Prevalence and sensitivity of trigger points in lumbo-pelvic-hip muscles in patients with patellofemoral pain syndrome

Samani, Mahbobeh; Ghaffarinejad, Farahnaz; Abolahrari-Shirazi, Sara; Khodadadi, Tahereh; Roshan, Fatemeh

doi:10.1016/j.jbmt.2019.10.012

Cited by 9 publications

(7 citation statements)

References 22 publications

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“…Current evidence recommends a multidisciplinary therapeutic approach, including MTrP management to reduce exacerbated mechano-sensitivity and SAKPP and improve knee function[ 6 , 18 ]. Although several invasive procedures have been compared ( e.g.…”

Section: Discussionmentioning

confidence: 99%

“…As a previous study proposed that treatment of MTrP may be an effective way to diminish the pain associated with PFPS[ 6 , 18 ], the aim of this study was to assess the efficacy of percutaneous electrolysis compared with DN in patients with unilateral PFPS for improving rectus femoris MTrP and patellar tendon pain pressure thresholds (PPTs), subjective anterior knee pain perception (SAKPP) and perceived pain during interventions.…”

Section: Introductionmentioning

confidence: 99%

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Short-term effectiveness of high- and low-intensity percutaneous electrolysis in patients with patellofemoral pain syndrome: A pilot study

Valera‐Calero

Sánchez-Mayoral-Martín

Varol

2021

WJO

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BACKGROUND Unilateral patellofemoral pain syndrome (PFPS) is the most frequently diagnosed knee condition in populations aged < 50 years old. Although the treatment of myofascial trigger points (MTrPs) is a common and effective tool for reducing pain, previous studies showed no additional benefits compared with placebo in populations with PFPS. Percutaneous electrolysis is a minimally invasive approach frequently used in musculotendinous pathologies which consists of the application of a galvanic current through dry needling (DN). AIM To evaluate changes in sensitivity, knee pain perception and perceived pain during the application of these three invasive techniques. METHODS A triple-blinded, pilot randomized controlled trial was conducted on fifteen patients with unilateral PFPS who were randomized to the high-intensity percutaneous electrolysis (HIPE) experimental group, low-intensity percutaneous electrolysis (LIPE) experimental group or DN active control group. All interventions were conducted in the most active MTrP, in the rectus femoris muscle. The HIPE group received a 660 mA galvanic current for 10 s, the LIPE group 220 mA × 30 s and the DN group received no galvanic current. The MTrP and patellar tendon pain pressure thresholds (PPTs) and subjective anterior knee pain perception (SAKPP) were assessed before, after and 7 d after the single intervention. In addition, perceived pain during the intervention was also assessed. RESULTS Both groups were comparable at baseline as no significant differences were found for age, height, weight, body mass index, PPTs or SAKPP. No adverse events were reported during or after the interventions. A significant decrease in SAKPP (both HIPE and LIPE, P < 0.01) and increased patellar tendon PPT (all, P < 0.001) were found, with no differences between the groups (VAS: F = 0.30; η 2 = 0.05; P > 0.05; tendon PPT immediate effects: F = 0.15; η 2 = 0.02; P > 0.05 and tendon PPT 7-d effects: F = 0.67; η 2 = 0.10; P > 0.05). A significant PPT increase in rectus femoris MTrP was found at follow-up in both the HIPE and LIPE groups (both, P < 0.001) with no differences between the groups (immediate effects: F= 1.55; η 2 = 0.20; P > 0.05 and 7-d effects: F = 0.71; η 2 = 0.10; P > 0.05). Both HIPE and LIPE interventions were considered less painful compared with DN (F = 8.52; η 2 = 0.587; P < 0.01). CONCLUSION HIPE and LIPE induce PPT changes in MTrPs and patellar tendon and improvements in SAKPP, and seem to produce less pain during the intervention compa...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Short-term effectiveness of high- and low-intensity percutaneous electrolysis in patients with patellofemoral pain syndrome: A pilot study

Valera‐Calero

Sánchez-Mayoral-Martín

Varol

2021

WJO

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“…In fact, active MTrPs in the sartorius muscle are as prevalent (11.1%) as in other knee muscles such as gastrocnemius, vastus lateralis, and medialis [ 7 , 8 ]. Surprisingly, the presence of active MTrPs in other muscles more commonly associated with anterior knee pain, e.g., gracilis, tibialis anterior, and rectus femoris, have shown a prevalence rate of 5.5%.…”

