Trigger Points Research Articles

Decrease of the peak heights of EEG bicoherence indicated insufficiency of analgesia during surgery under general anesthesia.

Studies show that the two peak heights of electroencephalographic bicoherence (pBIC-high, pBIC-low) decrease after incision and are restored by fentanyl administration. We investigated whether pBICs are good indicators for adequacy of analgesia during surgery. After local ethical committee approval, we enrolled 50 patients (27-65years, ASA-PS I or II) who were scheduled elective surgery. Besides standard anesthesia monitors, to assess pBICs, we used a BIS monitor and freeware Bispectrum Analyzer for A2000. Fentanyl 5µg/kg was completely administered before incision, and anesthesia was maintained with sevoflurane. After skin incision, when the peak of pBIC-high or pBIC-low decreased by 10% in absolute value (named LT10-high and LT10-low groups in order) or when either peak decreased to below 20% (BL20-high and BL20-low groups), an additional 1g/kg of fentanyl was administered to examine its effect on the peak that showed a decrease. The mean values and standard deviation for pBIC-high 5min before fentanyl administration, at the time of fentanyl administration, and 5min after fentanyl administration for LT10-high group were 39.8% (10.9%), 26.9% (10.5%), and 35.7% (12.5%). And those for pBIC-low for LT10-low group were 39.5% (6.0%), 26.8% (6.4%) and 35.0% (7.0%). Those for pBIC-high for BL20-high group were 26.3% (5.6%), 16.5% (2.6%), and 25.7% (7.0%). And those for pBIC-low for BL20-low group were 26.7% (4.8%), 17.4% (1.8%) and 26.9% (5.7%), respectively. Meanwhile, at these trigger points, hemodynamic parameters didn't show significant changes. Superior to standard anesthesia monitoring, pBICs are better indicators of analgesia during surgery. Clinical trial Number and registry URL: UMIN ID: UMIN000042843 https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno = R000048907.

Relationship of myofascial trigger points with related disability, anxiety, and depression in patients with migraine headaches

BackgroundMigraine affects one in ten individuals worldwide and is the second leading cause of disability. Studies have shown an association between migraine and the musculoskeletal system, and myofascial trigger points (MTrPs) play an essential role. Additionally, those with myofascial pain have been proven to experience higher levels of depression and anxiety. Understanding the association between MTrPs and migraine is crucial for developing targeted treatment strategies. Additionally, recognizing the link between MTrPs and migraine-related depression and anxiety underscores the importance of a holistic approach to migraine management. By addressing both musculoskeletal and neurological factors, healthcare providers can provide more effective and personalized care for migraine patients. This study aims to determine the association between MTrPs with migraine-related disability, anxiety, depression, and migraine characteristics.MethodsThis cross-sectional study included 68 migraine patients from an outpatient neurology clinic. The number of MTrPs was determined through examination by an experienced neurologist during a migraine-free period using the recommended international criteria. We evaluated anxiety and depression with the Hospital Anxiety and Depression Scale (HADS) and disability with the Migraine Disability Assessment Scale (MIDAS).ResultsWe enrolled 68 patients (22 males) with a mean age of 36.23 ± 9.63 years. The mean number of MTrPs was 2.75 ± 2.934. MTrPs were positively correlated with severity (CC: 0.576, P-value < 0.001). There was no association between MTrPs and HADS-D or MIDAS, but migraine patients with abnormal HADS-A scores had more MTrPs than patients with normal HADS-A scores (0.6 ± 0.84 vs 3.56 ± 3.11, P-value:0.013).ConclusionsThe number of MTrPs is associated with higher anxiety levels and headache intensity. Further research could investigate the impact of MTrP-based therapies on anxiety among individuals suffering from migraines.

Effects of dry needling on vertical jump performance in female volleyball players. A randomized controlled trial.

