• Title/Summary/Keyword: Pressure Pain Threshold

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Immediate Effects of Posteroanterior Cervical Mobilization on Pressure Pain Threshold and Gait Parameters in Patients with Chronic Neck Pain: A Pilot Study

  • Choi, Taeseok;Moon, Okkon;Choi, Wansuk;Heo, Seoyoon;Lee, Sangbin
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.4
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    • pp.1914-1920
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    • 2019
  • Background: Mobilization and cranio-cervical flexion exercise has been reported in reducing pain from cervical part and improving its motor function; also, has been represented that alleviate of neck pain and recover of neck muscles improve the normal gait performance. However, few studies have identified the effects of mobilization and exercise on pain and gait parameters with preceding issues. Objective: To examine the effects or changes of pressure pain threshold (PPT) and gait parameters in patients with chronic neck pain. Design: Cross-Sectional Clinical Trials Methods: Twenty patients with the history of neck pain (>3 months) performed the cervical mobilization and cranio-cervical flexion exercise. Gait parameters were assessed with wireless device and collected data were transmitted to the personal computer via Bluetooth. The PPT was measured posteroanterior direction at the prone position and the mean of subsequent three PPT measurements was used for the final analysis. Results: Both cervical central posteroanterior mobilization (CCPAM) (p<.000) and sling-based cranio-cervical flexion exercise (SBCCFE) (p<.000) group showed a significant increase in the PPT and the gait parameters, cadence (p<.023), was significantly increased in the CCPAM group, however slightly increased in the SBCCFE group. The comparison between the CCPAM and the SBCCFE groups after treatment did not show significant differences for the score on the PPT and gait parameters. Conclusions: This study suggests that CCPAM and SBCCFE increase PPT, cadence, and gait speed.

The effect of taping applied to the lower trapezius muscle on the upper trapezius muscle tone, pain, and cervical range of motion in chronic upper trapezius pain patients (만성 상부승모근 통증 환자의 하부승모근에 적용한 테이핑이 상부승모근 긴장도 통증 목뼈 가동성에 미치는 영향)

  • Lee, Yang-Jin;Park, Dong-Chun;Kim, Won-Deuk;Kim, Sung-Yeol
    • Journal of Korean Physical Therapy Science
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    • v.28 no.1
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    • pp.46-53
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    • 2021
  • Background: The purpose of this study was to investigate the effect of taping applied to the lower trapezius on the upper trapezius muscle tone, pain intensity, cervical rotation range of motion in chronic upper trapezius pain patients. Design: Case-control study. Methods: Twenty subjects with chronic upper trapezius pain were classified into an experimental group and a control group. The experimental group applied lower trapezius facilitation taping and the control group applied sham taping. Taping Before and after the application of taping, muscle tone, pain intensity, and cervical rotation range of motion of the upper trapezius were measured. Results: In the experimental group, there were significant differences in the pressure pain threshold and muscle tone before and after taping. In the comparison between groups, there was a significant difference in muscle tone between the experimental group and the control group. Conclusion: The application of the lower trapezius facilitation taping was found to be effective in reducing the pressure threshold and muscle tone of the upper trapezius. Therefore, it is expected that more effective treatment can be provided by adding lower trapezius facilitation taping to the treatment protocol for patients with chronic shoulder pain.

Correlation Among the Cervical Kyphotic Angle, Pain, and Disability Level in Patients With Temporomandibular Disorders (턱관절장애 환자의 목뼈 뒤굽음 각과 통증 및 기능장애 수준 간에 상관성 연구)