Section: Discussionmentioning

confidence: 99%

“…Active MTrPs elicit referred pain that reproduces the symptoms of a patient, whereas MTrPs are latent when referred pain does not reproduce any symptom [ 6 ]. In fact, the prevalence of active MTrPs in the sartorius muscle is 57.6% in individuals with patellofemoral pain syndrome [ 7 ] and 64.8% in those with painful knee osteoarthritis [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Regression Model Decreasing the Risk of Femoral Neurovascular Bundle Accidental Puncture

et al. 2022

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Although most of the adverse events derived from dry needling are minor, avoiding potential hazards for patients including accidental invasion of vessels, ganglia, and nerves is essential to ensure patients’ safety. We aimed to investigate the contribution of predictors explaining the variance of sartorius muscle depth limit at proximal third and middle thigh as these locations lead to an augmented risk of neurovascular bundle invasion during dry needling application. A diagnostic study was conducted on 84 subjects to calculate the accuracy of a prediction model for sartorius depth, as assessed with ultrasound imaging, based on sex, age, height, weight, body mass index (BMI), thigh perimeter, and length. After calculating a correlation matrix, a multiple linear regression analysis was performed to detect those variables contributing to the sartorius deep limit in both locations. Although males showed greater thigh perimeter than women (p < 0.001), the deep limit of the sartorius muscle was significantly more superficial for both the proximal third (p = 0.003) and the mid-third (p = 0.004) points. No side-to-side anthropometric differences were found (p > 0.05). In addition, we found sartorius muscle depth to be associated with the proximal and mid-third girth, gender, height, and BMI (all, p < 0.01). Gender, proximal-third girth, and BMI explained 51.1% and 42.6% of the variance for the sartorius deep limit at the proximal and the mid-third, respectively. This study analyzed whether anthropometric features could predict sartorius muscle depth in healthy participants for assisting clinicians in choosing the optimal needle length to avoid accidental femoral bundle puncture.

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“…Muscle weakness, pain, abnormal motor control, and impairment in proprioception inputs are possible reasons for the alteration of postural control in these patients [ 6 , 9 ]. Pain threshold has been reported to be lower, especially in the quadriceps, in patients with PFP in comparison to the healthy individuals [ 10 ]. Quality of life (QOL) is disturbed among patients with PFP.…”

Section: Introductionmentioning

confidence: 99%

The effects of virtual reality training on clinical indices and brain mapping of women with patellofemoral pain: a randomized clinical trial

Ebrahimi

Rojhani-Shirazi

Yoosefinejad

et al. 2021

BMC Musculoskelet Disord

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Background Virtual reality training (VRT) is a new method for the rehabilitation of musculoskeletal impairments. However, the clinical and central effects of VRT have not been investigated in patients with patellofemoral pain (PFP). To comprehensively assess the effects of VRT on clinical indices and brain function, we used a randomized clinical trial based on clinical and brain mapping assessment. Methods Twenty-six women with PFP for more than 6 months were randomly allocated to 2 groups: intervention and control. The intervention consisted of lifestyle education + 8 weeks VRT, in 24 sessions each lasting 40 min of training, whereas the control group just received lifestyle education. The balance was the primary outcome and was measured by the modified star excursion balance test. Secondary outcomes included pain, function, quality of life, and brain function which were assessed by visual analogue scale, step down test and Kujala questionnaire, SF-36, and EEG, respectively. Pre-intervention, post-intervention and follow-up (1 month after the end of the intervention) measurements were taken for all outcome measures except EEG, which was evaluated only at pre-intervention and post-intervention). Analyses of variance was used to compare the clinical outcomes between the two groups. The independent t-test also was used for between group EEG analyses. Results Balance score (P < 0.001), function (P < 0.001), and quality of life (P = 0.001) improved significantly at post-intervention and 1 month follow-up in the VRT group compared with the control group. VRT group showed a significantly decreased pain score (P = 0.004). Alpha (P < 0.05) and theta (P = 0.01) power activity also increased in the brain of the VRT group. Conclusion This study demonstrated that long term VRT was capable of improving both clinical impairments and brain function in patients with PFP. Therefore, therapists and clinicians can use this method as a more holistic approach in the rehabilitation of PFP. Trial registration IRCT, IRCT20090831002391N40. Registered 23 / 10 / 2019.

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Prevalence and sensitivity of trigger points in lumbo-pelvic-hip muscles in patients with patellofemoral pain syndrome

Cited by 9 publications

References 22 publications

Short-term effectiveness of high- and low-intensity percutaneous electrolysis in patients with patellofemoral pain syndrome: A pilot study

Short-term effectiveness of high- and low-intensity percutaneous electrolysis in patients with patellofemoral pain syndrome: A pilot study

Regression Model Decreasing the Risk of Femoral Neurovascular Bundle Accidental Puncture

The effects of virtual reality training on clinical indices and brain mapping of women with patellofemoral pain: a randomized clinical trial

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