Injury prevention and performance enhancement are paramount goals in sports. Myofascial Pain Syndrome, primarily caused by myofascial trigger points, can result in referred pain, stiffness, muscle shortening, and weakness. This study aimed to assess the impact of dry needling (DN) on latent myofascial trigger points on vertical jump performance in female volleyball players. A single-blind, randomized controlled clinical trial was conducted with twenty-six healthy female volleyball players who had no lower limb injuries in the last six months, exhibited latent trigger points in the triceps surae muscles, and were familiar with the countermovement jump test. Participants were randomly assigned to either a control group or an experimental group (which received a single DN session). Vertical jump performance variables, including jump height as the primary outcome, were assessed using a force platform at five time points: before the intervention, immediately post-treatment, 24 h post-treatment, 72 h post-treatment, and one-week post-intervention. The experimental group showed significantly lower values for vertical jump height, flight time, velocity, strength, and power immediately after the needling intervention (p < 0.05). However, these values were significantly higher one-week post-intervention across all variables (p < 0.01). These findings indicate that DN initially decreases jumping performance, but improvements are observed one week after the intervention. In the comparison between groups, the experimental group exhibited higher values at the one-week follow-up for vertical jump height, flight time, speed, and power compared to the control group (p < 0.05). DN appears to be an effective technique for improving vertical jump performance in female volleyball players one week after its application. ClinicalTrials.gov, identifier (NCT06184672).

The effect of physical therapy integrated with pharmacotherapy on tension-type headache and migraine in children and adolescents

BackgroundTension-type headache (TTH) and migraine are prevalent neurological conditions in children and adolescents that significantly impact activity of daily living (ADL) and quality of life (QOL). Although physical therapy targeting cervical myofascial trigger points (MTrPs) on TTH and migraine has been extensively studied in adults, the efficacy in pediatric patients remains unexplored. The aim of this study is to reveal the effect of physical therapy integrated with pharmacotherapy on TTH and migraine in children and adolescents.MethodsWe conducted a prospective, observational cohort study recruiting consecutive patients aged 6 to 18 years with TTH and migraine with cervical MTrPs. They were classified into 4 types of headaches: frequent episodic TTH (FRTTH), chronic TTH (CTTH), episodic migraine (EM) and chronic migraine (CM). The once-weekly 40-minutes physical therapy session integrated with pharmacotherapy (integrated physical therapy) was continued until the treatment goals (headache days per week less than 2 days, headache impact test-6 (HIT-6) score to below of 50, and the ability to attend school daily) was achieved. Multifaceted assessments including headache frequency (headache days per week), headache intensity using the Visual Analogue Scale (VAS), pain catastrophizing score (PCS), hospital anxiety and depression scale (HADS) score, HIT-6 scores, and EuroQol 5 dimensions 5-level questionnaire (EQ-5D-5 L) scores, were conducted to evaluate the treatment effects.Results161 patients were enrolled in this study. 106 patients (65.8%) were diagnosed with TTH: 70 (66.8%) with FETHH, 36 (34.0%) with CTTH, and 55 patients (34.2%) were diagnosed with migraine: 43 patients (78.2%) with EM, 12 patients (21.8%) with CM. We observed significant improvements in headache frequency, headache intensity, PCS, HADS score, HIT-6 scores, and EQ-5D-5 L scores before and after the treatment in all 4 types of headaches. The average number of sessions required to achieve the treatment goals was 4 times (weeks) for patients with FETTH and EM, 5.5 for those with CTTH, and 7.5 for those with chronic migraine.ConclusionThe integrated physical therapy on pediatric TTH and migraine patients with the cervical MTrPs was significantly effective in reducing headache symptoms and improving ADL and QOL.

The effect of combining physiotherapy with dry needling in patients with cervical spondylosis: A randomized controlled trial.

There are no data on the additional contribution of dry needling (DN) for trigger points (TPs) accompanying patients with cervical spondylosis (CS). To analyse the contribution of DN applied to concomitant active TPs in the upper trapezius muscle on the treatment outcomes of physiotherapy in CS. In this prospective randomized controlled study, 70 patients with CS and active TPs in the upper trapezius muscle were included. The first group received physiotherapy for 5 days per week for 3 weeks. The second group received DN with the same program. All participants were evaluated before treatment (day 0) and at the end of treatment (day 21) in terms of pain, functional status, quality of life, anxiety/depression scores, and number of TPs. 33 patients in the first group and 32 patients in the second group completed the study. While the change over time was found significant in all variables, the change was not different between groups. The group-time interaction effect was not found to be statistically significant in any variable. Percentage changes of all variables were similar between the groups. DN treatment added to the physiotherapy did not contribute to recovery in patients with CS.

