Emine Eda KURT, Yeliz DADALI, Fatmanur Aybala KOÇAK, Hatice Rana ERDEM, Figen TUNCAY, Turgut Tursem TOKMAK

Aktif miyofasiyal tetik noktaların ultrason elastografi ile tedavisi sonrası semptomların düzelmesinin monitörizasyonu

Amaç: Ultrason elastografi (UE), dokuların mekanik özelliklerini belirlemek için son zamanlarda geliştirilen bir yöntemdir. Bu çalışmada trapeziusun üst liflerindeki aktif miyofasyal tetik noktaları (MTrP) olan hastaların tedavi öncesi ve sonrası monitorizasyonunda aksiyel-strain UE'nin yararlılığını değerlendirmeyi amaçladık.Gereç ve Yöntem: Çalışmaya miyofasiyal ağrı sendromlu 49 hasta (66 MTrP) dahil edildi. Hastalar iki tedavi grubuna, grup 1 (germe egzersizleri ile tetiknokta enjeksiyonu) ve grup 2 (tetik noktaenjeksiyonu) olarak randomize edildi. Gruplar tedaviden önce, 2 ve 14 gün sonra UE ile, ayrıca dizabilite, ağrı ve basınç ağrı eşiği (PPT) açısından değerlendirildi.Bulgular: Her iki grupta tüm klinik parametreler, başlangıçta, tedavi sonrası 2 ve 14 gün sonra gerinim oranı (Strain ratio –SR) değeri ile kuvvetle ilişkiliydi. Ayrıca Grup 1, tedaviden sonraki 14 gün içinde grup 2'den daha iyi skorlara sahip olsa da her iki grupta dizabilite, ağrı ve tedavi sonrası PPT skorları açısından anlamlı iyileşmeler tespit edildi.Sonuç: Çalışmamızda üst trapezius liflerinde MTrPs için SR değerlerinin başlangıçta ve tedavi sonrası klinik parametrelerle korele olduğu gösterilmiştir. Bu sonuçlara göre, aktif MTrPs 'li hastalarda değerlendirme ve iyileşmeyi izlemek için noninvaziv ve yarı-kantitatif bir yöntem olan aksiyel strain UE yararlı bir yöntem olabilir.

Anahtar Kelimeler:

myofasial tetik nokta, ağrı, basınç ağrı eşiği, Ultrasound elastografi

Monitoring symptom improvements after the treatment of active myofascial trigger points with ultrasound elastography

Purpose: Ultrasound elastography (UE) is a recently developed technique and is used to determine the mechanical properties of tissues. We aimed to assess the usefulness of axial-strain UE for pre and post treatment evaluation of patients with active myofascial triggerpoints (MTrPs) of the upper trapezius.Materials and Methods: The study included 49 patients (66 MTrPs) with myofascial pain syndrome. Patients were randomized into two treatment groups, group 1 (trigger point injection with stretching exercises) and group 2 (trigger point injection). The groups were evaluated with UE before, 2 and 14 days post-treatment. Disability, pain, and pressure pain threshold (PPT) were also assessed. Results: All clinical parameters were strongly correlated with strain ratio (SR) value at baseline, 2 and 14 days post-treatment. Both groups demonstrated significant improvements with respect to Neck Pain and Disability Scale , VAS, and PPT scores post-treatment. However, group 1 had better scores than group 2 in 14 days post-treatment. Conclusion: Our study demonstrated that SR values for MTrPs in the upper trapezius correlated with clinical parameters at baseline and after treatment. According to these results, axial-strain UE, which is non-invasive and semiquantitative method may be usefull to evaluation and monitor improvement in patients with active MTrPs.

Keywords:

myofascial trigger point, pain, pressure pain threshold, ultrasound elastography,

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