About
Scope & Aims
Editorial office
Editorial board
Reviewers
Ethical standards and procedures
Abstracting and indexing
Contact
Articles & Issues
Current issue
Articles in press
Archive
For Authors
General rules
Guide for authors
Templates
Publication charge
For Reviewers
Guide for reviewers
Our reviewers
ORIGINAL PAPER
Effect of myofascial trigger points release with shockwave therapy on shoulder hand syndrome in stroke patients
1
Lecturer, Faculty of Physical Therapy, Department of Neuromuscular Disorder and Its Surgery, October 6 University, Egypt
2
Faculty of Physical Therapy, Department of Musculoskeletal Disorders and Its Surgery, October 6 University, Egypt
3
Lecturer, Faculty of Physical Therapy, Department of Physical Therapy For Internal Diseases, October 6 University, Egypt
Submission date: 2020-11-18
Acceptance date: 2021-04-06
Publication date: 2022-02-07
Physiother Quart. 2023;31(2):59-65
KEYWORDS
TOPICS
ABSTRACT
Introduction:
To investigate the influence of Myofascial Trigger Points (MTrPs) release combined with shockwave therapy on pain and functions of the upper extremity with shoulder hand syndrome (SHS) in stroke patients with diabetic neuropathy.
Methods:
Two groups of thirty stroke patients, divided equally into, the study group: which received MTrPs release with shockwave therapy and conventional physical therapy program, while the control group: received the conventional physical therapy program. All the patients were evaluated pre-and post-intervention by the severity score of the Complex Regional Pain Syndrome (CRPS), Motor Evaluation Scale Upper Extremity Stroke Patients (MESUPES), the figure of eight test for hand swelling, and the Visual Analogue Scale for pain (VAS-P).
Results:
highly significant improvement of affected upper extremity functions, with a significant reduction of SHS symptoms, swelling, and pain of the study group compared to the control group (p < 0.05), also there was a negative significant correlation between MESUPES- all-out score and VAS-P.
Conclusions:
The combination of both MTrPs release with shockwave therapy had a significant improvement effect on upper extremity function and a significant reduction of both SHS symptoms and pain in stroke patients with diabetic neuropathy, which leads to improvement in stroke patients’ functional rehabilitation.
To investigate the influence of Myofascial Trigger Points (MTrPs) release combined with shockwave therapy on pain and functions of the upper extremity with shoulder hand syndrome (SHS) in stroke patients with diabetic neuropathy.
Methods:
Two groups of thirty stroke patients, divided equally into, the study group: which received MTrPs release with shockwave therapy and conventional physical therapy program, while the control group: received the conventional physical therapy program. All the patients were evaluated pre-and post-intervention by the severity score of the Complex Regional Pain Syndrome (CRPS), Motor Evaluation Scale Upper Extremity Stroke Patients (MESUPES), the figure of eight test for hand swelling, and the Visual Analogue Scale for pain (VAS-P).
Results:
highly significant improvement of affected upper extremity functions, with a significant reduction of SHS symptoms, swelling, and pain of the study group compared to the control group (p < 0.05), also there was a negative significant correlation between MESUPES- all-out score and VAS-P.
Conclusions:
The combination of both MTrPs release with shockwave therapy had a significant improvement effect on upper extremity function and a significant reduction of both SHS symptoms and pain in stroke patients with diabetic neuropathy, which leads to improvement in stroke patients’ functional rehabilitation.
REFERENCES (41)
1.
Adey-Wakeling Z, Arima H, Crotty M, Leyden J, Kleinig T, Anderson CS, et al. Incidence and associations of hemiplegic shoulder pain poststroke: prospective population-based study. Arch Phys Med Rehabil. 2015;96(2):241–247; doi: 10.1016/j.apmr.2014.09.007.
2.
Liu S, Zhang CS, Cai Y, Guo X, Zhang AL, Xue CC, et al. Acupuncture for post-stroke shoulder-hand syndrome: a systematic review and meta-analysis. Front Neurol. 2019;10:433; doi: 10.3389/fneur.2019.00433.
3.
Kocabas H, Levendoglu F, Ozerbil OM, Yuruten B. Complex regional pain syndrome in stroke patients. Int J Rehabil Res. 2007;30(1):33–38; doi: 10.1097/MRR.0b013e3280146f57.
4.
Sebastin SJ. Complex regional pain syndrome. Indian J Plastic Surg. 2011;44(2):298–307; doi: 10.4103/0970-0358.85351.
5.
Kim YW, Kim Y, Kim JM, Hong JS, Lim HS, Kim HS. Is poststroke complex regional pain syndrome the combination of shoulder pain and soft tissue injury of the wrist?: A prospective observational study: STROBE of ultrasonographic findings in complex regional pain syndrome. Medicine. 2016;95(31):e4388; doi: 10.1097/MD.0000000000004388.