Prevalence of Myofascial Trigger Points in Isolated Idiopathic Cervical Dystonia: A Possible Contributor to Pain, Movement and Disability.

Myofascial trigger points (TrPs) are hypersensitive points located in a tight band of muscle that, when palpated, produce not only local pain but also referred (distant) pain. The role of TrPs in patients with cervical dystonia (CD) has not been investigated. To identify the presence of TrPs in patients with isolated idiopathic CD and their association with pain. Thirty-one patients (74.2% women; age: 61.2 years, SD: 10.1 years) participated. TrPs were explored in the sternocleidomastoid, upper trapezius, splenius capitis, levator scapulae, anterior scalene, suboccipital, and infraspinatus muscles. Clinical features of CD were documented as well as the presence of pain. The severity of dystonia and its consequences were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). The mean number of TrPs for each patient was 12 (SD:3), with no differences between patients with pain (n = 20) and those without pain (n = 11). Active TrPs were only found in patients with pain (mean: 7.5, SD:4). Latent TrPs were found in both groups but were more prevalent (P < 0.001) in patients without pain (mean: 11, SD:3.5) than in those with pain (mean: 5, SD:3.5). The number of active TrPs or latent TrPs was positively associated with the TWSTRS disability subscale and the TWSTRS total score. The number of active, but not latent, TrPs was associated with worse scores on the TWSTRS pain subscale. Active TrPs were present in patients with CD reporting pain, while latent TrPs were present in all CD patients, irrespective of their pain status. The numbers of active/latent TrPs were associated with disability. TrPs could act as pain generators in CD and also contribute to the involuntary muscle contractions characteristic of dystonia.

Evaluation of lignocaine HCl as a therapeutic and diagnostic tool in myofascial pain dysfunction syndrome and internal derangement

Background: Myofascial pain syndrome MPS is one of the most common causes of chronic musculoskeletal pain. It clinically presents with hypersensitive points in the muscle called “trigger points”. Most of the time it remains undiagnosed/undertreated and this leads to severity in symptoms. Deactivation/elimination of trigger points (TrPs) remains the cornerstone of myofascial pain dysfunction syndrome (MPDS) management. The most commonly employed techniques clinically are dry needling of the TrP, local anesthetics or saline injections into TrP, spray and stretch, and ultrasound/electrogalvanic stimulation. Although peripheral nerve blocks are widely used for chronic pain management, their role in myofascial pain dysfunction syndrome is not yet well established. Our study aims to demonstrate the role of mandibular nerve block using lignocaine hydrochloride in the management of MPDS. Materials and Method: Our study is a single-centered randomized control trial performed to evaluate the diagnostic and therapeutic role of mandibular nerve block in treating myofascial pain dysfunction syndrome. A total of 20 subjects fulfilling the inclusion criteria were enrolled in the study. Clinical parameters (pain, mouth opening, and mandibular deviation) were assessed at each follow-up appointment. Result: All of our patients had significant pain relief at the end of 1 month (P &lt; 0.001), and a substantial improvement in mouth opening is also noted (P &lt; 0.001). There was a significant improvement in deviation immediately after nerve block, and further gradual improvement was observed during each follow-up. Conclusion: Our study confirmed the role of mandibular nerve block in myofascial pain management. The diagnostic value of mandibular nerve block in differentiating MPDS from internal derangement is also highlighted.

Chronic pain management in primary care: Using population-based data to examine family physician practice patterns.

