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manuelletherapie 2016; 20(05): 225-232
DOI: 10.1055/s-0042-117980
Originalia
Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Triggerpunkt-Therapie zusätzlich zum Training bei Patienten mit chronischen Nackenschmerzen

Randomisierte, kontrollierte PilotstudieTrigger Point Therapy as an Adjunct Exercise in Patients with Chronic Neck PainRandomised Controlled Pilot Study
Uta Muggli-Höppner
1   Praxis für Osteopathie und Physiotherapie, CH-Glarus
2   ZHAW Zürcher Hochschule für Angewandte Wissenschaften, CH-Winterthur
,
Karin Weber-Geiger
2   ZHAW Zürcher Hochschule für Angewandte Wissenschaften, CH-Winterthur
3   Physio-Center, CH-Wetzikon
› Author Affiliations
Further Information

Publication History

04 July 2016

20 August 2016

Publication Date:
23 December 2016 (online)

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Zusammenfassung

Die Pilotstudie untersuchte die Auswirkung von Triggerpunkt-Behandlung (TrPB) zusätzlich zu einem Training auf Bewegungskontrolle, Schmerz und Behinderung bei 20 Frauen mit chronischen Nackenschmerzen sowie die Machbarkeit für zukünftige Forschung.

Die Patientinnen wurden in eine Interventionsgruppe mit TrPB plus Training und eine nur trainierende Kontrollgruppe randomisiert. Joint Position Error (JPE), Schmerz (VAS) und die körperliche Behinderung (NDI) wurden gemessen. Die Zufriedenheit mit der Behandlung wurde anhand eines selbst entworfenen Fragebogens erfasst.

Insgesamt zeigte TrPB keine signifikante Überlegenheit gegenüber dem isolierten Training bezüglich Bewegungskontrolle, Schmerzen und Behinderungen. Die Machbarkeit für zukünftige Forschung wird als gut eingeschätzt.

Abstract

This pilot study investigated the effects of trigger point treatment (TrPT) in addition to exercise on movement control, pain and disability in 20 women with chronic neck pain as well as the feasibility for future research.

The patients were randomised into an intervention group with TrPT plus exercise and a control group with exercise only. Joint position error (JPE), pain (VAS) and physical disability (NDI) were measured. Satisfaction with the treatment was assessed using a self-developed questionnaire.

In summary trigger point treatment did not show significant advantages compared to isolated exercise regarding movement control, pain and disability. The feasibility for future research is considered to be good.

Schlüsselwörter

chronische Nackenschmerzen - Bewegungskontrolle - Behinderung - Triggerpunkte - Training