  • Lee, In-su;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.27 no.2
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    • pp.102-110
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    • 2020
  • Background: There is an opinion that improper postures of the head and cervical spine are associated with temporomandibular joint (TMJ) disorders (TMDs). Objects: The aim of this study was to investigate the proportions among the cervical kyphotic angle, physical symptoms including the pain intensity level of the TMJ, and severity of TMD disability in patients diagnosed with TMD. Methods: Sixty-two subjects participated in the study. The evaluation tools included measurements of the cervical kyphotic angle based on the Ishihara index, pressure pain threshold (PPT) on the TMJ, maximal mouth opening (MMO) without pain, current pain intensity level of the TMJ measured using the Quadruple Visual Analogue Scale (QVAS), Korean TMD (KTMD) disability index, KTMD Symptom Frequency/Intensity Scales (SFS/SIS), and Korean Headache Impact Test-6. Correlation analysis was conducted to investigate the correlations between the cervical kyphotic angle and parameters related to TMJ symptoms. Results: Variables that were significantly correlated with the cervical kyphotic angle were the PPT around the TMJ (r = 0.259, p < 0.05), current pain intensity level of the TMJ based on the QVAS (r = -0.601, p< 0.01), and usual pain intensity level based on the SIS (r = -0.379, p < 0.01). The level of TMD functional disability was significantly correlated with the degree of headache (r = 0.551, p < 0.01), level of PPT of the TMJ (r = -0.383, p < 0.01), pain-free MMO (r = -0.515, p < 0.01), pain intensity level of the TMJ based on the QVAS (r = 0.393, p < 0.01), TMD symptom frequency (r = 0.739, p < 0.01), usual pain intensity of the TMJ (r = 0.624, p < 0.01), and most severe pain intensity of the TMJ (r = 0.757, p < 0.01). Conclusion: There is a positive correlation between the cervical kyphotic angle and PPT and a negative correlation between the current and usual pain intensity levels of the TMJ. The cervical kyphotic angle was a predictor of the pain level, tenderness threshold, and intensity of pain in the TMJ.

Analysis of the Change of the Pressure Pain Threshold in Chronic Tension-Type Headache and Control (만성 긴장성 두통 환자와 정상 대조군의 압력통각 역치 변화에 대한 비교연구)

  • Kim, Min-Jung;Kang, Wee-Chang;Hong, Kwon-Eui
    • Journal of Pharmacopuncture
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    • v.12 no.2
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    • pp.41-50
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    • 2009
  • Although Chronic tension-type headache(CTTH) is one of the most common symptom in primary headache, there is no definite mechanisms. But muscular factors and psychological factors is supposed to be related with CTTH according to many other studies and pressure pain threshold(PPT) is used to measure muscular factors. Methods 1. We performed this study with 63 patients fulfilling the International Headache Societ criteria for chronic tension-type headache and 20 healthy control group and measured the PPT of temporal muscle and trapezius muscle. 2. We investigated the correlation between clinical characteristic and PPT. 3. Each of the CTTH groups and Control group is divided to four group again - HNP, Spondylosis, Sprain, Normal according to Cervical spine X-ray. Results 1. The PPT of temporal muscle and trapezius muscle in the CTTH is significantly lower than that of Control. 2. In CTTH group, the PPT has significant positive relation with duration of headache and continued time of headache. And the PPT has significant inverse relation with Frequency of headache and Level of headache. 3. In CTTH group, spondylosis group has the highest PPT and normal group is second. And there are significant difference between spondylosis group and the others. Conclusion : We found that PPT is strongly significant to measure muscular factor in CTTH.

Correlation of Testosterone and Pain Threshold in the Patients with Somatoform Disorder (신체형 장애에서의 Testosterone과 통각 역치의 상관관계)

  • Park, Jae-Hong;Kim, Myung-Jung;Park, Je-Min;Kim, Yong-Ki;Han, Kwi-Won;Park, Seong-Hwa;Yun, Kyung-Il;Chung, Young-In;Kim, Sung-Gon
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.22-27
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    • 1998
  • Thirteen female patients of somatization disorder, undifferentiated somatoform disorder and somatoform disorder, NOS, diagnosed by DSM-IV were studied for their pain threshold and serum testosterone and the results were compared with the respective data of 20 control females. The results are as follows : 1) The pain threshold as measured by Variable Weight Pressure Algometer was significantly lower in the patient group(153.8${\pm}$39.5 gm/$0.05mm^2$) as compared to the control group(197.5${\pm}$66.7 gm/$0.05mm^2$)(p<0.05). 2) There was no significant difference of serum testosterone between the patient(0.175${\pm}$0.081 ng/ml) and the control(0.174${\pm}$0.108 ng/ml) groups. 3) A significant positive correlation was noted between the pain threshold and serum testosterone in the patient group(r=0.632, p<0.05, two tailed, Pearson's correlation test), but not in the normal control group(r= -0.405). From these results, it was suggested that the role of testosterone in endogenous pain control system might be more important in somatoform disorders than normals.

