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Myofascial trigger points alter the modular control during the execution of a reaching task: a pilot study.

ABSTRACT: Myofascial trigger points (TP) constitute a conundrum in research and clinical practice as their etiopathogenesis is debated. Several studies investigating one or few muscles have shown that both active and latent TP causes an increased muscle activity, however the influence of TP on modular motor control during a reaching task is still unclear. Electromyographic signals, recorded from the muscles of the shoulder girdle and upper arm during a reaching task, were decomposed with Non-Negative Matrix Factorization algorithm. The extracted matrices of motor modules and activation signals were used to label the muscles condition as dominant or non-dominant. The presence of latent and active TP was detected in each muscle with manual examination. Despite a similar muscle activity was observed, we found that muscles with active TP had increased weighting coefficients when labeled in the dominant condition. No influences were found when muscles were in the non-dominant condition. These findings suggest that TP altered the motor control without co-contraction patterns. As a preliminary evidence, the present results suggest that the increased weighting coefficients in presence of TPs are associated with an alteration of the modular motor control without affecting the dimensionality of motor modules for each individual and reciprocal inhibition.

SUBMITTER: Geri T

PROVIDER: S-EPMC6831581 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Myofascial trigger points alter the modular control during the execution of a reaching task: a pilot study.

Geri Tommaso T Gizzi Leonardo L Di Marco Anna A Testa Marco M

Scientific reports 20191105 1

Myofascial trigger points (TP) constitute a conundrum in research and clinical practice as their etiopathogenesis is debated. Several studies investigating one or few muscles have shown that both active and latent TP causes an increased muscle activity, however the influence of TP on modular motor control during a reaching task is still unclear. Electromyographic signals, recorded from the muscles of the shoulder girdle and upper arm during a reaching task, were decomposed with Non-Negative Matr ...[more]

PMID: 31690799

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Project description:BACKGROUND:Myofascial trigger points (MTrPs) are hyperirritable areas in the fascia of the affected muscle, possibly related to mitochondrial impairment. They can result in pain and hypoxic areas within the muscle. This pilot study established a minimally invasive biopsy technique to obtain high-quality MTrP tissue samples to evaluate mitochondrial function via high-resolution respirometry. Secondary objectives included the feasibility and safety of the biopsy procedure. METHODS:Twenty healthy males participated in this study, 10 with a diagnosis of myofascial pain in the musculus (m.) trapezius MTrP (TTP group) and 10 with a diagnosis of myofascial pain in the m. gluteus medius (GTP group). Each participant had 2 muscle biopsies taken in one session. The affected muscle was biopsied followed by a biopsy from the m. vastus lateralis to be used as a control. Measurements of oxygen consumption were carried out using high-resolution respirometry. RESULTS:Mitochondrial respiration was highest in the GTP group compared to the TTP group and the control muscle whereas no differences were observed between the GTP and the control muscle. When normalizing respiration to an internal reference state, there were no differences between muscle groups. None of the participants had hematomas or reported surgical complications. Patient-reported pain was minimal for all 3 groups. All participants reported a low procedural burden. CONCLUSIONS:This pilot study used a safe and minimally invasive technique for obtaining biopsies from MTrPs suitable for high-resolution respirometry analysis of mitochondrial function. The results suggest that there are no qualitative differences in mitochondrial function of MTrPs of the trapezius and gluteus medius muscles compared to the vastus lateralis control muscle, implying that alterations of mitochondrial function do not appear to have a role in the development of MTrPs. TRIAL REGISTRATION:Registered as No. 20131128-850 at the Coordinating Center for Clinical Studies of the Medical University of Innsbruck, trial registration date: 28th November 2013 and retrospectively registered on 11th of October 2018 at ClinicalTrials.gov with the ID NCT03704311 .

Project description:ObjectiveThis study aimed to assess the effects of single and multiple massage treatments on pressure-pain threshold (PPT) at myofascial trigger points (MTrPs) in people with myofascial pain syndrome expressed as tension-type headache.DesignIndividuals (n = 62) with episodic or chronic tension-type headache were randomized to receive 12 twice-weekly 45-min massage or sham ultrasound sessions or wait-list control. Massage focused on trigger point release (ischemic compression) of MTrPs in the bilateral upper trapezius and suboccipital muscles. PPT was measured at MTrPs with a pressure algometer pre and post the first and final (12th) treatments.ResultsPPT increased across the study timeframe in all four muscle sites tested for massage, but not sham ultrasound or wait-list groups (P < 0.0001 for suboccipital; P < 0.004 for upper trapezius). Post hoc analysis within the massage group showed (1) an initial, immediate increase in PPT (all P values < 0.05), (2) a cumulative and sustained increase in PPT over baseline (all P values < 0.05), and (3) an additional immediate increase in PPT at the final (12th) massage treatment (all P values < 0.05, except upper trapezius left, P = 0.17).ConclusionsSingle and multiple massage applications increase PPT at MTrPs. The pain threshold of MTrPs have a great capacity to increase; even after multiple massage treatments additional gain in PPT was observed.To claim cme creditsComplete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Understand the contribution of myofascial trigger points to myofascial pain; (2) Describe an effective treatment for decreasing tenderness of a myofascial trigger point; and (3) Discuss the relative values of single vs. multiple massage sessions on increasing pressure-pain thresholds at myofascial trigger points.LevelAdvanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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Myofascial trigger points alter the modular control during the execution of a reaching task: a pilot study.

Publications

Myofascial trigger points alter the modular control during the execution of a reaching task: a pilot study.

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