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Therapeutic Effectiveness of Low Level Laser on Myofascial Trigger Points

低階雷射對肌筋膜疼痛誘發點的療效研究

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摘要


研究背景與目的:肌筋膜疼痛誘發點(moyofascial trigger points, MTrP)是臨床上常見的一個問題。過去的文獻對低階雷射在肌筋膜疼痛誘發點的治療成效並無定論。因此本研究藉由隨機控制的實驗設計(randomized controlled trials),以評估雷射治療對於減緩肌筋膜疼痛誘發點的疼痛與緊繃的療效。方法:受試者為24位上斜方肌(upper trapezius muscle)有MTrP的病人,隨機將這些病人分成三組以接受不同型式的雷射治療。組A的5位病人接受偽雷射治療(sham laser therapy);組B的10位病人接受連續波(continous wave)的雷射治療;組C的9位病人接受10Hz間歇波(pulsed wave)的雷射治療。所有受試者接受每週兩次為期三週的雷射治療。療效的評估參數為:1)主觀疼痛強度,2)MTrP的疼痛彧值,3)頸椎側彎到對側的活動度。主要之新發現:結果顯示三組病人在接受完雷射治療後,都立即表示主觀疼痛強度降低;然而只有真正接受雷射治療的病人,在主觀疼痛強度的減緩才有顯著的長期療效。就MTrP的疼痛彧值而言,接受連續波與間歇波雷射治療的病人都能立即升高;但只有連續波雷射對疼痛彧值的提昇具有累積療效(accumulative effects)。雷射治療對頸椎活動度僅有一些立即療效,而無顯著的長期效果。結論:根據本研究的結果,作者得到以下結論:1)雷射治療對有MTrP的病人疼痛緩減具有一定療效,2)對MTrP引起的肌肉緊繃,雷射治療可能會有舒緩的效果。

並列摘要


Background and Purposes: Myofascial trigger points (MTrPs) are commonly seen in clinics. There are controversial results of previous investigations related to the effectiveness of low level laser therapy on MTrPs. The purposes of this study are to assess and compare the effectiveness of laser therapy on the relief of pain and tightness in MTrPs based on a design with randomized controlled trials. Methods: Twentyfour patients with MTrP in upper trapezius muscle were studied. These patients were randomly divided into three groups to receive different modes of laser therapy. Five patients were assigned into Group A to receive sham laser therapy. Ten patients in Group B were treated by laser therapy with continuous wave. Nine subjects in Group C received laser therapy with 10 Hz pulsed wave. All modes of laser therapy were applied two times per week for three weeks. The effectiveness of laser therapy was measured by: 1) subjective pain intensity, 2) pain threshold of MTrP , and 3) the range of cervical lateral bending to opposite side. Results: Subjective pain intensity was significantly reduced immediately following laser therapy in all three groups of patients. Only patients received true laser therapy demonstrated significantly long-term attenuation of pain intensity. Significant elevation of pain threshold was revealed immediately following continuous and pulsed laser therapy. Only continuous laser therapy had accumulative effects on elevation of pain threshold. There were some immediate effects but no significant long-term effects of laser therapy on cervical range of motion. Conclusions: The results of this study suggest that: 1) laser therapy is effective in relief of pain in patients with MTrP, 2) laser therapy may have some effects on alleviation of muscle tightness caused by MTrP.

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