To examine trends in chronic pain (CP) practice patterns among community-based family physicians (FPs). Population-based descriptive study using health administrative data. British Columbia from fiscal years 2008-2009 to 2017-2018. Patients with an algorithm-defined CP condition and community-based FPs, both registered with the British Columbia Medical Services Plan. Using British Columbia health administrative data and a CP algorithm adapted from a previous study, the following were compared between fiscal years 2008-2009 and 2017-2018: CP patient volumes, pain-related medication prescriptions, referrals to pain specialists, musculoskeletal imaging requests, and interventional procedures. In the fiscal year 2017-2018, among community-based family physicians (N=4796), an average of 32.5% of their patients had CP. Between 2008-2009 and 2017-2018, the proportion of CP patients per FP who were prescribed long-term opioids increased by an average absolute change of 0.56%; the proportion prescribed long-term neuropathic pain medications increased by 1.1%; and the proportion prescribed long-term nonsteroidal anti-inflammatory drugs decreased by 0.49%. The proportion of musculoskeletal imaging out of all imaging requests made by FPs increased by 2.0%; pain-related referrals increased by 1.73%; there was a 4.6% increase in the proportion of community-based FPs who performed 1 or more pain injections; and 10% more FPs performed 1 or more trigger point injections within a fiscal year. Findings show that the work of providing care to patients with CP increased while CP patient volumes per FP decreased. Workforce planning for community-based FPs should consider these increased demands and ensure FPs are adequately supported to provide CP care.

Comparison of the researched analyses evaluating the physiotherapy of the pain with a cause in the region of the cervical spine

Introduction. Neck pain is a common musculoskeletal problem. This individual and socio-economic health problem is associated with a reduction in daily activities, a reduction in labour productivity and an impact on quality of life levels. Objective. To evaluate the effectiveness of the therapy of non-specific pain originating from the cervical region in terms of the applied physiotherapy methods. Methods. 40 research articles published in 2018-2023 in journals with registration in databases Web of Science, Science Direct and Scopus were included in the research. Results. The most frequent target studied was the education of patients on ergonomics, correct posture and home exercises. The preparation phase of therapy included the administration of thermotherapy and electrotherapy – ultrasound or transcutaneous electrical nerve stimulation (TENS), classical massage, administration of non-steroidal anti-inflammatory drugs. The techniques often used were manipulation and/or mobilization, trigger and tender points therapy – acupressure, acupuncture, dry needle application. Among the therapeutic methods, the most frequently chosen are exercises in the form of pilates, yoga, Alexander technique, sensomotor training, proprioceptive neuromuscular facilitation, Jakobson progressive muscle relaxation. Reduction of painful mobility was addressed by the application of local immobilization and kineziotaping. Conclusion. According to the results of our analysis, the combination of several physiotherapy techniques and methods appears to be significantly effective for reducing pain and improving quality of life.

Runners have more latent myofascial trigger point than non-runners in medialis gastrocnemii

ObjectivesThe goals of this study were to i. describe the prevalence of latent myofascial trigger points (MTrPs) in the medialis gastrocnemius in runners versus non-runners, and ii. examine their level of pain and stiffness. MethodsHealthy runners and non-runners were recruited. Each participant's medialis gastrocnemius MTrPs count was recorded in both legs. The mean pain and the most painful MTrPs pain levels were recorded using an algometer, and the stiffness was evaluated using myotonometry (MyotonPro device) on the most painful MTrP. ResultsWith a medium effect size (p = 0.001), runners (n = 20) showed significantly more latent MTrPs than non-runners (n = 26). Runners also reported higher overall pain on the latent MTrPs site than non-runners (p = 0.003) and a significant difference (p = 0.001) for the most painful latent MTrP. Runners were substantially stiffer than non-runners in the most painful latent MTrP, with a mean stiffness difference of +9.98 N/m (p = 0.018, medium effect size). ConclusionsRunners have a higher number of latent MTrPs than non-runners. The MTrPs found in runners' legs were more painful and stiff than those found in non-runners' legs.

POSTURE CORRECTION IN MIDDLE SCHOOL STUDENTS USING APPLIED KINESIOLOGY

The purpose of the study was to evaluate the effectiveness and feasibility of using applied kinesiology in a posture correction program for middle school children. The study involved 20 children aged 14-15 years (10 girls and 10 boys) who had postural disorders in the frontal plane. Three methods were used to assess posture: visual diagnosis, diagnosis by plumb line, and scoliosis measurement. Visual diagnosis included the evaluation of posture symmetry by shoulder height, scapula angles, and waist triangles symmetry. Diagnosis by plumb line assessed the alignment of spinous processes along a vertical line. Scoliometry was used to measure the degree of spinal curvature. The posture correction program included manual muscle testing, kinesio taping, manual techniques (ischemic pressure of trigger points, fascial release using a vibration gun, deep point massage), and special corrective exercises. The results showed a significant decrease in scoliosis measurements in all students, from 8.6 to 4 degrees. This indicates the effectiveness of applied kinesiology in correcting postural disorders in middle school children. Performing the exercises helped inhibit old and establish new connections in the cerebral cortex by building new motor pathways. Additionally, it fostered an understanding and habit of maintaining correct posture in children. Overall, the study demonstrated that applied kinesiology is an effective method for correcting postural disorders in middle school-aged children, leading to better posture habits and improved spinal alignment.

