Chang-Zern Hong

Hungkuang University · Physical Therapy

Background This study investigated the effects of percutaneous soft tissue release (PSTR) performed using a blunt cannula on (1) the inflammatory cells-count, (2) expressions of calcitonin gene-related peptide (CGRP) and (3) substance P (SP) in rabbits with chronic phase of collagenase-induced Achilles tendinopathy. Methods Thirty-two adult male N...

Background and aim Acupuncture applied at myofascial trigger points (MTrPs) of distant anatomical regions, to reduce pain in a patient's area of primary complaint, is one strategy that is available to manage myofascial pain. However, the endogenous opioid-mediated analgesic mechanism of distant acupuncture associated with pain control is still uncl...

Despite a plethora of literature has documented that osteoarthritis (OA) is veritably associated with oxidative stress-mediated chondrocyte death and matrix degradation, yet the possible involvement of synoviocyte abnormality as causative factor of OA has not been thoroughly investigated. For this reason, we conduct the current studies to insight i...

TUNEL analysis on FC, MFD and FD treatment. HIG-82 synoviocytes (1.5×105) were plated in 60-mm cultured dishes for 24 h. The culture medium was replaced with FC, MFD, and FD media and then continued cultivating for additional 48 h. Cells were fixed in 1% paraformaldehyde in PBS for 30 min, and then washed with PBS, and stored in 70% methanol at 4°C...

Caspase 8 analysis on FC, MFD, FD and TNF-α treatments. HIG-82 synoviocytes (1.5×105) were plated in 60-mm cultured dishes for 24 h. The cultured media were replaced with FC, MFD, and FD media for 48 h or 100 ng/ml TNF-α(a positive control) for 24 h. Aliquot 1×105 cells were suspended in an F-12 medium, and then homogeneous FITC-IETD-FMK substrate...

Folate concentrations in cells and media. (TIF)

Apoptosis effects (sub G1) and cell cycle on FC, MFD and FD treatment. HIG-82 synoviocytes (1.5×105) were plated in 60-mm cultured dishes for 24 h. The culture medium was replaced with FC, MFD, and FD media and then continued cultivating for additional 48 h. Cells were then collected, washed with PBS, fixed in PBS-methanol (1:2 v/v) solution and ma...

Caspase 9 analysis on FC, MFD, FD and epirubicin (Epi) treatments. HIG-82 synoviocytes (1.5×105) were plated in 60-mm cultured dishes for 24 h. The cultured media were replaced with FC, MFD, and FD media for 48 h or 500 nM Epi (a positive control) for 24 h. Aliquot 1×105 cells were suspended in an F-12 medium, and then homogeneous FITC-LEHD-FMK sub...

Objective To investigate the therapeutic effectiveness of percutaneous fascia release to treat chronic recurrent gluteal myofascial pain related to recurrent tendonitis or bursitis at the attachment sites. Methods Five patients (three males, two females; aged 48.6 ± 8.9 years) with myofascial trigger points in the gluteus medius muscle were treate...

Evidence strongly supports that low-level laser therapy (LLLT) is an effective physical modality for the treatment of pain associated with myofascial trigger points (MTrP). However, the effect of laser fluence (energy intensity in J/cm(2)) on biochemical regulation related to pain is unclear. To better understand the biochemical mechanisms modulate...

Background: Dry needling at distant myofascial trigger points is an effective pain management in patients with myofascial pain. However, the biochemical effects of remote dry needling are not well understood. This study evaluates the remote effects of dry needling with different dosages on the expressions of substance P (SP) in the proximal muscle...

Background and aims The aim of this study was to demonstrate the effectiveness of lumbar facet joint injection for piriformis myofascial pain syndrome. Methods Fifty-two patients with chronic myofascial pain in the piriformis muscle each received a lumbar facet injection into the ipsilateral L5–S1 facet joint region, using the multiple insertion t...

Myofascial trigger point (MTrP) is a major cause of muscle pain, characterized with a hyperirritable spot due to accumulation of sensitized nociceptors in skeletal muscle fibers. Many needling therapy techniques for MTrP inactivation exist. Based on prior human and animal studies, multiple insertions can almost completely eliminate the MTrP pain fo...

