深部肌肉刺激疗法对延迟性肌肉酸痛的疗效研究

目的:研究应用深部肌肉刺激疗法(DMS)治疗仪对延迟性肌肉酸痛(DOMS)症患者进行治疗时,患者的酸痛缓解情况。探讨DMS对延迟性肌肉酸痛症的治疗作用。方法:将40例健康人随机分成两组,观察组20例接受DMS治疗,对照组20例不接受特别治疗。两组受试对象均以力竭性离心运动方式诱导出小腿三头肌的DOMS,DMS治疗组在运动后立刻接受DMS治疗,连续5天;对照组不接受任何康复治疗。期间两组对象均进行简单的自我牵伸训练。在DOMS诱导后立刻至诱导后5天期间,每天对主观体力感觉(PRE)和视觉类比疼痛指数(VAS)两项指标进行检测。结果:1DMS治疗组和对照组相比,PRE在运动后24h、48h、72h,经组间独立样本比较,t24h=-6.76,t48h=-15.44,t72h=-3.17(P0.05),观察组的PRE比对照组低;2VAS评分在运动后24h、48h、72h、96h两组间对比,t24h=-2.37,t48h=-11.05,t72h=-16.87,t96h=-17.56(P0.05)。DMS治疗组以上各时间点的VAS评分比对照组评分低。结论:DMS治疗可以缓解因DOMS导致的疲劳及酸痛,降低运动后损伤程度。     

深层肌肉刺激治疗足底筋膜炎的疗效观察

目的 观察深层肌肉刺激（DMS）治疗足底筋膜炎的临床疗效。 方法 采用随机数字表法将56例足底筋膜炎患者分为观察组及对照组,每组28例。2组患者均给予传统康复干预(包括足底按摩手法及超声波治疗),观察组还同时辅以DMS治疗。每周治疗5 d,连续治疗4周。于治疗前、治疗4周后分别采用疼痛视觉模拟评分法（VAS）、足底超声检查及改良Barthel指数(MBI)评价患者疼痛、足底筋膜厚度及日常生活活动（ADL）能力改善情况。 结果 治疗后2组患者疼痛VAS评分、足底筋膜厚度及MBI评分均较治疗前明显改善（P<0.05）;并且观察组治疗后疼痛VAS评分［（2.9±1.9）分］、足底筋膜厚度［（2.84±0.71）mm］及MBI评分［（74.9±9.2）分］亦显著优于对照组水平（P<0.05）。 结论 DMS治疗足底筋膜炎的疗效明显优于传统康复干预,能进一步缓解疼痛,促进患部炎症水肿消散及生活质量提高,该疗法值得临床推广、应用。     

深层肌肉刺激治疗梨状肌综合征的临床研究

目的:观察深层肌肉刺激(DMS)对梨状肌综合征(PS)的临床疗效。方法:将2019年1月—2019年5月收治的50例梨状肌综合征患者随机分成治疗组(n=25)和对照组(n=25)。治疗组给予深层肌肉刺激治疗,对照组给予推拿治疗,每天1次,疗程为2周。在治疗前和治疗2周后,分别采用疼痛视觉模拟评分法(VAS)、超声检查下梨状肌厚度的测量、Oswestry功能障碍指数(ODI)评分及临床疗效进行评定。结果:两组患者治疗前VAS疼痛评分、梨状肌厚度及ODI评分差异均无显著性意义(P>0.05)。2周治疗后,两组VAS疼痛评分、梨状肌厚度及ODI评分较治疗前均有改善,差异均具有显著性意义(P<0.05)。治疗后治疗组VAS疼痛评分(t=-14.076)、梨状肌厚度(t=-2.306)、ODI评分(t=-36.653)改善情况均优于对照组,P<0.05。治疗后治疗组总有效率为96%,对照组治疗总有效率为80%,治疗组总有效率高于对照组,差异具有显著性意义(P<0.05)。结论:深层肌肉刺激在改善梨状肌综合征患者的临床症状和功能方面优于推拿疗法。     

延迟性肌肉酸痛的机制及其理论研究

延迟性肌肉酸痛妨碍了大部分运动员或普通人运动能力的发挥,因此探讨延迟性肌肉酸痛的产生机制对于预防或治疗延迟性肌肉酸痛有着举足轻重的作用。但诱发延迟性肌肉酸痛的内在机制尚未完全清晰。新近的一些研究成果表明延迟性肌肉酸痛可能与肌节重塑过程、微循环紊乱和外周神经系统的变化有关。文章就形成延迟性肌肉酸痛的机制学说进行述评,并试图依据此提出相应治疗原则。     