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The Effects of Sling and Resistance Exercises on Muscle Activity and Pelvic Rotation Angle During Active Straight Leg Raises and Pain in Patients with Chronic Low Back Pain (만성 허리통증 환자에게 슬링과 기구저항운동이 통증과 능동 뻗은발올림 동안 근활성도, 골반 회전각에 미치는 영향)

  • Kim, Dae-Hyun;Kim, Tae-Ho
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.4
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    • pp.113-121
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    • 2018
  • PURPOSE: This study was conducted to identify a more effective intervention in sling and resistance exercise for chronic low back pain patients. METHODS: Seventy (70) subjects were randomly divided into the sling group (SG) and resistance exercise group (REG). Muscular activity of the internal oblique (IO), external oblique (EO), rectus abdominis (RA), and pelvic rotation angle during active straight leg raise (ASLR), a pressure pain threshold (PPT) and a visual analog scale (VAS) were measured. Sling and resistance exercises were conducted for 12 weeks. Intermediate measurements were taken after 8 weeks and final measurements were taken after 12 weeks. RESULTS: Both groups showed significantly decreased RA muscle activity and significantly increased IO muscle activity (p<.05). Additionally, EO muscle activity was significantly decreased in the REG, but significantly increased in the SG (p<.05), while the pelvic rotation angle and VAS were significantly decreased in the SG (p<.05). The pressure pain threshold was significantly increased in both groups (p<.05). CONCLUSION: Based on the results of this study, a 12-week intervention seems to be effective at improving back pain in both groups. However, a lower VAS was seen in the sling group after 8 weeks of intervention. Therefore, it is recommended that the sling be applied first when establishing a chronic back pain treatment program to shorten the treatment period and reduce the pain period.

Correlation between Qi-Stagnation and Pressure Pain Threshold on $CV_{17}$ (Danzhong : 膻中) in Burning Mouth Syndrome Patients - In the Perspective of Quantification of Pressure Pain Threshold on $CV_{17}$ by using Algometer - (구강작열감증후군 환자에서 기울과 전중($CV_{17}$)압통의 상관성 - Algometer를 이용한 전중압통의 정량화 측면에서 -)

  • Kang, Kyung;Kim, Jin-Sung;Seon, Jong-Ki;Son, Ji-Hee;Kim, Ju-Yeon;Jang, Seung-Won;Son, Ji-Young;Lee, Hyun-Ju;Ryu, Bong-Ha
    • The Journal of Internal Korean Medicine
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    • v.33 no.4
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    • pp.498-510
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    • 2012
  • Objectives : This study was designed to find out whether there is a correlation between qi-stagnation score and pressure pain threshold (PPT) on acupuncture point $CV_{17}$ in burning mouth syndrome (BMS) patients. Methods : Thirty BMS patients who newly visited Oral Disease Clinic at the Kyung Hee University Korean Medicine Hospital were surveyed. The subjects were evaluated on age, illness duration, sex, self-assessed severity of BMS, qi-stagnation score, and PPT on 3 acupuncture points ($CV_{17}$, Rt. $SP_9$, Lt. $SP_9$). Results : There was significant correlation between age and PPT on $CV_{17}$ (p=0.005). Therefore, partial correlation analysis with age as control variable was done, and the result showed significant correlation between qi-stagnation score and PPT on $CV_{17}$ (p=0.001). Qi-stagnation diagnostic point by PPT on $CV_{17}$ was suggested as 3.8056 $kg/cm^2$ based on the fact that diagnostic score is 28.50 in the qi-stagnation questionnaire. Furthermore, considering that PPT is effected by age, we could attain qi-stagnation diagnostic equation of PPT on $CV_{17}$, that is suggested as $0.047{\times}(age)+0.848kg/cm^2$. PPT of 3 acupuncture points ($CV_{17}$, Rt. $SP_9$, Lt. $SP_9$) was compared, and the result showed that PPT was significantly lower on $CV_{17}$ (w/Rt $SP_9$: p=0.022, w/Lt. $SP_9$: p=0.012). Also, significance and correlation coefficient with qi-stagnation were higher on $CV_{17}$ (p<0.001, r=-0.620) than Rt. $SP_9$ (p=0.023, r=-0.413) or Lt. $SP_9$ (p=0.014, r=-0.444). Conclusions : The result of this study suggested that PPT on $CV_{17}$, measured quantitatively by algometer, had a strong correlation with qi-stagnation score in BMS patients. Therefore, the study showed that $CV_{17}$ can be a useful acupuncture point in diagnosing qi-stagnation by measuring PPT in BMS patients.