Effect of elemental sulfur on anaerobic ammonia oxidation: Performance and mechanism

Biological nitrogen removal processes provide effective means to mitigate nitrogen-related issues in wastewater treatment. Previous studies have highlighted the collaborative efficiency between sulfur autotrophic denitrification and Anammox processes. However, the trigger point induced the combination of nitrogen and sulfur metabolism is unclear. In this study, elemental sulfur (S0) was introduced to Anammox system to figure out the performance and mechanism of S0-mediated autotrophic denitrification and Anammox (S0SAD-A) systems. The results showed that the nitrogen removal performance of the Anammox reactor decreased with the increasing concentrations of NH4+-N and NO2−-N in influent, denitrification occurred when NH4+-N concentration reached 100 mg/L. At stage ⅳ (150 mg/L NH4+-N), the total nitrogen removal efficiency in S0SAD-A system (95.99%) was significantly higher than that in the Anammox system (77.22%). Throughout a hydraulic retention time, the consumption rate of NH4+-N in S0SAD-A was faster than that in Anammox reactor. And there existed a nitrate-concentration peak in S0SAD-A system. Metagenomic sequencing was performed to reveal functional microbes as well as key genes involved in sulfur and nitrogen metabolism. The results showed that the introduction of S0 elevated the abundance of Ca. Brocadia. Moreover, the relative abundance of Anammox genes, such as hao, hzsA and hzsC were also stimulated by sulfur. Notably, unclassified members in Rhodocyclaceae acted as the primary contributor to key genes involved in the sulfur metabolism. Overall, the interactions between Anammox and denitrification were stimulated by sulfur metabolism. Our study shed light on the potential significance of Rhodocyclaceae members in the S0SAD-A process and disclosed the relationship between anammox and denitrification.

Dry needling as adjuvant therapy for post-operative pain: a systematic review of randomized clinical trial

The prolonged post-operative pain often associated with myofascial trigger point which also contribute to reduction of range of motion (ROM). State Boards of Physical Therapy defined dry needling as an ‘intramuscular procedure involving the isolated treatment of myofascial (muscle) trigger point. The purpose of this systematic review was to determine if the addition dry needling to a rehabilitation protocol is more effective in reducing pain levels and improving prognosis of the post-operative patient of extremity when compared to a rehabilitation protocol alone based on current study evidence. Three electronic databases were used; PubMed, Cochrane Library, and ProQuest. Studies included were randomized clinical studies that written in English and published from last 10 years (2014). Post operative patient, any type of extremity surgery, any sex, any age, getting rehabilitation procedure with or without dry needling. Data collection was conducted using standard agreed form by two independent reviewers. The risk of bias and quality were assessed using Revised Cochrane risk-of-bias tool for randomized trials (RoB2). Three studies were selected for this systematic review, include total of 103 patients. Two of selected studies had some concern, and one study were deemed to have high risk of bias. Overall both group shown reduced pain levels, and improvement of other criteria (ROM, functionality, activity of daily living) over time, with dry needling on top of rehabilitation protocol have advantage in prognosis of the patient. Looking at the data collected, although there is still a lot of bias in this review. Even though there was no evidence of superiority in reducing the pain level, we support dry needling as the adjuvant therapy for post-operative pain (extremity surgery) alongside with physical therapy rehabilitation protocol because the procedure has better prognosis than physical therapy rehabilitation protocol alone (ROM, functionality, activity of daily living).