深层肌肉刺激联合本体感觉神经肌肉促进疗法治疗颞下颌关节紊乱病的疗效观察

目的观察深层肌肉刺激联合本体感觉神经肌肉促进技术治疗颞下颌关节紊乱病的疗效。 方法采用随机数字表法将52例颞下颌关节紊乱病（TMD）患者分为观察组及对照组,对照组患者给予常规物理因子治疗及本体感觉神经肌肉促进治疗（PNF）,观察组患者在上述干预基础上辅以深层肌肉刺激治疗（DMS）。于治疗前、治疗3周后分别观察2组患者疼痛视觉模拟评分(VAS)及Fricton颞下颌关节紊乱指数改善情况。 结果治疗后2组患者疼痛VAS评分均较治疗前显著降低（P<0.05）,且治疗后观察组疼痛VAS评分［（2.18±0.98）分］较对照组［（3.43±1.03）分］显著降低（P<0.05）。治疗后观察组患者颞下颌关节功能障碍指数（DI）、肌肉压痛指数（PI）、颞下颌关节紊乱指数（CMI）［分别为（0.424±0.067）、（0.032±0.017）和（0.129±0.034）］均较治疗前及对照组显著降低（P<0.05）;对照组患者治疗后DI指数（0.581±0.098）、CMI指数（0.172±0.051）均较治疗前显著降低（P<0.05）,但PI指数治疗前、后差异无统计学意义（P>0.05）。 结论深层肌肉刺激联合本体感觉神经肌肉促进技术治疗颞下颌关节紊乱病具有协同疗效,能进一步缓解患者疼痛,提高颞下颌关节功能,该联合疗法值得临床推广、应用。     

推拿对一次性离心运动后延迟性肌肉酸痛的影响

背景：推拿是运动性疲劳防治的常用手段之一,但有关推拿防治延迟性肌肉酸痛疗效的客观评价较少。目的：评价推拿对一次性离心运动后延迟性肌肉酸痛的影响。设计、时间及地点：对比观察,于2008—04／07在南京中医药大学完成。对象：将30名健康男性学生按照条件对等原则随机分成对照组和运动前推拿组、运动后推拿组共3组,每组10名。方法：运动前推拿组学生于训练前在左上肢进行30min的推拿,推拿结束5min后开始训练。运动后推拿组学生于训练后30min在左上肢进行30min的推拿,并在此后的3d内按规定的时间继续接受推拿治疗,30min/次,1次／d。对照组学生仅参加训练,不做任何的准备活动或整理活动,也不接受任何治疗。主要观察指标：观察训练前、训练后即刻、训练后24,48,72h测定肌肉酸痛程度和持续时间、最大等长收缩力量、臂围、肘关节的屈伸度,训练前1h、训练后即刻、训练后24,48h血清肌酸激酶的变化。结果：与对照组相比,运动前推拿组、运动后推拿组的肌肉酸痛持续时间明显缩短,酸痛的程度明显减轻（P〈0．01,P〈0．05）,运动后72h的肌肉最大等长收缩力量的恢复明显（P〈0．01）,运动后72h的血清肌酸激酶升高幅度明显降低。运动前推拿组运动后即刻的肘关节屈曲程度变化明显小于对照组（P〈0．05）,运动后推拿组在运动后72h的肘关节伸直程度的恢复明显优于对照组（P〈0．05）;运动前推拿组、运动后推拿组的臂围变化与对照组无明显差异。结论：运动前推拿能一定程度预防延迟性肌肉酸痛,减轻延迟性肌肉酸痛的严重程度,而运动后推拿能一定程度促进延迟性肌肉酸痛的恢复。     

推拿对延迟性肌肉酸痛作用机制的研究进展

延迟件肌肉酸痛(delayed-onset musele soreness,DOMS)是指人们在进行不习惯运动或强度突然增加后所出现的肌肉疼痛或不舒适的感觉.它最大的特征即为延迟性,常在运动后8-24h出现,24-48h时达到高峰[1-3].     

不同推拿手法对延迟性肌肉疼痛的治疗作用*

延迟性肌肉疼痛(delayecl-onset musele soreness,DOMS)是指人们在进行不习惯运动或强度突然增加后所出现的肌肉疼痛或不舒适的感觉.它最大的特征即为延迟性,做离心运动时更加明显,常在运动后8-24h出现,24-48h时达到高峰~([1-3]).     