6.
Vahdatpour B, Taheri P, Zade AZ, Moradian S. Efficacy of extracorporeal shockwave therapy in frozen shoulder. Int J Prev Med. 2014;5(7):875–881.
7.
Hannan MA, Sabeka MM, Miah MBA. Shoulder hand syndrome in hemispheric stroke. J Neurol Sci. 2013;333(Suppl 1):e167; doi: 10.1016/j.jns.2013.07.693.
8.
Maxwell AMW, Nguyen VQC. Management of hemiplegic shoulder pain. Curr Phys Med Rehabil Rep. 2013;1:1–8; doi: 10.1007/s40141-012-0001-y.
9.
Wyatt LH, Ferrance RJ. The musculoskeletal effects of diabetes mellitus. J Can Chiropr Assoc. 2006;50(1):43–50.
10.
Choi JH, Yu KP, Yoon Y-S, Kim ES, Jeon JH. Relationship between HbA1c and complex regional pain syndrome in stroke patients with type 2 diabetes mellitus. Ann Rehabil Med. 2016;40(5):779–785; doi: 10.5535/arm.2016.40.5.779.
11.
Liporaci FM, Mourani MM, Riberto M. The myofascial component of the pain in the painful shoulder of the hemiplegic patient. Clinics. 2019;74:e905; doi: 10.6061/clinics/2019/e905.
12.
Duncan B, McDonough-Means S, Worden K, Schnyer R, Andrews J, Meaney FJ. Effectiveness of osteopathy in the cranial field and myofascial release versus acupuncture as complementary treatment for children with spastic cerebral palsy: a pilot study. J Am Osteopath Assoc. 2008;108(10):559–570.
14.
Kim SH, Ha KW, Kim YH, Seol P-H, Kwak H-J, Park S-W, et al. Effect of radial extracorporeal shock wave therapy on hemiplegic shoulder pain syndrome. Ann Rehabil Med. 2016;40(3):509–519; doi: 10.5535/arm.2016.40.3.509.
15.
Park SK, Yang DJ, Uhm YH, Yoon JH, Kim JH. Effects of extracorporeal shock wave therapy on upper extremity muscle tone in chronic stroke patients. J Phys Ther Sci. 2018;30(3):361–364; doi: 10.1589/jpts.30.361.
16.
Sahar MA, Shimaa NAE,Neveen AA-R, Khaled TA. Shock wave therapy versus phonophoresis in treatment of diabetic frozen shoulder. Biosci Res. 2019;16(1):733–740.
17.
Harden RN, Bruehl SP. Diagnosis of complex regional pain syndrome: signs, symptoms, and new empirically derived diagnostic criteria. Clin J Pain. 2006;22(5):415–419; doi: 10.1097/01.ajp.0000194279.36261.3e.
18.
Kondo I, Hosokawa K, Soma M, Iwata M, Maltais D. Protocol to prevent shoulder-hand syndrome after stroke. Arch Phys Med Rehabil. 2001;82(11):1619–1623; doi: 10.1053/apmr.2001.25975.
19.
Kozin F, Ryan LM, Carerra GF, Soin JS, Wortmann RL. The reflex sympathetic dystrophy syndrome (RSDS): III. Scintigraphic studies, further evidence for the therapeutic efficacy of systemic corticosteroids, and proposed diagnostic criteria. Am J Med. 1981;70(1):23–30; doi: 10.1016/0002-9343(81)90407-1.
20.
Meseguer-Henarejos A-B, Sanchez-Meca J, Lopez-Pina J-A, Carles-Hernandez R. Inter-and intra-rater reliability of the Modified Ashworth Scale: a systematic review and meta-analysis. Eur J Phys Rehabil Med. 2018;54(4):576–590; doi: 10.23736/S1973-9087.17.04796-7.
21.
Llewelyn JG, Tomlinson DR, Thomas PK. Diabetic Neuropathies. In: Dyck PJ, Thomas PK (eds.) Peripheral Neuropathy. 4th ed. Philadelphia: Elsevier; 2005:1951–1992.
22.
Harden RN, Bruehl S, Perez RSGM, Birklein F, Marinus J, Maihofner C, et al. Development of a severity score for CRPS. Pain. 2010;151(3):870–876; doi: 10.1016/j.pain.2010.09.031 .
23.
Johansson GM, Häger CK. Measurement properties of the motor evaluation scale for upper extremity in stroke patients (MESUPES). Disabil Rehabil. 2012;34(4):288–294; doi: 10.3109/09638288.2011.606343.
24.
Van de Winckel A, Feys H, van der Knaap S, Messerli R, Baronti F, Lehmann R, et al. Can quality of movement be measured? Rasch analysis and inter-rater reliability of the Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES). Clin Rehabil. 2006;20(10):871–884; doi: 10.1177/0269215506072181.
