Publication date: Available online 16 January 2020
Source: Archives of Physical Medicine and Rehabilitation
Author(s): Fariba Eslamian, Fatemeh Jahanjou, Neda Dolatkhah, Alireza Pishgahi, Ali Pirani
Abstract
Objective
To determine the differences between clinical effects of electro-acupuncture and biofeedback therapy in addition to conventional treatment in patients with cervical Myofascial Pain Syndrome (MPS).
Design
Randomized clinical trial.
Setting
Physical medicine and rehabilitation clinic of a university hospital.
Participants
50 patients aged 25-55 years old of both genders with chronic neck pain diagnosed to have MPS (characterized by trigger points within taut bands) were randomly assigned into two equal groups of 25 individuals.
Interventions
The patients in electroacupuncture group were treated with standard acupuncture concomitant electrical stimulation and those in biofeedback group received visual EMG-biofeedback therapy for muscle activity and relaxation. Both groups received the intervention 2 times a week for a total of 6 sessions. Basic exercise trainings and medicines were administered for all the patients.
Outcome Measures
Pain severity based on Visual Analogue Scale (VAS), functional status using Neck Disability Index (NDI), cervical Range of Motion (ROM) using inclinometer and Pressure Pain Threshold (PPT) using algometer were evaluated before and at 3 and 12 weeks after the treatment. Primary outcome was defined as 20% reduction in the 3-month neck pain and dysfunction compared to baseline, assessed through NDI.
Results
50 patients (39 women, 11 men) with an average age of 39.0 (5.5) years old and neck pain duration of 6.0(2.2) weeks were analyzed. All parameters, except for PPT of lower trapezius and paravertebral muscles were improved significantly in both groups, while baseline values were controlled. Achieving primary outcome was significantly more in acupuncture group compared to biofeedback group: 20 (80.0%) versus 10 (40.0%); RR = 2 with 95% CI = 1.19 to 3.36; NNT = 2.5 with 95% CI = 1.54 to 6.58. Advantages of the acupuncture over biofeedback were observed according to values obtained from NDI,VAS, extension and left lateral bending ROM and PPT on left upper trapezius after the last session of intervention until 3 months (P < 0.05).
Conclusion
Both electroacupuncture and biofeedback therapies were found to be effective in management of MPS when integrated with conventional treatment. However, intergroup differences showed priority of acupuncture in some parameters versus biofeedback. Thus, electro-acupuncture seems to be a better complementary modality for treatment of MPS in neck and upper back area.
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