability studies in different materials and in-vivo tissues are needed to ensure the utility of this method.

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“…skurcz mięśni) oraz wykazuje korelacje między strukturą a funkcją [32]. Coraz więcej doniesień wskazuje, że TR można zobrazować podczas badania USG, szczególnie gdy wyniki są analizowanie w korelacji do badania przedmiotowego [32,[43][44][45][46]. TR podczas badania USG widoczne jest jako echogeniczne, owalne pasmo zlokalizowane na odpowiedniej głębokości w mięśniu [47].…”

Section: Ultrasonografiaunclassified

Objective methods of diagnosing myofascial pain syndrome

Piętka¹,

Onik²,

Knapik³

et al. 2021

Med Og Nauk Zdr.

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Wprowadzenie i cel pracy. Zespół bólu mięśniowo-powięziowego (ang. myofascial pain syndrome, MPS) to istotny problem kliniczny, który pomimo licznych doniesień naukowych pozostaje nadal nie w pełni wyjaśniony. Dotyczy to szczególnie zagadnień związanych z patomechanizmem oraz tworzeniem standardów diagnostycznych i terapeutycznych. W praktyce klinicznej do najczęściej stosowanych metod rozpoznawania MPS zalicza się badanie palpacyjne. Niemniej jednak badanie to obarczone jest ryzykiem dużego błędu. W związku z powyższym podczas diagnostyki MPS potrzeba rzetelnych, powtarzalnych pomiarów, które powinny charakteryzować się wysoką czułością, aby umożliwić wykrycie klinicznie ważnych zmian. Celem artykułu jest przegląd obiektywnych metod diagnostycznych istotnych dla prawidłowego rozpoznania MPS. Opis stanu wiedzy. Postęp medycyny klinicznej zależy od umiejętności dokładnego diagnozowania choroby i bezstronnej oceny efektów leczenia. Wydaje się zatem kluczowe opracowanie skutecznych, obiektywnych metod diagnozowania MPS. Obecnie brak jest konsensusu wśród klinicystów dotyczącego schematu diagnostycznego MPS. Podsumowanie. Najbardziej rzetelnym badaniem wydaje się badanie palpacyjne wykonane przez doświadczonego terapeutę. Następnie ustalając na jego podstawie kryteria diagnostyczne D.G. Simonsa wraz z podparciem diagnozy za pomocą jednego z obiektywnych narzędzi oceniających zmiany w tkance mięśniowej sugerujące obecność punktu spustowego.

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Novel method to measure active myofascial trigger point stiffness using ultrasound imaging

Cited by 22 publications

References 20 publications

Sex Differences in Ultrasound-Based Muscle Size and Mechanical Properties of the Cervical-Flexor and -Extensor Muscles

Sex Differences in Ultrasound-Based Muscle Size and Mechanical Properties of the Cervical-Flexor and -Extensor Muscles

How Accurate Is Semi-quantitative Elastography for Calculating Strain Ratios? A Validity and Reliability Study

Objective methods of diagnosing myofascial pain syndrome

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