Research Items (4)
- Jul 2017
Background: Chronic migraine is a disabling disorder associated with myofascial and trigger point disorders in the neck. Pharmacological management is the first line of treatment; however, rehabilitation procedures aimed at lessening symptoms of myofascial and trigger point disorders may add value in the management of headache symptoms. Aim: To evaluate the feasibility of myofascial and trigger point treatment in chronic migraine patients receiving prophylactic treatment with onabotulinumtoxinA. To evaluate the treatment effects on headache frequency and intensity, analgesic consumption, cervical range of motion, trigger point pressure pain threshold, quality of life, and disability. Design: Pilot, single-blind randomized controlled trial with two parallel groups. Setting: Neurorehabilitation unit. Population: 22 outpatients with chronic migraine. Methods: Patients were randomly assigned to receive either cervicothoracic manipulative treatment (n=12) or transcutaneous electrical nerve stimulation (TENS) in the upper trapezius (n=10). Treatment consisted of 4 sessions (30 min/session, 1 session/week for 4 weeks). A rater blinded to treatment allocation evaluated outcomes before treatment, during treatment, and 1 month after the end of treatment. Consistent with the pilot nature of the study, feasibility was considered the primary outcome and efficacy the secondary outcome. Results: All patients completed the study. No adverse events were reported. No significant between-group differences in pain intensity were observed during the study period. At post-treatment evaluation, the total consumption of analgesics (p=.02) and non-steroidal anti-inflammatory (p=.02) drugs was significantly lower in the manipulative treatment group than in the TENS group. These effects paralleled significant improvements in trigger point sensitivity and cervical active range of motion. Conclusions: Manipulative techniques aimed at reducing peripheral nociceptive triggers might add value in the management of chronic migraine symptoms and lower acute medication use. Clinical rehabilitation impact: An interdisciplinary approach comprising pharmacological and non- pharmacological strategies can reduce analgesic consumption and myofascial dysfunction symptoms in chronic migraine patients.
- Apr 2013
The purpose of this study was to evaluate brachial artery blood flow changes during submaximal isometric contraction of the biceps and triceps brachii, in order to clarify the influence of the upper arm muscles activity on the local arterial flow. The brachial artery blood flow velocity and diameter were evaluated in twenty healthy men (mean age 29.6 years) at baseline (resting position) and during submaximal isometric contraction of the biceps and triceps brachii by means of ultrasonography (B-MODE and Doppler ultrasound methods). The brachial artery blood flow velocity was significantly higher than resting position during submaximal isometric contraction of the biceps (P < 0.001) and triceps brachii (P = 0.019). As to the brachial artery diameter, no significant change was observed during submaximal isometric contractions of the biceps and triceps brachii. Our preliminary findings suggest that the brachial artery blood flow velocity similarly increases during submaximal isometric contraction of the biceps and triceps brachii.
- Jan 2013
The objective of this review is to analyze in detail the microscopic structure and relations among muscular fibers, endomysium, perimysium, epimysium and deep fasciae. In particular, the multilayer organization and the collagen fiber orientation of these elements are reported. The endomysium, perimysium, epimysium and deep fasciae have not just a role of containment, limiting the expansion of the muscle with the disposition in concentric layers of the collagen tissue, but are fundamental elements for the transmission of muscular force, each one with a specific role. From this review it appears that the muscular fibers should not be studied as isolated elements, but as a complex inseparable from their fibrous components. The force expressed by a muscle depends not only on its anatomical structure, but also the angle at which its fibers are attached to the intramuscular connective tissue and the relation with the epimysium and deep fasciae.
Whiplash associated disorders commonly affect people after a motor vehicle accident, causing a variety of disabling manifestations. Some manual and physical approaches have been proposed to improve myofascial function after traumatic injuries, in order to effectively reduce pain and functional limitation. To evaluate whether the application of the Fascial Manipulation© technique could be more effective than a conventional approach to improve cervical range of motion in patients with subacute whiplash associated disorders. Pilot randomized clinical trial. Eighteen patients with subacute whiplash associated disorders were randomized into two groups. Group A (N.=9) received three, 30-minute sessions, (every five days during a two week period) of neck Fascial Manipulation©. Group B (N.=9) received ten, 30-minute sessions (five days a week for two consecutive weeks) of neck exercises plus mobilization. Patients were evaluated before, immediately after and two weeks post-treatment. Primary outcome measures: cervical active range of motion (flexion, extension, right lateral-flexion, left lateral-flexion, right rotation, and left rotation). A statistically significant improvement in neck flexion was found after treatment in favour of Group A (60.2±10.8°) compared with Group B (46.3±15.1°). No differences were found between groups for the other primary outcomes at post-treatment or follow-up. The Fascial Manipulation© technique may be a promising method to improve cervical range of motion in patients with subacute whiplash associated disorders. Myofascial techniques may be useful for improving treatment of subacute whiplash associated disorders also reducing their economic burden.