Lysophosphatidic acid (LPA) has been found to mediate myeloid differentiation, stimulate osteogenesis, alter cell proliferation and migration, and inhibit apoptosis in chondrocytes. The effect of LPA on the angiogenic capability of chondrocytes is not clear. This study aimed to investigate its effect on the angiogenic capability of human chondrocyt...

Meningiomas are the most common benign brain tumors, and are characterized by slow growth and a long asymptomatic period. Once the tumor becomes symptomatic, the various presentations may be related to the location and compression of adjacent structures. Meningioma is primarily treated through surgical intervention, and thus earlier diagnosis is li...

This study aimed to investigate the role of muscle pain in post-stroke pain syndromes. This cross-sectional-designed study enrolled 145 stroke patients at three different stroke duration periods (≤3 mos, 3 mos to 1 yr, and >1 yr) receiving inpatient or outpatient rehabilitation programs in a regional teaching hospital. Three common muscle tender po...

The "180° turning and sitting down task" is a very conscious movement that requires focusing on turning at the exact moment, and very few studies address on this topic in older adults. The purpose of the study was to compare kinematics and electromyography of the head, lumbar and knee joints during 180°turning in older and young adults. Twenty olde...

This study investigates the kinematic variability of the head, lumbar spine and knee during the various walk and turn to sit phases in older and young adults. Sixteen older adults and eighteen young adults were recruited for this study. Each subject performed the "Walk and turn to sit down" test. A 16-channel telemetry system with electrogoniometer...

Central hyperthermia is characterized by a rapid onset, high temperature, marked temperature fluctuation, and poor response to antipyretics and antibiotics. Although poststroke central hyperthermia is common, prolonged instances are rare. We report a case of prolonged central fever after an intracranial hemorrhage. Before the accurate diagnosis and...

Propyl gallate (PG) is an antioxidant that has been used as an additive in several foods to protect against oxidation. The present study examined the anti-inflammatory effect of PG on 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced inflammation in human THP-1 monocytes. Pretreatment with PG markedly inhibited the TPA-induced expression levels of...

Objective: The aims of this study were to investigate the correlation of the findings of multiple median and ulnar F-wave variables and magnetic resonance imaging examinations in the prediction of cervical radiculopathy. Design: The data of 68 patients who underwent both nerve conduction studies of the upper extremities and cervical spine magnet...

Objective. To obtain electrophysiological effects of Fu's subcutaneous needling (FSN) on needling distance by assessment of endplate noise (EPN) recorded from the myofascial trigger spots (MTrSs) in rabbit skeletal muscle. Method. Eighteen New Zealand rabbits weighing 2.5-3.0 kg were randomly divided into two groups as follows: proximal needling (P...

Objective To assess the correlation between the trigger point [TrP] irritability in the myofascial pain syndrome [MPS] and the prevalence of one or more local twitch responses [LTRs] during TrP injection.Methods Patients with MPS, active TrPs in the trapezius muscle, and a pain intensity greater than 5 [numerical pain scale, 0no pain; 10worst pain...

We report a case of thymic carcinoma presenting as unilateral shoulder pain for 13 months. Before an accurate diagnosis was made, the patient received conservative treatment, cervical discectomies, and myofascial trigger point injection, none of which relieved his pain. When thymic carcinoma was eventually diagnosed, he received total resection of...

Nerve inflammation plays an important role in the development and progression of neuropathic pain after chronic constrictive injury (CCI). Recent studies have indicated that hypoxia-inducible factor 1α (HIF-1α) is crucial in inflammation. Low-level laser therapy has been used in treating musculoskeletal pain, but rare data directly support its use...

The present study compares the incidence of various infections among patients in acute and rehabilitation wards and examines the risk factors and pathogens involved in rehabilitation ward infections. The study included 341 acute stroke patients (age, ≥65 yrs). The assessment of risk factors was done by comparison of patients with or without infecti...

It is still unclear when latent myofascial trigger points (MTrPs) develop during early life. This study is designed to investigate the mechanical pain sensitivity of deep tissues in children in order to see the possible timing of the development of latent MTrPs and attachment trigger points (A-TrPs) in school children. Five hundreds and five health...

This study aimed to investigate the remote effect of acupuncture (AcP) on the pain intensity and the irritability of the myofascial trigger point in the upper trapezius muscle. Forty-five patients were equally divided into three groups: patients in the placebo control group received sham AcP, those in the simple needling group were treated using si...

