Mateusz D Kobylarz, Sebastian Klich, Sandra Sánchez-Jorge, Jorge Buffet-García, Ricardo Ortega-Santiago, Juan Antonio Valera-Calero
{"title":"剪切波弹性成像支持肌肉刚度不应该被认为是确定冈下肌肌筋膜触发点存在的标准。","authors":"Mateusz D Kobylarz, Sebastian Klich, Sandra Sánchez-Jorge, Jorge Buffet-García, Ricardo Ortega-Santiago, Juan Antonio Valera-Calero","doi":"10.1097/PHM.0000000000002721","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine latent myofascial trigger points and asymptomatic surrounding areas differences in pain pressure thresholds and shear-wave elastography metrics differences.</p><p><strong>Design: </strong>Latent myofascial trigger points and asymptomatic control points were identified within the infraspinatus muscle. A blinded examiner assessed the pain pressure thresholds and acquired three shear-wave elastography images of each location. Pain pressure threshold and shear-wave elastography scores were compared by location (myofascial trigger point and control) and gender. Finally, correlations among demographics, pain pressure thresholds, and shear-wave elastography data were calculated.</p><p><strong>Results: </strong>Forty participants were analyzed. Pain pressure thresholds were significantly lower in latent myofascial trigger points compared with control points in males ( P = 0.003) and females ( P < 0.001), and lower in females compared with males (myofascial trigger point P < 0.001; control point P = 0.006). No significant shear-wave elastography differences were found between myofascial trigger points and control points ( P > 0.05) nor between males and females (myofascial trigger point and control points, P > 0.05). In contrast with the accepted myofascial trigger point definition, those areas with greater pain pressure thresholds exhibited greater stiffness via shear-wave elastography ( P < 0.01).</p><p><strong>Conclusions: </strong>Although pain pressure threshold scores indicated significant differences in hyperirritability between latent myofascial trigger points and control points, shear-wave elastography measurements revealed no significant differences in muscle stiffness. Furthermore, muscle stiffness was significantly associated with greater pain pressure threshold scores, challenging the hypothesis that stiffer areas can be identified as myofascial trigger points or sources of pain.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"890-895"},"PeriodicalIF":2.4000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Shear-Wave Elastography Supports That Muscle Stiffness Should Not Be Considered a Criterion to Determine the Presence of Myofascial Trigger Points in the Infraspinatus Muscle.\",\"authors\":\"Mateusz D Kobylarz, Sebastian Klich, Sandra Sánchez-Jorge, Jorge Buffet-García, Ricardo Ortega-Santiago, Juan Antonio Valera-Calero\",\"doi\":\"10.1097/PHM.0000000000002721\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to determine latent myofascial trigger points and asymptomatic surrounding areas differences in pain pressure thresholds and shear-wave elastography metrics differences.</p><p><strong>Design: </strong>Latent myofascial trigger points and asymptomatic control points were identified within the infraspinatus muscle. A blinded examiner assessed the pain pressure thresholds and acquired three shear-wave elastography images of each location. Pain pressure threshold and shear-wave elastography scores were compared by location (myofascial trigger point and control) and gender. Finally, correlations among demographics, pain pressure thresholds, and shear-wave elastography data were calculated.</p><p><strong>Results: </strong>Forty participants were analyzed. Pain pressure thresholds were significantly lower in latent myofascial trigger points compared with control points in males ( P = 0.003) and females ( P < 0.001), and lower in females compared with males (myofascial trigger point P < 0.001; control point P = 0.006). No significant shear-wave elastography differences were found between myofascial trigger points and control points ( P > 0.05) nor between males and females (myofascial trigger point and control points, P > 0.05). In contrast with the accepted myofascial trigger point definition, those areas with greater pain pressure thresholds exhibited greater stiffness via shear-wave elastography ( P < 0.01).</p><p><strong>Conclusions: </strong>Although pain pressure threshold scores indicated significant differences in hyperirritability between latent myofascial trigger points and control points, shear-wave elastography measurements revealed no significant differences in muscle stiffness. Furthermore, muscle stiffness was significantly associated with greater pain pressure threshold scores, challenging the hypothesis that stiffer areas can be identified as myofascial trigger points or sources of pain.</p>\",\"PeriodicalId\":7850,\"journal\":{\"name\":\"American Journal of Physical Medicine & Rehabilitation\",\"volume\":\" \",\"pages\":\"890-895\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Physical Medicine & Rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/PHM.0000000000002721\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Physical Medicine & Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PHM.0000000000002721","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/8 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
Shear-Wave Elastography Supports That Muscle Stiffness Should Not Be Considered a Criterion to Determine the Presence of Myofascial Trigger Points in the Infraspinatus Muscle.
Objective: This study aimed to determine latent myofascial trigger points and asymptomatic surrounding areas differences in pain pressure thresholds and shear-wave elastography metrics differences.
Design: Latent myofascial trigger points and asymptomatic control points were identified within the infraspinatus muscle. A blinded examiner assessed the pain pressure thresholds and acquired three shear-wave elastography images of each location. Pain pressure threshold and shear-wave elastography scores were compared by location (myofascial trigger point and control) and gender. Finally, correlations among demographics, pain pressure thresholds, and shear-wave elastography data were calculated.
Results: Forty participants were analyzed. Pain pressure thresholds were significantly lower in latent myofascial trigger points compared with control points in males ( P = 0.003) and females ( P < 0.001), and lower in females compared with males (myofascial trigger point P < 0.001; control point P = 0.006). No significant shear-wave elastography differences were found between myofascial trigger points and control points ( P > 0.05) nor between males and females (myofascial trigger point and control points, P > 0.05). In contrast with the accepted myofascial trigger point definition, those areas with greater pain pressure thresholds exhibited greater stiffness via shear-wave elastography ( P < 0.01).
Conclusions: Although pain pressure threshold scores indicated significant differences in hyperirritability between latent myofascial trigger points and control points, shear-wave elastography measurements revealed no significant differences in muscle stiffness. Furthermore, muscle stiffness was significantly associated with greater pain pressure threshold scores, challenging the hypothesis that stiffer areas can be identified as myofascial trigger points or sources of pain.
期刊介绍：
American Journal of Physical Medicine & Rehabilitation focuses on the practice, research and educational aspects of physical medicine and rehabilitation. Monthly issues keep physiatrists up-to-date on the optimal functional restoration of patients with disabilities, physical treatment of neuromuscular impairments, the development of new rehabilitative technologies, and the use of electrodiagnostic studies. The Journal publishes cutting-edge basic and clinical research, clinical case reports and in-depth topical reviews of interest to rehabilitation professionals.
Topics include prevention, diagnosis, treatment, and rehabilitation of musculoskeletal conditions, brain injury, spinal cord injury, cardiopulmonary disease, trauma, acute and chronic pain, amputation, prosthetics and orthotics, mobility, gait, and pediatrics as well as areas related to education and administration. Other important areas of interest include cancer rehabilitation, aging, and exercise. The Journal has recently published a series of articles on the topic of outcomes research. This well-established journal is the official scholarly publication of the Association of Academic Physiatrists (AAP).
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