25.
Leard JS, Breglio L, Fraga L, Ellrod N, Nadler L, Yasso M, et al. Reliability and concurrent validity of the figure-of-eight method of measuring hand size in patients with hand pathology. J Orthop Sports Phys Ther. 2004;34(6):335–340; doi: 10.2519/jospt.2004.34.6.335.
26.
Bourdel N, Alves J, Pickering G, Ramilo I, Roman H, Canis M. Systematic review of endometriosis pain assessment: how to choose a scale? Hum Reprod Update. 2015;21(1):136–152; doi: 10.1093/humupd/dmu046.
27.
Mendigutia-Gómez A, Martín-Hernández C, Salom-Moreno J, Fernández-de-las-Peñas C. Effect of dry needling on spasticity, shoulder range of motion, and pressure pain sensitivity in patients with stroke: a crossover study. J Manipulative Physiol Ther. 2016;39(5):348–358; doi: 10.1016/j.jmpt.2016.04.006.
28.
Tang L, Li Y, Huang Q-M, Yang Y. Dry needling at myofascial trigger points mitigates chronic post-stroke shoulder spasticity. Neural Regen Res. 2018;13(4):673–676; doi: 10.4103/1673-5374.230293.
29.
Kostopoulos D, Rizopoulos K. The Manual of Trigger Point and Myofascial Therapy. Thorofare: SLACK; 2001;10:14–64.
30.
Moraska AF, Schmiege SJ, Mann JD, Butryn N, Krutsch JP. Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial. Am J Phys Med Rehabil. 2017;96(9):639–645; doi: 10.1097/PHM.0000000000000728.
31.
Mepsted R, Tyson S. The Bobath concept. A guru-led set of teachings unsupported by emerging evidence. A response to Vaughan-Graham and Cott. J Eval Clin Pract. 2017;23(5):1127–1128; doi: 10.1111/jep.12791.
32.
Villafañe JH, Lopez-Royo MP, Herrero P, Valdes K, Cantero-Téllez R, Pedersini P, Negrini S. Prevalence of myofascial trigger points in poststroke patients with painful shoulders: a cross-sectional study. PM R. 2019;11(10):1077–1082; doi: 10.1002/pmrj.12123 .
33.
Bron C, de Gast A, Dommerholt J, Stegenga B, Wensing M, Oostendorp RAB. Treatment of myofascial trigger points in patients with chronic shoulder pain: a randomized, controlled trial. BMC Med. 2011;9:8; doi: 10.1186/1741-7015-9-8.
34.
Falla D, Farina D, Graven-Nielsen T. Experimental muscle pain results in reorganization of coordination among trapezius muscle subdivisions during repetitive shoulder flexion. Exp Brain Res. 2007;178:385–393; doi: 10.1007/s00221-006-0746-6.
35.
Mahmoud LSED, Aly SM. The effect of scapular dyskinesia on the scapular balance angle and upper extremity sensorimotor function in stroke patients with spasticity. Bull Fac Phys Ther. 2020;25(1):1–8; doi: 10.1186/s43161-020-00004-w.
36.
Hains G, Descarreaux M, Hains F. Chronic shoulder pain of myofascial origin: a randomized clinical trial using ischemic compression therapy. J Manipulative Physiol Ther. 2010;33(5):362–369; doi: 10.1016/j.jmpt.2010.05.003.
37.
Pawaria S, Kalra S. Comparing effectiveness of myofascial release and muscle stretching on pain, disability and cervical range of motion in patients with trapezius myofascial trigger points. Indian J Health Sci Care. 2015;2(1):8–13; doi: 10.5958/2394-2800.2015.00002.4.
38.
Neviaser AS, Neviaser RJ. Adhesive capsulitis of the shoulder. J Am Acad Orthop Surg. 2011;19(9):536–542; doi: 10.5435/00124635-201109000-00004.
39.
Seyam MK, Moubarak EE, Shaik AR. The Effect of extracorporeal shock wave therapy for patients with diabetic frozen shoulder. Majmaah J Health Sci. 2018;6(2):40–49.
40.
Santoboni F, Balducci S, D’Errico V, Haxhi J, Vetrano M, Piccinini G, et al. Extracorporeal shockwave therapy improves functional outcomes of adhesive capsulitis of the shoulder in patients with diabetes; Diabetes Care. 2017;40(2):12–13; doi: 10.2337/dc16-2063.
41.
Abba MA, Muhammad AS, Badaru UM, Abdullahi A. Comparative effect of constraint-induced movement therapy and proprioceptive neuromuscular facilitation on upper limb function of chronic stroke survivors. Physiother Quart. 2020;28(1):1–5; doi: 10.5114/pq.2020.89809.
Share
RELATED ARTICLE
| eISSN: | 2544-4395 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