To investigate factors affecting upper gastrointestinal bleeding (UGIB) in elderly first-time acute stroke patients undergoing rehabilitation. Three hundred and thirty-one elderly first-time acute stroke patients (age ≥65 years) transferred to our rehabilitative ward from July 2002 to June 2009 were included in the study. We divided patients into U...

Cross-sectional study. To investigate the automatic balance correction related to anticipatory perturbation (AP) and quick backward perturbation in adolescent idiopathic scoliosis (AIS). Most previous studies on AIS patients focused on posture sway and lacked analysis of muscle activated patterns in dynamic standing control. Thirty-two AIS patients...

To elucidate the neural mechanisms underlying the remote effects produced by dry needling rabbit skeletal muscle myofascial trigger spots (MTrSs) via analyses of their endplate noise (EPN) recordings. Experimental animal controlled trial. An animal laboratory of a university. Male New Zealand rabbits (N=96) (body weight, 2.5-3.0kg; age, 16-20wk). A...

Plantar fasciitis is a common cause of heel pain and is the result of a degenerative process of the plantar fascia at its calcaneal attachment. A case study of a preliminary experience with local injections of botulinum toxin A (BTX-A) for the treatment of chronic plantar fasciitis in a 43-year-old woman is presented. We injected the patient with 7...

The purpose of this study was to compare the two-dimensional kinematic and electromyographic (EMG) changes during the squat-to-reach task in older and young adults. Twenty-six older adults and thirty-three young adults were studied. A 16-channel telemetry system was used for recording muscular activity and kinematic data during two trials of a squa...

Background: The purpose of this case report is to demonstrate a patient of chronic myofascial pain syndrome in the gluteal region secondary to lumbar facet joint lesion. Findings: Initially, he was treated conservatively with medication and physical therapy and had only temporary pain relief for few days. Later, he was treated with lumbar facet joi...

A cross-sectional study of balance control in adolescents with idiopathic scoliosis (AIS). To investigate the impact of visual and somatosensory deprivation on the dynamic balance in AIS patients and to discuss electromyographic (EMG) and posture sway findings. Most studies focus on posture sway in quiet standing controls with little effort on exam...

ABSTRACT Objective: To evaluate the effect of low-level laser treatment with different dosages on the irritability of myofascial trigger spots [MTrS] in rabbit skeletal muscles. Methods: Twenty rabbits were equally divided into a low dose group and a high dose group. In each rabbit, the MTrS on the experimental side was irradiated with 660-nm conti...

SUMMARY Objectives: To summarize recent studies on myofascial trigger point [MTrP] to further clarify the mechanism of MTrP. Methods: To review recent clinical and basic science studies related to the pathophysiology of MTrPs. Results: There are multiple loci in an MTrP region. A clinical MTrP characteristically exhibits a sensory component [sensit...

Objective: One of the important characteristics of myofascial trigger point [MTrP] is spontaneous electrical activity [SEA]. Spontaneous electrical activity is recorded from an active locus [a basic unit] of MTrP and has been considered as an abnormal endplate potential, which might be due to excessive acetylcholine release in neuromuscular junctio...

SUMMARY Background: The most important strategy in myofascial pain syndrome therapy is to identify the etiological lesion that causes the activation of myofascial trigger points [s] and to treat the underlying pathology. If the underlying etiological lesion is not appropriately treated, the TrP can only be inactivated temporarily, and never complet...

Objective: Spontaneous electrical activity [SEA] can be recorded electrophysiologically from an active locus in a myofascial trigger point [MTrP] region. Recent studies on humans and rabbits suggest that the MTrP region is always in the endplate zone. The purpose of this study is to map the distribution of active loci in rat skeletal muscle in orde...

Objective: This study investigated spinal cord mediation of rabbit localized twitch responses [R-LTRs] by transection of the spinal cord and later of the peripheral nerve. Rabbit localized twitch response [R-LTR] is a brisk contraction of a group of rabbit skeletal muscle fibers which is most responsive to mechanical stimulation of the pressure-sen...