Keywords

chronic neck pain - movement control - disability - trigger points - exercise
 

  • Literatur

  • 1 Bärtschi E. Propriozeption der HWS: Ist ein koordinatives Training bei Nackenbeschwerden sinnvoll?. manuelletherapie 2009; 13: 14-22
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Blaser-Sziede R, Hilfiker R, Heynen S. et al. Triggerpunkttherapie und Bewegungskontrolle bei Rückenschmerzen: Eine Fallserie. Manuelle Medizin 2013; 51: 395-401
    CrossrefPubMedGoogle Scholar
  • 3 Bremerich FH, Grob D, Dvorak J. et al. The Neck Pain and Disability Scale: cross-cultural adaptation into German and evaluation of its psychometric properties in chronic neck pain and C1–2 fusion patients. Spine (Phila Pa 1976) 2008; 33: 1018-1027
    CrossrefPubMedGoogle Scholar
  • 4 Cagnie B, Dewitte V, Coppieters I. et al. Effect of ischemic compression on trigger points in the neck and shoulder muscles in office workers: a cohort study. J Manipulative Physiol Ther 2013; 36: 482-489
    CrossrefPubMedGoogle Scholar
  • 5 Cleland JA, Glynn P, Whitman JM. et al. Short-term effects of thrust versus nonthrust mobilization manipulation directed at the thoracic spine in patients with neck pain: a randomized clinical trial. Phys Ther 2007; 87: 431-440
    CrossrefPubMedGoogle Scholar
  • 6 Dommerholt J, Bron C, Franssen J. Myofasziale Triggerpunkte. manuelletherapie 2011; 15: 20-32
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Falla D. Schlüsselprinzipien für das Training von Patienten mit Nackenschmerzen. manuelletherapie 2013; 17: 7-13
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Gallagher EJ, Bijur PE, Latimer C. et al. Reliability and validity of a visual analog scale for acute abdominal pain in the ED. Am J Emerg Med 2002; 20: 287-290
    CrossrefPubMedGoogle Scholar
  • 9 Gautschi R. Manuelle Triggerpunkt-Therapie. Myofasziale Schmerzen und Funktionsstörungen erkennen, verstehen und behandeln. Stuttgart: Thieme; 2013
    Google Scholar
  • 10 Gong W. Effects of cervical joint manipulation on joint position sense of normal adults. J Phys Ther Sci 2013; 25: 721-723
    CrossrefPubMedGoogle Scholar
  • 11 Haavik H, Murphy B. The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. J Electromyogr Kinesiol 2012; 22: 768-776
    CrossrefPubMedGoogle Scholar
  • 12 Hirthe L, Möller C. Evidenz für die Wirksamkeit von Physiotherapie bei HWS-Dysfunktionen. manuelletherapie 2011; 15: 163-171
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Hogg-Johnson S, van der Velde G, Carroll LJ. et al. The burden and determinants of neck pain in the general population: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. J Manipulative Physiol Ther 2009; 32 (Suppl. 02) S46-S60
    CrossrefPubMedGoogle Scholar
  • 14 Jorritsma W, Dijkstra PU, de Vries GE. et al. Detecting relevant changes and responsiveness of Neck Pain and Disability Scale and Neck Disability Index. Eur Spine J 2012; 21: 2550-2557
    CrossrefPubMedGoogle Scholar
  • 15 Jull G, Trott P, Potter H. et al. A randomized controlled trial of exercise and manipulative therapy for cervico-genic headache. Spine (Phila Pa 1976) 2002; 27: 1835-1843 discussion: 1843
    CrossrefPubMedGoogle Scholar
  • 16 Jull G, Falla D, Treleaven J. et al. Retraining cervical joint position sense: The effect of two exercise regimes. J Orthop Res 2007; 25: 404-412
    CrossrefPubMedGoogle Scholar
  • 17 Jull G, Falla D, Vicenzino B. et al. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther 2009; 14: 696-701
    CrossrefPubMedGoogle Scholar
  • 18 Kaminski C. Wirkung aktiver und passiver Bewegungen versus rein aktiver Übungen bei nicht spezifischen Nackenschmerzen. manuelletherapie 2011; 15: 117-123
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Knecht M, Hämmig O. Mangelnde Work-Life Balance und Rückenschmerzen. Ausgewählte Ergebnisse einer grossangelegten Betriebsumfrage. 2008 www.newsd.admin.ch/newsd/message/attachments/16740.pdf (16.08.2016)
    PubMedGoogle Scholar
  • 20 Kristjansson E, Hardardottir L, Asmundardottir M. et al. A new clinical test for cervicocephalic kinesthetic sensibility: “the fly“. Arch Phys Med Rehabil 2004; 85: 490-495