Effectiveness of adding dry needling of the upper trapezius muscle to the usual physiotherapy for managing chronic neck pain: A randomized controlled trial with a 7-week follow-up

BackgroundMyofascial pain syndrome (MPS) is a chronic condition caused by sensitive pressure regions within the muscles known as myofascial trigger points (MTrPs). ObjectiveThe purpose of this randomized controlled trial (RCT) was to assess the effectiveness of adding dry needling (DN) to activate MTrPs in the upper trapezius muscle compared with usual physiotherapy among individuals with chronic neck pain. MethodsThirty participants were recruited from a private clinic in Saudi Arabia. Their mean age was 29.7 ± 4.4 years. The subjects were randomized into two groups: the experimental group (application of DN to the MTrPs coupled with usual physiotherapy (n = 15)) and the control group (usual physiotherapy alone (n = 15)). The primary outcomes were pain (assessed using the visual analog scale) and disability (Neck Disability Index), and the secondary outcomes were neck active range of motion (AROM; assessed using cervical ROM) and depression (Beck's Depression Inventory). ResultsSignificant between-group difference in pain intensity was observed immediately post-intervention. Participants in the experimental group had significantly higher pain (mean difference = 1.27, 95% confidence interval [CI] 0.20, 2.33, p = 0.022, Cohen's d = 0.889) than those in the control group. There was no significant difference between both groups in pain intensity during the follow-up. There were no between-group differences in disability immediately post-intervention. However, there was a between-group difference in disability at follow-up; participants in the experimental group had significantly lower disability (mean difference = −3.13, 95%CI -5.07, −1.20, p = 0.003, Cohen's d = 1.211) than those in the control group. Immediately post-intervention, the experimental group showed greater flexion AROM compared to the control group, with no differences in other AROM measures. At follow-up, the experimental group exhibited significantly higher neck AROM in extension, flexion, right and left side bending, and lower depression, while no differences were observed in right- and left-rotation AROMs between groups. ConclusionsThe addition of DN to standard physiotherapy effectively improved disability, AROM (extension, flexion, and side bending), and depression among patients with chronic neck pain.

Myofascial pain syndrome in patients with cancer: a narrative review.

Myofascial pain syndrome (MPS) is a chronic musculoskeletal pain syndrome. The purpose of this review is to describe the epidemiological and treatment evidence and to address the future research agenda in patients with cancer. A narrative review of previous reports investigating the prevalence and treatment of MPS in the oncology field is presented. The target population is patients with cancer and cancer survivors. There have been three prospective and two retrospective studies investigating the prevalence of MPS. MPS is as high as 38%-45% in patients with advanced or incurable cancer and 11.9%-44.8% in cancer survivors. A total of nine reports investigated the efficacy of the following interventions: trigger point injection (TPI), myofascial techniques and ischaemic compression. TPI has been reported to be effective in four observational studies. One randomised study reported the efficacy of myofascial techniques, but two randomised studies reported no added beneficial effects of it in breast cancer survivors. Two randomised studies investigated the efficacy of ischaemic compression, but the obtained results were contradictory. MPS is highly prevalent. We should know that non-cancer pain is also common in both patients with cancer and survivors. In treating such pain, careful physical examination is essential. Then, non-pharmacological treatment should be considered as well as pharmacotherapy. As evidence regarding MPS in the oncology field is scarce, further research is warranted.

Modulation effects of pressing manipulation on local inflammatory responses and ERK/NF-κB pathway in trigger point model rats

Modulation effects of pressing manipulation on local inflammatory responses and ERK/NF-κB pathway in trigger point model rats

Evaluating the Correlation between Myofascial Pelvic Pain and Female Sexual Function: A Prospective Pilot Study.

Introduction: Myofascial pelvic pain (MFPP) is a prevalent yet frequently overlooked condition characterized by myofascial trigger points located within the pelvic floor muscles. Women with MFPP often experience severely reduced quality of life due to impaired sexual health. Here, we examined the relationship between MFPP and sexual function. Materials and Methods: Eighty-three women with a benign gynecological condition were included in this pilot study. For each patient, we obtained a complete medical history, measured different types of subjective pain intensity using a visual analog scale, performed a validated standardized examination of the pelvic floor muscles for measuring MFPP, and used the German Female Sexual Function Index (FSFI-d) questionnaire. Results: Compared to women without MFPP (46 out of 83; 55.4%), the women with MFPP (37 out of 83; 44.6%) reported experiencing pain on more days per month (8 vs. 3 days/month; p = 0.002) and higher median VAS scores for dyspareunia (4 vs. 0; p < 0.001). We also found a significant inverse correlation between the severity of MFPP and overall FSFI-d scores (r = -0.35; p < 0.001), particularly in the FSFI-d subdomains of pain (r = -0.364; p < 0.001), lubrication (r = -0.230; p = 0.005), and arousal (r = -0.360; p < 0.001). Conclusions: Due to the higher prevalence of dyspareunia and pelvic pain, MFPP significantly impacts several aspects of female sexual health and function. This information, combined with increased awareness regarding MFPP, may provide a foundation for designing individualized therapies, thereby improving the quality of life of women affected by MFPP.