Objective: This case report describes a patient with chronic recurrent myofascial pain syndrome in the shoulder/scapular area secondary to teres minor tendinitis. The purpose is to emphasize the importance of treating the underlying pathological lesion in order to eliminate the recurrent trigger points [TrPs] completely and permanently. Methods: Th...

Objectives: This study is designed to investigate the immediate effectiveness of combining ultrasound [deep heat] therapy and modified electrotherapy for the treatment of myofascial trigger points [TrPs] of upper trapezius [UT] muscle. Methods: Twenty-six patients [12 males and 14 females, average age 42.1 ± 16.4 years] were studied. All patients h...

Objective: This case study was conducted to investigate the role of myofascial trigger points of the pectoralis minor muscle in producing symptoms following whiplash injury. Methods: To be included in this retrospective study, patents were required to exhibit an active myofascial trigger point in at least one pectoralis minor muscle and should not...

Objectives: To assess the changes in the prevalence and the morphology of spontaneous electrical activity [SEA] after spinal cord transection and subsequent nerve transection in an animal model of myofascial trigger point [MTrP] in order to further understand the mechanism of MTrP. Spontaneous electrical activity can be recorded from a minute locus...

Objectives: This study is designed to investigate the change of the pressure pain threshold [PPT] of latent myofascial trigger points [MTrPs], immediately after rapid repetitive contraction of the involved muscle. Methods: Forty 8–19 year-old students who had taken piano lessons for longer than one year. Three consecutive measurements of PPT were o...

SUMMARY Objectives: The purpose of this report is to review clinical literature concerning the application of pressure algometer [PA] in the assessment of myofascial trigger points [MTrPs]. Findings: Results are presented on diagnosis of active and latent MTrPs, their taut bands and referred pain. Pressure algometer has been used to document the te...

Objectives: To investigate the influence of the chronic calf myofascial pain syndrome [MPS] on gait performance and the effectiveness of myofascial treatment programs in order to inform the clinical management for this impairment. Methods: A female subject suffered from chronic knee and ankle pain for five years as a result of calf muscles MPS. The...

Myofascial pain syndrome (MPS) is a common musculoskeletal pain syndrome characterized by acute or chronic regional muscle pain. MPS is primarily caused by myofascial trigger points (MTrP). MPS treatment consists of MTrP inactivation, which breaks the vicious cycle of pain-contracture-pain and activates the descending pain inhibitory system. In rec...

Locally administered nonsteroidal anti-inflammatory drugs have been widely used in acute soft-tissue damage and articular musculoskeletal pain. This double-blind, placebo-controlled, randomized study was designed to evaluate the efficacy and safety of a topical diclofenac sodium patch in the relief of pain and inflammation as a result of myofascial...

The goal of this double-blinded, randomized, controlled study was to confirm the effectiveness of the cervical facet joint injection in treating shoulder pain with the myofascial trigger point in the upper trapezius muscle secondary to cervical facet lesion. Eighty-nine patients with chronic unilateral shoulder pain due to myofascial trigger points...

Background: The purpose of this case report is to demonstrate a new acupuncture technique in treating fibromyalgia syndrome [FMS]. Findings: A patient with FMS had poor responses to previous treatments. She received treatment at our acupuncture clinic. The new acupuncture technique we applied was similar to Hong's technique for myofascial trigger p...

Background: A patient with a floating kidney and myofascial pain syndrome in the ipsilateral external oblique muscle. Findings: A female had aggravated right abdominal pain and responded poorly to medication and physical therapy. An examination revealed tender spots in the right kidney with referred pain to the trigger points [TrP] in the right abd...

To investigate the remote effect of acupuncture on the pain intensity and the endplate noise (EPN) recorded from a myofascial trigger point (MTrP) of the upper trapezius muscle. Randomized controlled trial. University hospital. Patients (N=20) with active MTrPs in upper trapezius muscles and no experience in acupuncture therapy. Patients were divid...

To investigate the remote effect of dry needling on the irritability of a myofascial trigger point in the upper trapezius muscle. Thirty-five patients with active myofascial trigger points in upper trapezius muscles were randomly divided into two groups: 18 patients in the control group received sham needling, and 17 patients in the dry-needling gr...