Change of Balance Ability in Subjects with Pain-Related Temporomandibular Disorders

  • Ja Young Kim;Sang Seok Yeo
    • The Journal of Korean Physical Therapy
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    • v.34 no.6
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    • pp.321-325
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    • 2022
  • Purpose: Temporomandibular disorder (TMD) is a condition defined as pain and dysfunction of temporomandibular joints and masticatory muscles. Abnormal interconnections between temporomandibular muscles and cervical spine structures can cause the changes of postural alignment and balance ability. The aim of this study was to investigate changes in static balance ability in subjects with painrelated TMD. Methods: This study conducted on 25 subjects with TMD and 25 control subjects with no TMD. Pressure pain thresholds (PPTs) of the masseter and temporalis muscles were measured using a pressure algometer. Static balance ability was assessed during one leg standing using an Inertial Measurement Unit (IMU) sensor. During balance task, the IMU sensors measured motion and transfer movement data for center of mass (COM) motion, ankle sway and hip sway. Results: PPTs of masseter and temporalis muscles were significantly lower in the TMD group than in the control group (p<0.05). One leg standing, hip sway, and COM sway results were significantly greater in the TMD group (p<0.05), but ankle sways were not different between group. Conclusion: We suggest pain-related TMD is positively related to reduced PPTs of masticatory muscles and to static balance ability. These results should be considered together with global body posture when evaluating or treating pain-related TMD.

상완골 외상과염 환자에 대한 오공약침 치험 2례

  • Park, Jang-Woo;Hwang, Jae-Pil;Kang, Jun-Hyuk;Kim, Hyun-Su;Heo, Dong-Seok;Yoon, Il-Ji;Oh, Min-Seok
    • Journal of Pharmacopuncture
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    • v.9 no.3 s.21
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    • pp.155-160
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    • 2006
  • Objective : The purpose of this study is to examine if scolopendrid acuacupucture may be effective to the lateral epicondylitis. Methods : Using scolopendrid aquacupucture, we injected a small dose of it to the affected area and operated 2 pre and post treatment test; VAS(visual analogue scale), PPT(pressure pain threshold). Results : The scolopendrid aquacupucture treatment led to improvement in the pain and symptom of lateral epicondylitis by all efficacy measures. After scolopendrid aquacupucture treatment, there was improvement in VAS, PPT. Conclusion :This results suggest that scolopendrid aquacupucture is good method for treatment of lateral epicondylitis, so we suggest the possibility to use this new remedy for the lateral epicondylitis.

Effect of Cervical HVLA Technique and Mulligan MWM Techniques on Pain, Function in Patients with Lateral Epicondylitis (경추 도수교정과 멀리건기법이 주관절 외측상과염의 통증과 기능에 미치는 영향)

  • kim, Dong-ya;Kim, Hyun;Jeon, Jae-guk
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.22 no.1
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    • pp.59-64
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    • 2016
  • Background: This study was to investigate the effect of cervical HVLA technique and mulligan MWM technique on patients with lateral epicondylitis. Methods: 36 participants were randomly allocated to the two groups; group I involved high velocity low amplitude (HVLA) cervical mobilization technique, mulligan mobilizations with movement (MWM) technique (n=18). group II mulligan MWM (n=18). Patient attended for three times a week for six weeks. Results: The change of visual analogue scale (VAS) was statistically and significantly decreased in both of the group I and the group II. The change of patients rated tennis elbow evaluation (PRTEE) was statistically and significantly decreased in both of the group I and the group II. The change of pressure pain threshold (PPT) was statistically and significantly increased in both of the group I and the group II. Nevertheless, There is no statistical differences between group I and group II. Conclusion: After experiment, pressure pain threshold and visual analogue scale, patients rated tennis elbow evaluation were improved in both group. But Cervical HVLA group does not showed the change better than mulligan MWM group.

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