Is musculoskeletal pain associated with increased muscle stiffness? Evidence map and critical appraisal of muscle measurements using shear wave elastography

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging Pub Date : 2023-12-28 DOI:10.1111/cpf.12870

Andreas Haueise, Guillaume Le Sant, Angelika Eisele-Metzger, Angela V. Dieterich

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引用次数: 0

Abstract

Introduction and Aims

Approximately 21% of the world's population suffers from musculoskeletal conditions, often associated with sensations of stiff muscles. Targeted therapy requires knowing whether typically involved muscles are objectively stiffer compared to asymptomatic individuals. Muscle stiffness is quantified using ultrasound shear wave elastography (SWE). Publications on SWE-based comparisons of muscle stiffness between individuals with and without musculoskeletal pain are increasing rapidly. This work reviewed and mapped the existing evidence regarding objectively measured muscle stiffness in musculoskeletal pain conditions and surveyed current methods of applying SWE to measure muscle stiffness.

Methods

A systematic search was conducted in PubMed and CINAHL using the keywords “muscle stiffness”, “shear wave elastography”, “pain”, “asymptomatic controls” and synonyms. The search was supplemented by a hand search using Google Scholar. Included articles were critically appraised with the AXIS tool, supplemented by items related to SWE methods. Results were visually mapped and narratively described.

Results

Thirty of 137 identified articles were included. High-quality evidence was missing. The results comprise studies reporting lower stiffness in symptomatic participants, no differences between groups and higher stiffness in symptomatic individuals. Results differed between pain conditions and muscles, and also between studies that examined the same muscle(s) and pathology. The methods of the application of SWE were inconsistent and the reporting was often incomplete.

Conclusions

Existing evidence regarding the objective stiffness of muscles in musculoskeletal pain conditions is conflicting. Methodological differences may explain most of the inconsistencies between findings. Methodological standards for SWE measurements of muscles are urgently required.

Abstract Image

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肌肉骨骼疼痛与肌肉僵硬度增加有关吗？- 使用剪切波弹性成像技术测量肌肉的证据图和批判性评估。

导言和目的：全球约有 21% 的人患有肌肉骨骼疾病，这些疾病通常与肌肉僵硬的感觉有关。要进行有针对性的治疗，就必须了解与无症状的人相比，受影响的肌肉是否明显僵硬。肌肉僵硬可通过超声剪切波弹性成像（SWE）进行量化。基于 SWE 对肌肉骨骼疼痛患者和无肌肉骨骼疼痛患者的肌肉僵硬度进行比较的文献正在迅速增加。本研究回顾并绘制了有关肌肉骨骼疼痛情况下客观测量肌肉僵硬度的现有证据，并调查了目前应用 SWE 测量肌肉僵硬度的方法：在 PubMed 和 CINAHL 中使用关键词 "肌肉僵硬度"、"剪切波弹性成像"、"疼痛"、"无症状对照组 "和同义词进行了系统检索。此外，还使用 Google Scholar 进行了人工搜索。使用 AXIS 工具对纳入的文章进行了严格评估，并补充了与剪切波弹性成像方法相关的项目。对结果进行了视觉映射和叙述性描述：在 137 篇已确定的文章中，有 30 篇被收录。缺少高质量的证据。结果包括报告有症状的参与者僵硬度较低、组间无差异以及有症状的个体僵硬度较高的研究。不同的疼痛情况和肌肉，以及检查相同肌肉和病理的研究之间的结果也不尽相同。应用SWE的方法不一致，报告也往往不完整：结论：有关肌肉骨骼疼痛情况下肌肉客观僵硬度的现有证据相互矛盾。方法上的差异可能是导致研究结果不一致的主要原因。迫切需要制定肌肉 SWE 测量方法标准。本文受版权保护。保留所有权利。

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来源期刊

Clinical Physiology and Functional Imaging 医学-生理学

CiteScore

3.40

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.