To better understand the mechanisms of therapeutic lasers for treating human myofascial trigger points, we designed a blinded controlled study of the effects of a therapeutic laser on the prevalence of endplate noise (EPN) recorded from the myofascial trigger spot (MTrS) of rabbit skeletal muscle. In eight rabbits, one MTrS in each biceps femoris m...

Background: Recent electrophysiological studies revealed that endplate noise (EPN) could be specifically recorded from a myofascial trigger point (MTrP) region. EPN has been considered as the focal graded potentials due to excessive acetylcholine release in neuromuscular junction. A recent histological study has demonstrated a free nerve ending at...

To investigate the changes in pressure pain threshold of the secondary (satellite) myofascial trigger points (MTrPs) after dry needling of a primary (key) active MTrP. Single blinded within-subject design, with the same subjects serving as their own controls (randomized). Fourteen patients with bilateral shoulder pain and active MTrPs in bilateral...

This study was designed to investigate the correlation between the irritability of the myofascial trigger point (MTrP) and the prevalence of endplate noise (EPN) in the MTrP region of human skeletal muscle. Twenty normal subjects with latent MTrPs and 12 patients with active MTrPs in the upper trapezius muscles were recruited for this study. The pa...

To determine whether latent myofascial trigger points (MTPs) can be identified in healthy infants and in healthy adult subjects. Blind comparison. Ambulatory. A convenience sample of 60 healthy adults and 60 infants (age range, 0-12mo). Not applicable. An algometer was used to measure the pressure pain threshold (PPT) on 3 different sites, includin...

Myofascial pain syndrome (MPS) is caused by myofascial trigger points (MTrPs) located within taut bands of skeletal muscle fibers. Treating the underlying etiologic lesion responsible for MTrP activation is the most important strategy in MPS therapy. If the underlying pathology is not given the appropriate treatment, the MTrP cannot be completely a...

This study was designed to assess the occurrence of end plate noise (EPN) in an acupuncture point (AcP). Ten male and 10 female normal volunteers were included in this study. For each subject, mapping of the distribution of EPN loci in an AcP region of Stomach-36 in one leg selected randomly, and also in a nearby non-AcP region in the other leg as...

Unilateral brachial plexus injury is a rare complication of thoracoscopic sympathectomy, which is generally considered to be a simple and safe procedure. We report on a 26-year-old man who developed weakness and numbness of the right arm after thoracoscopic sympathectomy for hyperhidrosis. Electromyographic study revealed evidence of denervation in...

Lee P-H, Hsieh L-F, Hong C-Z. Unilateral brachial plexus injury as a complication of thoracoscopic sympathectomy for hyperhidrosis: a case report. Arch Phys Med Rehabil 2003;84:1395–8.Unilateral brachial plexus injury is a rare complication of thoracoscopic sympathectomy, which is generally considered to be a simple and safe procedure. We report on...

This review article summarizes recent studies on myofascial trigger point (MTrP) to further clarify the mechanism of MTrP. MTrP is the major cause of muscle pain (myofascial pain) in clinical practice. There are multiple MTrP loci in an MTrP region. An MTrP locus contains a sensory component (sensitive locus) and a motor component (active locus). A...

(1) To describe the demographic features of patients with voiding dysfunction associated with herpes zoster; (2) to discuss the pathophysiology of voiding dysfunction associated with herpes zoster; and (3) to suggest the best management policy. A retrospective study. A university-affiliated medical center in Taiwan. Four hundred twenty-three patien...

To investigate the immediate effect of physical therapeutic modalities on myofascial pain in the upper trapezius muscle. Randomized controlled trial. Institutional practice. One hundred nineteen subjects with palpably active myofascial trigger points (MTrPs). Stage 1 evaluated the immediate effect of ischemic compression, including 2 treatment pres...

To assess the effect of botulinum toxin type A (BTX-A) on the endplate noise prevalence in rabbit myofascial trigger spots to confirm the role of excessive acetylcholine release on the pathogenesis of myofascial trigger points and to develop an objective indicator of the effectiveness of BTX-A in the treatment of myofascial trigger points. Eighteen...

A randomized, assessor-blinded clinical trial was conducted. To investigate the relative effectiveness of three manual treatments and back school for patients with subacute low back pain. Literature comparing the relative effectiveness of specific therapies for low back pain is limited. Among the 5925 inquiries, 206 patients met the specific admiss...