【論文摘要】The Immediate and Lasting Effects of Strain Counterstrain Technique on Trigger Points or Tender Points: A Systematic Review and Meta-analysis

Abstract

Background and Purpose: Strain counterstrain (SCS), also known as positional release, is an indirect osteopathic manipulative technique to relieve musculoskeletal pain and dysfunction such as myofascial trigger points. SCS begins by identifying specific tender points related to musculoskeletal pain and dysfunction, and then the practitioner positions the patient in the position-of-comfort which is typically obtained by shortening tissues around tender points for 90 seconds. The purpose of this study was to investigate the immediate and lasting effects of SCS technique on trigger points or tender points. Methods: Three databases (Pubmed, ScienceDirect, and Google Scholar) were searched and articles were included if met the following criteria: (1) subjects were randomly assigned to one of treatment groups; (2) subjects with identified trigger points or tender points; (3) the intervention group received either SCS technique alone or SCS technique combined with other treatment which was the same as control group; (4) the control group received no treatment, sham treatment, or other treatment which not contained SCS technique; (5) outcome measures contained visual analog scale (VAS) of pain intensity or pressure pain threshold (PPT) of trigger points or tender points. Results: A total of ten studies were included and analyzed. Immediately after single or multiple sessions of treatment, there was significant improvement of both VAS (standardized mean difference [SMD] = -1.85, p ＜ 0.0001) and PPT (SMD = 1.08, p ＜ 0.0001) in the intervention group compared with the control group. Moreover, 1-4 weeks after the end of multiple sessions of treatment, there was significant improvement of VAS (SMD = -0.56, p = 0.02) but no significant improvement of PPT (SMD = 0.97, p = 0.08) in the intervention group compared with the control group. Conclusion: This meta-analysis indicated that there were both immediate and lasting effects of SCS technique on significantly decreasing VAS and there was immediate effect of SCS technique on significantly increasing PPT. Clinical Relevance: This meta-analysis suggests that SCS technique can decrease pain intensity and sensitivity of trigger points or tender points.