Lack of effect of acupuncture upon signs and symptoms of delayed onset muscle soreness

The effect of acupuncture upon experimentally induced delayed onset muscle soreness (DOMS) was assessed in a placebo‐controlled study under blinded conditions. Volunteers (n=48; 24 M & 24 F) were randomly allocated to one of four groups: control (20 min rest), placebo (minimal needling at non‐acupuncture points), treatment group 1 (acupuncture at classic acupuncture points) and treatment group 2 (acupuncture at ‘tender’ points). DOMS was induced in the elbow flexors of the non‐dominant arm using a standardized eccentric exercise regime. Measurements of elbow range of movement (flexion, extension, relaxed angle), and pain as well as visual analogue scores (VAS), tenderness (using a pressure algometer) were employed as indices of treatment efficacy. Measurements of elbow range of movement and tenderness were made prior to DOMS induction on the first day, and repeated pre‐ and post‐treatment on subsequent days; pain was assessed using visual analogue scales post‐induction and post‐treatment on the first day, and pre‐ and post‐treatment thereafter. For all conditions, subjects rested supine for a period of 20 min, during which treatment was delivered according to group allocation. Repeated measures and one‐way analysis of variance (ANOVA) demonstrated no significant interactive (AB) effects, except for visual analogue scores (P=0·0483); one factor ANOVA on the second day of the experiment (pre‐treatment) indicated significant differences between the control and all other groups. However, such differences were not found on any other day of the experiment. It is concluded that acupuncture has little effect upon the cardinal signs and symptoms of DOMS, at least under the conditions of the current experiment.     

The effect of delayed onset of muscle soreness on habitual trapezius activity

The aim of the study was to investigate the effect of acute trapezius pain, induced by delayed onset of muscle soreness (DOMS), on habitual trapezius activity. Long‐term (5 h) surface electromyographic (sEMG) activity was recorded bilaterally from the clavicular, descending, transverse, and ascending trapezius on two consecutive weekdays in eleven female subjects (mean age 22 years, range 20–24 years). Body and arm posture were recorded by inclinometers. Immediately after the first long‐term recording, the subjects performed eccentric depression exercise of the left shoulder to induce DOMS. From day 1 to day 2, pressure pain threshold (PPT) decreased and pain scores on visual analog scale (VAS) increased for the left upper trapezius (P <.004 for all comparisons). Habitual sEMG activity (median sEMG level, μV) of the clavicular and descending part of the exercised left trapezius increased from first to second long‐term recording during periods with seated posture (P <.05 for both comparisons). In contrast, trapezius sEMG activity remained unchanged for all other trapezius parts and postures. This study indicates that acute trapezius pain induces elevated habitual trapezius activity during periods with low biomechanical loading of the shoulder/neck muscles with the elevated sEMG activity being restricted to the painful part of the muscle. In contrast to the pain‐adaption model, the current study indicates a relation between acute muscle pain and elevated low‐level muscle activity; however, it remains unknown if development of chronic muscle pain can be preceded by an initial stage with elevated muscle activity.     

Effects of microwave diathermy on signs and symptoms of delayed onset muscle soreness: a systematic review of Japanese primary studies

Background: Delayed onset muscle soreness (DOMS) is a common problem experienced after exercise. The use of heat has been proposed to relieve symptoms. Microwave diathermy (MWD) is a physical modality that produces deep heat in the tissues. Although its use in the Western world has become less common since the 1980s, it is still frequently used in Japan.

Objective: The purpose of this systematic review was to collect and assess Japanese language experimental research regarding the effect of MWD on signs and symptoms of DOMS.

Methods: Three Japanese databases (CiNii, Ichushi and Medical*Online) and five English databases (CINAHL, Embase, MEDLINE, Scopus and Web of Science) were searched until 2 March 2015. Only Japanese-language experimental studies were included. Two Japanese native speakers independently assessed the methodological quality of included studies using the McMaster Critical Review Form. Data were synthesised qualitatively.

Results: Three non-randomised experimental trials investigating the effects of MWD at 2450 MHz on DOMS in elbow flexors were included. All studies had moderate methodological qualities. Two studies reported significant positive effects on active range of motion (ROM) after eccentric exercises. No significant effect was identified in pain, circumference, maximal isometric strength and biochemical markers.

Conclusion: Our systematic review found limited formal evidence about the effect of MWD to improve active elbow ROM for subjects with DOMS. Real effects were difficult to assess due to the potential lack of statistical precision in data derived from small sample sizes. Future research should address the methodological flaws identified in this review, to provide more conclusive evidence.     

