Article

OBJECTIVE: To evaluate the effect of different intensities of electrical
stimulation on botulinum toxin A (BTX-A) injection at trigger points (TrPs) in
patients with chronic myofascial pain syndrome (MPS).
DESIGN: Double-blind
randomized trial. SETTING: Outpatient rehabilitation clinic. PARTICIPANTS:
Patients (N=76) with chronic MPS of the neck and shoulder regions. INTERVENTIONS:
Patients were randomly assigned to 1 of 2 intervention groups: BTX-A injection
followed by (1) electrical stimulation that induces visible muscle contraction
(MOTOR group); or (2) electrical stimulation with an intensity just above the
sensory threshold (SENSORY group). Electrical stimulation was administered for 30
minutes a day for 3 consecutive days after injection. MAIN OUTCOME MEASURES: The
primary outcome was the visual analog scale (VAS) for pain. Secondary outcomes
included the Neck Pain and Disability Scale (NPAD), Global Assessment of
Improvement Scale (GAS), and pressure pain threshold (PPT). RESULTS: The VAS
scores decreased significantly at 4, 8, 12, and 16 weeks from the baseline in
both groups. Significant changes in the NPAD score over time were noted only in
the SENSORY group at 8, 12, and 16 weeks. The SENSORY group showed lower VAS and
NPAD scores at 16 weeks (P=.043 and P=.041, respectively), and higher treatment
success rates at 12 and 16 weeks (P=.039 and P=.024, respectively) than the MOTOR
group. There was no significant result in the GAS and PPT. CONCLUSIONS:
Short-term electrical stimulation may affect the reduction in pain after BTX-A
injection at TrPs in patients with chronic MPS of the neck and shoulder regions.
Based on the results, it seems that sensory electrical stimulation was superior
to motor electrical stimulation as an adjuvant therapy to BTX-A injection in
patients with chronic MPS. Further studies are warranted to investigate the
method facilitating the effect of BTX-A on MPS.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS