• Journal of Korean Physical Therapy Science
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• v.2 no.3
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• pp.727-738
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• 1995

Myofascial pain syndrome is one of the major cause of chronic pain and trigger point injection, stretching, spray and electrical therapy are often used in clinical situation for treatment of myofascial pain syndrome. Myofascial pain syndrome is characterzied by the existence of a hypersensitive region, called the trigger point in a muscle or in the connective tissue, together with palpable noble, stiffness, limitation of motion and referred pain when trigger point is stimulated. Physiologically, they represent a self-sustaining vicious cycle of pain-spasm-pain. The purpose of this study is to illustrate mechanisms of pain by stimulation of acupuncture and trigger point, to introduce clinic application of orient and western stimulative point (acupuncture, trigger point)for treatment of MPS(myofascial pain syndrome), to make physiotherapist use both stimulative points for treatment of MPS.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.1 no.2
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• pp.69-76
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• 2003

The purpose of this study was to determine the effect of transcutaneous electrical nerve stimulation(TENS) on the alteration of pressure pain threshold of myofascial trigger points. We used fifty nine patients with upper trapezius mayofascial pain syndrome. Participants classified according to each group in conventional TENS(high rate, low intensity) and acupuncture like TENS(low rate, high intensity). The test was measured continuously pre test, post-test by algometer. The following results were obtained; 1. Pressure pain threshold were significantly increased in all groups(p<.001). 2. In comparison between groups, pressure pain threshold were not significantly differenced. These results lead us to the conclusion that each method by TENS were significantly increased pressure pain threshold of upper trapezius trigger points. Therefore, a further direction of this study will be to provide more evidence that TENS method have an effect on pressure pain threshold of myofascial trigger points.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.2
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• pp.127-131
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• 2014

Skeletal muscles which are the largest part of human body may develop pain and dysfunction. The myofascial pain syndrome that has trigger points as a unique characteristic is a major cause of morbidity. Trigger points are focal, hyperirritable painful areas located in a taut band of skeletal muscle. They produce local area pain and a referred pattern pain and often accompany chronic joint dysfunction. Various modalities are used to inactivate trigger points in myofascial pain syndrome. Trigger-point injection has been shown to be one of the most effective treatment modality to provide prompt relief of symptoms. This review article presents general concept of myofascial pain syndrome and technique of trigger point injection.

• The Journal of Korean Physical Therapy
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• v.25 no.2
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• pp.76-80
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• 2013

Purpose: The objective of this study was to offer primary clinical data examining whether change of imaging structure and quantitative evaluation of muscle activity on myofascial trigger points can lead to implementation of an analytical technique for evaluation of myofascial pain diagnoses. In addition, we examined the effect of a variety of mediation techniques, in order to examine neuromuscular physiological characteristics of myofascial trigger points muscle by comparing differences in pressure pain threshold and ultrasound imaging. Methods: Participants in the study included 30 adults in their twenties. The subjects were divided into the normal and myofascial trigger points groups. Clinical outcomes were evaluated by pressure pain threshold for pain and ultrasound imaging was performed for evaluation of the structural characteristics of muscle. Independent t-test was used for statistical analysis. Results: The two groups showed statistical significance in the change in pressure pain threshold (p<0.05). Findings of ultrasound imaging analysis showed no significant differences, increased muscle thickness was observed (p>0.05). Findings of ultrasound imaging analysis showed significant differences, increased muscle echodensity was observed (p<0.05). Findings on ultrasound imaging analysis showed significant differences, increased muscle white area index was observed (p<0.05). Conclusion: From these results, active myofascial trigger points muscle showed quality deterioration on ultrasound imaging. Thorough evaluation of imaging structure and physiological characteristics can be useful quantitative analytical techniques for diagnosis of myofascial pain syndrome and a primary factor reflected in physical therapy intervention.

• The Journal of Korean Physical Therapy
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• v.33 no.5
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• pp.258-263
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• 2021

Purpose: Myofascial syndrome is a chronic muscle pain caused by repetitive motions with stress-related muscle tension. This study aimed to investigate the validity and reliability of the evidence for diagnosing myofascial pain syndrome in trapezius muscle using a pressure algometer and surface electromyography. Methods: The experiments were performed using a total of 10 subjects, and the target locations were determined by means of a pressure algometer in the right upper trapezius muscle. The part with the lowest pain value as the trigger point and the part with the highest pain value as the non-pain trigger point were selected for measuring the locations. The median frequency and average frequency were measured in those locations with electromyography. To check the muscle fatigue, the upper trapezius muscle was moved up and down for 2 seconds at 5-second intervals in 30 seconds. The measured values were evaluated using the independent paired t-test and MannWhitney U-test. Results: The median frequency at the non-trigger point (13.7) was significantly higher than that at the trigger point (7.3). Furthermore, the mean frequency (14.7) at the non-trigger point was significantly higher than that at the trigger point (6.3). Conclusion: The results showed the correlations between the trigger points of the muscle pain and frequency analysis of surface electromyography. Thus, this study may be possible to use as a diagnostic tool for myofascial pain syndrome.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.1 no.2
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• pp.61-68
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• 2003

The purpose of this study was to compare the application method of ultrasound on the alteration of pressure pain threshold of myofascial trigger points. We used thirty patients with mayofascial pain syndrome in upper trapezius. Participants classified according to each group in non noxious dose, noxious dose by the ultrasound. The test was measured continuously pre test, post-test by algometer. The following results were obtained; 1. Pressure pain threshold were significantly increased in non-noxious dose and noxious dose group(p<.001). 2. In noxious dose group, pressure pain threshold were more significantly increased than non-noxious dose group(p<.001). These results lead us to the conclusion that non-noxious dose and noxious dose were significantly increased pressure pain threshold of upper trapezius trigger points. Therefore, a further direction of this study will be to provide more evidence that noxious dose have more effect on pressure pain threshold of myofascial trigger points.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.8 no.1
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• pp.23-29
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• 2010

Purpose : This study is to offer clinical primary data that examines the change of imaging structure and the quantitative evaluation of muscle activity on myofascial trigger points. This study examines neuromuscular physiological characteristic by comparing the differences in physical findings, pressure pain threshold, imaging, and electrophysiological characteristics in latent and active myofascial trigger points muscle and normal muscle through the following experimental procedures. Methods : The participants for the study were thirty-three adults in their twenties. We divided three groups into normal, latent and active myofascial trigger points groups by physical findings. We analyzed the results of measured pressure pain, threshold for pain, ultrasound imaging perform for structure characteristic of muscle, surface EMG according to type of muscle contraction for function of muscle contraction. Results : Significant differences were indicated in pressure pain threshold (p<0.05). Significant differences were discovered in the ultrasound imaging analysis. There were increases in muscle Echogenicity white area index (p<0.001). There were significant differences that decrease in %MVIC (p<0.05), increase in MDF (p<0.05). Conclusion : From these results, active rnyotascial trigger points muscle showed quality deterioration on ultrasound imaging and decreased function of muscle contraction, increased motor unit action potential of II type fiber, and electrophysiologically. Imaging structure and neuromuscular physiological characteristic can be diagnostic and quantitative analytical techniques for myofascial pain syndrome and a primary factor that reflected in physical therapy intervention.

• Journal of Korean Physical Therapy Science
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• v.2 no.1
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• pp.393-404
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• 1995

The purpose of this review was to examine the clinical characteristics of patients who had a diagnosis of Myofascial Pain Syndrome(MPS). Myofascial pain is a painful condition of skeletal muscle characterized by the presence of one or more trigger points. A trigger point(TrP) is a focus of hyperirritability in a tissues. Of the patients with MPS, 21(44.7 %) were male and 26(55.3 %) were female. The mean duration of MPS was 9.6 months for males and 11.3 months for females. Trigger points with associated referred patterns of pain were found in muscles of the post neck(trapezius, infrasupinatus) and in quadratus lumborum muscle. Patients reported increased fatigue(87.2 %), tingling sensation(66.0 %), numbness(66.0 %), tension(55.3 %), anxiety(44.7 %), headache (59.6 %), pilomotor activation(59.6 %).

• Korean Journal of Acupuncture
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• v.39 no.3
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• pp.84-90
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• 2022

Objectives : Acupoints are divided into three categories: classical acupoints, extra-acupoints, and Ashi points. The aim of this study was to understand the meaning and features of Ashi points. Methods : We examined the original meaning of Ashi points from the classical medical texts, including the Beijiqianjinyaofang, the Essential Prescriptions Worth a Thousand Gold for Emergencies, and the Huangdi Neijing, the Yellow Emperor's Canon of Internal Medicine. Results : First, the Ashi method is to locate the points for the acupuncture and moxibustion based on the patients' reactions mainly manifested by sensations of comfort and pain, which can help identify not only Ashi points but also classical and extra-acupoints. Thus, Ashi points may or may not match to classical or extra-acupoints, and we propose that Ashi points should not be classified mutually exclusive to classical or extra-acupoints. Second, there are several similarities between Ashi points and myofascial trigger points. They are located by palpation and have no fixed anatomical positions. Patients experience painful but pleasant feeling when Ashi and myofascial trigger points are pressed, and stimulation of these points have treatment effects. Conclusions : We suggest that Ashi method be used to identify the acupoints based on how patients react when these points are pressed. Ashi points may or may not correspond to classical or extra-acupoints, and share traits with myofascial trigger points.

• The Korean Journal of Pain
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• v.14 no.1
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• pp.32-36
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• 2001

Background: There is no reliable objective test for the diagnosis of myofascial pain syndromes. The aim of this study was to evaluate the usefulness of a pressure algometer for the diagnosis of the trigger points and for the evaluation of the treatment in myofascial pain syndromes (MPS). Methods: Twenty female patients with clinical MPS of shoulder were included in this study. Pressure pain thresholds were measured by a pressure algometer at three different sites including the trapezius, supraspinatus and infraspinatus before, and then the 1st, 3rd and 7th days after TPI. Results: Mean pressure pain thresholds were lower in patients with MPS in than normal volunteers in all the examined skeletal muscles. Mean pressure pain thresholds in patients with MPS were increased significantly after TPI in all the examined skeletal muscles. Conclusions: Pressure algometer can be used as relatively objective diagnostic tool for locating trigger points and to quantify the effect of TPI in MPS. However, more investigation is necessary.