    CrossrefPubMedGoogle Scholar
  • 21 Läubli T, Müller C. Arbeitsbedingungen und Erkrankungen des Bewegungsapparates. Geschätzte Fallzahlen und volkswirtschaftliche Kosten für die Schweiz. 2009 www.news.admin.ch/NSBSubscriber/message/attachments/16739.pdf (16.08.2016)
    PubMedGoogle Scholar
  • 22 Licht G, Müller-Ehrenberg H, Mathis J. et al. Untersuchung myofaszialer Triggerpunkte ist zuverlässig. Intertester-Reliabilität an insgesamt 304 Muskeln überprüft. Manuelle Medizin 2007; 45: 402-408
    CrossrefPubMedGoogle Scholar
  • 23 Lucas KR, Polus BI, Rich PA. Latent Myofascial Triggerpoints: Their Effects on Muscle Activation and Movement Efficiency. J Bodywork Mov Ther 2004; 8: 160-166
    CrossrefPubMedGoogle Scholar
  • 24 Nijs J, Oosterwijck J, Hertogh W. Rehabilitation of chronic whiplash: treatment of cervical dysfunctions or chronic pain syndrome?. Clin Rheumatol 2009; 28: 243-251
    CrossrefPubMedGoogle Scholar
  • 25 Palmgren PJ, Sandström PJ, Lundqvist FJ. et al. Improvement after Chiropractic Care in Cervicocephalic Kinesthetic Sensibility and Subjective Pain Intensity in Patients with Nontraumatic Chronic Neck Pain. J Manipulative Physiol Ther 2006; 29: 100-106
    CrossrefPubMedGoogle Scholar
  • 26 Price DD, McGrath PA, Rafii A. et al. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983; 17: 45-56
    CrossrefPubMedGoogle Scholar
  • 27 R Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2013
    Google Scholar
  • 28 Rix GD, Bagust J. Cervicocephalic kinesthetic sensibility in patients with chronic, nontraumatic cervical spine pain. Arch Phys Med Rehabil 2001; 82: 911-919
    CrossrefPubMedGoogle Scholar
  • 29 Schellingerhout JM, Verhagen AP, Heymans MW. et al. Measurement properties of diseasespecific questionnaires in patients with neck pain: a systematic review. Qual Life Res 2012; 21: 659-670
    CrossrefPubMedGoogle Scholar
  • 30 Shah JP, Phillips TM, Danoff JV. et al. An in Vivo Microanalytical Technique for Measuring the Local Biochemical Milieu of Human Skeletal Muscle. Journal of Applied Physiology 2005; 99: 1977-1984
    CrossrefPubMedGoogle Scholar
  • 31 Sterling M, Jull G, Wright A. Cervical mobilisation: concurrent effects on pain, sympathetic nervous system activity and motor activity. Manual Therapy 2001; 6: 72-81
    CrossrefPubMedGoogle Scholar
  • 32 Swait G, Rushton AB, Miall RC. et al. Evaluation of Cervical Proprioceptive Function. Spine 2007; 32: E692-E701
    CrossrefPubMedGoogle Scholar
  • 33 Travell JG, Simons DG. Handbuch der Muskel-Triggerpunkte: Obere Extremität, Kopf und Rumpf. München: Urban & Fischer; 2002
    Google Scholar
  • 34 Treleaven J, Jull G, Sterling M. Dizziness and unsteadiness following whiplash injury: characteristic features and relationship with cervical joint position error. J Rehabil Med 2003; 35: 36-43
    CrossrefPubMedGoogle Scholar
  • 35 Treleaven J. Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Part 2: Case studies. Manual Therapy 2008; 13: 266-275
    CrossrefPubMedGoogle Scholar
  • 36 Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther 1991; 14: 409-415
    PubMedGoogle Scholar
  • 37 Visser B, van Dieën JH. Pathophysiology of upper extremity muscle disorders. J Electromyogr Kinesiol 2006; 16: 1-16
    CrossrefPubMedGoogle Scholar
  • 38 Wiedemeier P, Ernst MJ. Manuelle Triggerpunktbehandlung gegen Kopfschmerzen: Eine systematische Literaturübersicht. Manuelle Medizin 2013; 51: 374-380
    CrossrefPubMedGoogle Scholar
  • 39 Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs 2005; 14: 798-804
    CrossrefPubMedGoogle Scholar
  • 40 Ylinen J. Physical Exercises and Functional Rehabilitation for the Management of Chronic Neck Pain. Eura Medicophys 2007; 43: 119-132
    PubMedGoogle Scholar
  • 41 Ylinen J, Häkkinen A, Nykänen M. et al. Neck muscle training in the treatment of chronic neck pain: a three-year follow-up study. Eura Medicophys 2007; 43: 161-169
    PubMedGoogle Scholar
  • 42 Ylinen J, Nikander R, Nykänen M. et al. Effect of neck exercises on cervicogenic headache: a randomized controlled trial. J Rehabil Med 2009; 42: 344-349
    PubMedGoogle Scholar