Short-term effectiveness of dry needling on pain and ankle range of motion in athletes with medial tibial stress syndrome- a randomized control trial

ABSTRACT Introduction Medial tibial stress syndrome (MTSS) is also called soleus syndrome because the resultant periostitis is localized to the medial insertion of the soleus muscle. This study explores the effectiveness of dry needling (DN) targeting soleus myofascial trigger points (MTrPs) in managing MTSS. Aim To assess the impact of DN on pain reduction and ankle range of motion (ROM) improvement in athletes with MTSS. Study Design This randomized controlled trial (RCT) included 50 university-level athletes. (DN group = 25; control group = 25) Method Outcome variables, pain, and ankle dorsiflexion ROM were measured using the Numeric Pain Rating Scale (NPRS) and universal goniometer, respectively. The trial used statistical analyses like Wilcoxon rank test for within-group comparisons and Mann-Whitney U test for between-group comparisons. The trial was registered with the Clinical Trials Registry of India; CTRI/2023/10/058837. Result There were 24 Females (Age = 21.4 ± 2.06) & 26 Males (Age = 20.5 ± 2.35). DN significantly reduced pain in the intervention group from NPRS 7 ± 1.30 to 2 ± 0.87 (p < 0.001), but in the control group, the pain increased from NPRS 7 ± 0.99 to 7 ± 1.05 (p = 0.009). There was no improvement in ankle ROM. Conclusion DN effectively alleviated MTSS-associated pain in the short-term but was not effective in improving ankle ROM.

Control components in the work of the head of nursing service of a dental clinic

In the management activities of each head of the nursing service, an important place is occupied by control over the work of mid-level and junior medical personnel. Control is a process of ensuring the achievement of organizational goals, which consists of setting standards, measuring the actual results achieved and comparing them with the standards, as well as making adjustments if the achieved results differ from the established standards. Target. To study the components of the control function used by the head nurse of the dental clinic in management activities. Results. The main areas of control over the activities of the middle and junior medical personnel of the dental clinic have been studied, the content of the types of control and trigger points have been determined. Conclusion. Each work performed requires verification and comparison of actual results with the planned work. Therefore, the topic of control is always relevant. Modern management theory has developed clear requirements for control: it must be prompt, transparent, objective.

Pendampingan Kesehatan Fisik bagi Pembatik sebagai Upaya Mengurangi Risiko dan Keluhan Work-related Musculoskeletal Disorder (WMSD) di Kampung Batik Laweyan

The high incidence of Work-related Musculoskeletal Disorder (WMSD) in workers is caused by various factors from the individual and the work environment. Musculoskeletal complaints in workers also occur and disrupt productivity for batik workers. Batik itself has several types and several divisions of work. Workload, duration, and poor work posture cause excess work on the muscles which results in functional disorders of the structural muscles in the neck and causes myofascial trigger point syndrome (MTPS). This service activity is carried out to resolve complaints, prevent further impacts, and increase worker productivity. The program is provided in the form of Integrated Neuromuscular Inhibition Technique (INIT) and Self Stretching combined with infrared radiation. Apart from that, educational efforts are also being made regarding Musculoskeletal Disorders and ergonomic working positions. Measurement of activity effectiveness is carried out using the VAS, NDI, NBM and WERA instruments. Based on the results of the activities carried out, it can be concluded that health assistance efforts for batik workers in Laweyan Batik Village in the form of providing therapeutic and educational measures have proven effective in reducing complaints and incidents of WMSD. By reducing complaints, the work output and productivity of batik makers increases.