PMID- 22677576
OWN - NLM
STAT- MEDLINE
DCOM- 20121119
LR  - 20140227
IS  - 1938-1344 (Electronic)
IS  - 0190-6011 (Linking)
VI  - 42
IP  - 7
DP  - 2012 Jul
TI  - Muscle trigger points, pressure pain threshold, and cervical range of motion in 
      patients with high level of disability related to acute whiplash injury.
PG  - 634-41
LID - 10.2519/jospt.2012.4117 [doi]
AB  - STUDY DESIGN: Cross sectional cohort study. OBJECTIVE: To analyze the differences 
      in the prevalence of trigger points (TrPs) between patients with acute 
      whiplash-associated disorders (WADs) and healthy controls, and to determine if 
      widespread pressure hypersensitivity and reduced cervical range of motion are 
      related to the presence of TrPs in patients with acute WADs. BACKGROUND: The 
      relationship between active TrPs and central sensitization is not well understood 
      in patients with acute WADs. METHODS: Twenty individuals with a high level of 
      disability related to acute WAD and 20 age- and sex-matched controls participated 
      in the study. TrPs in the temporalis, masseter, upper trapezius, levator 
      scapulae, sternocleidomastoid, suboccipital, and scalene muscles were examined. 
      TrPs are defined as hypersensitive spots in a palpable taut band, producing a 
      local twitch response and referred pain when palpated. Pressure pain threshold 
      (PPT) was assessed bilaterally over the C5-6 zygapophyseal joints, second 
      metacarpal, and tibialis anterior muscle. Active cervical range of motion, neck 
      pain, and self-rated disability using the Neck Disability Index were also 
      assessed. RESULTS: The mean +/- SD number of TrPs for the patients with acute WAD 
      was 7.3 +/- 2.8 (3.4 +/- 2.7 were latent TrPs; 3.9 +/- 2.5 were active TrPs). In 
      comparison, healthy controls had 1.7 +/- 2.2 latent and no active TrPs (P<0.01). In 
      patients with acute WAD, the most prevalent sites for active TrPs were the 
      levator scapulae and upper trapezius muscles. The number of active TrPs increased 
      with higher neck pain intensity (P<0.001) and a higher number of days since the 
      accident (P=.003). Patients had significantly lower PPTs in all tested locations 
      and less active cervical range of motion than controls (P<.001). In the patient 
      group, there were significant negative correlations between the number of active 
      TrPs and PPT over the C5-C6 joints and cervical range of motion in flexion, 
      extension, and rotation in both directions: the greater the number of active 
      TrPs, the lower the bilateral PPT over the neck and the greater the cervical 
      range of motion limitation. CONCLUSIONS: The local and referred pain elicited 
      from active TrPs reproduced neck and shoulder pain patterns in individuals with 
      acute WADs with higher levels of disability. Patients with acute WADs exhibited 
      widespread pressure hypersensitivity and reduced cervical mobility. The number of 
      active TrPs was related to higher neck pain intensity, the number of days since 
      the accident, higher pressure pain hypersensitivity over the cervical spine, and 
      reduced active cervical range of motion.
FAU - Fernandez-Perez, Antonio Manuel
AU  - Fernandez-Perez AM
AD  - Department of Physical Therapy, Universidad de Granada, Granada, Spain.
FAU - Villaverde-Gutierrez, Carmen
AU  - Villaverde-Gutierrez C
FAU - Mora-Sanchez, Aurora
AU  - Mora-Sanchez A
FAU - Alonso-Blanco, Cristina
AU  - Alonso-Blanco C
FAU - Sterling, Michele
AU  - Sterling M
FAU - Fernandez-de-Las-Penas, Cesar
AU  - Fernandez-de-Las-Penas C
LA  - eng
PT  - Journal Article
DEP - 20120607
PL  - United States
TA  - J Orthop Sports Phys Ther
JT  - The Journal of orthopaedic and sports physical therapy
JID - 7908150
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Cervical Vertebrae/*physiopathology
MH  - Cross-Sectional Studies
MH  - Disabled Persons
MH  - Female
MH  - Humans
MH  - Male
MH  - Muscle, Skeletal/*physiopathology
MH  - Myofascial Pain Syndromes/*physiopathology
MH  - Neck Pain/etiology/physiopathology
MH  - Pain Threshold/*physiology
MH  - Pressure
MH  - Range of Motion, Articular/physiology
MH  - Severity of Illness Index
MH  - Shoulder Pain/etiology/physiopathology
MH  - Trigger Points/*physiopathology
MH  - Whiplash Injuries/*physiopathology
MH  - Young Adult
EDAT- 2012/06/09 06:00
MHDA- 2012/12/10 06:00
CRDT- 2012/06/09 06:00
PHST- 2012/06/09 06:00 [entrez]
PHST- 2012/06/09 06:00 [pubmed]
PHST- 2012/12/10 06:00 [medline]
AID - 2770 [pii]
AID - 10.2519/jospt.2012.4117 [doi]
PST - ppublish
SO  - J Orthop Sports Phys Ther. 2012 Jul;42(7):634-41. doi: 10.2519/jospt.2012.4117. 
      Epub 2012 Jun 7.