Delayed onset muscle soreness in neck/shoulder muscles

The aim of the present study is to: (1) induce delayed onset muscle soreness (DOMS) in the neck and shoulder muscles; (2) compare the pressure pain sensitivity of muscle belly with that of musculotendinous tissue after DOMS; (3) examine the gender differences in the development of DOMS. An eccentric shoulder exercise was developed to induce DOMS on neck/shoulder muscles using a specially designed dynamometer. Eccentric shoulder contraction consisted of 5 bouts, each bout lasted 3min, with 3min rest period between each bout. The right shoulder was elevating against a downward pressure force of 110% maximal voluntary contraction force exerted by the dynamometer. Pressure pain thresholds (PPT) of 11 sites (seven sites measured were muscle belly and four sites were myotendinous area) on neck/shoulder region were measured before, immediately after, 24 and 48h after exercise. Pain intensity, pain area and index of McGill pain questionnaire were assessed and all were increased after exercise. DOMS was induced in the shoulder muscles. PPT was significantly decreased and reached lowest values at 24h. The muscle belly sites are more sensitive to pain than the musculotendinous sites. No gender differences were found in any of the parameters used to assess the development of DOMS. DOMS did not distribute evenly in the neck/shoulder region. Soreness after exercise in the neck and shoulder seems not to be among the conditions that produce predominant musculoskeletal pain in females.     

MG53基因敲除对小鼠延迟性肌肉酸痛期骨骼肌损伤的影响

目的:探讨MG53敲除对骨骼肌损伤的影响,研究MG53在延迟性肌肉酸痛期是否具有减轻骨骼肌膜损伤的作用。方法:8周龄雄性C57小鼠84只,根据基因型分为两大组,野生型(WT)组和敲除型(KO)组,每一大组按照取材时间点又分为7个小组,共14组,即WT组(WC、WE0、WE2、WE12、WE24、WE48、WE72)和KO组(KC、KE0、KE2、KE12、KE24、KE48、KE72),每组6只。在离心运动后相应时间点内眦取血,脱颈处死小鼠,取左腿股直肌用于Western blot实验,右侧用于形态学观察。全自动生化分析仪检测血清肌酸激酶(CK),透射电镜观察14个组大鼠骨骼肌超微结构的变化,Western blot检测MG53蛋白水平。结果:KE0和KE2组CK较安静组非常显著性升高(P0.01),KE24和WE0组CK较安静组显著升高(P0.05),同一时间点CK值相比,KE0较WE0显著升高,KE24较WE24显著升高(P0.05);骨骼肌超微结构随时程变化较为明显,KO组在运动后损伤较WT组更为严重,呈现出损伤早、恢复慢的特点,KE24损伤最为严重,且KE72仍然没有恢复到安静水平;WT组MG53蛋白在运动后即刻达到峰值并显著高于安静组(P0.05),在24h出现第二次升高(P0.05)。结论:离心运动后KO组小鼠骨骼肌损伤较WT组更为严重,表明MG53能够明显减轻骨骼肌在延迟性肌肉酸痛期的损伤,WT组MG53蛋白在离心运动后即刻和24h显著升高,提示其在延迟性肌肉酸痛期骨骼肌损伤的修复中发挥了重要作用。     

深层肌肉刺激疗法对痉挛型双瘫患儿步态的影响

目的:研究深层肌肉刺激疗法对痉挛型双瘫患儿步态的影响。方法:将32例痉挛型双瘫患儿随机分为观察组和对照组各16例。2组均进行常规康复训练,观察组在此基础上给予深层肌肉刺激治疗,分别于治疗前和治疗12周后使用三维步态分析仪进行步态分析。结果:治疗12周后,2组步幅、步速均较治疗前有明显增加(均P<0.05),且治疗后观察组患儿步幅、步速均较对照组高(均P<0.05),其余各项参数2组间比较均差异无统计学意义。2组髋关节最大伸展角度和踝关节最大跖屈角度均较治疗前明显增大(均P<0.05),观察组膝关节最大屈曲角度、踝关节最大跖屈角度均较对照组明显增大(均P<0.05),且观察组膝关节最大伸展角度较治疗前及对照组均明显增大(均P<0.05),其余各项参数在统计学上无显著性差异。结论:在常规康复疗法的基础上,应用深层肌肉刺激疗法能改善痉挛型双瘫患儿步态,是痉挛型双瘫患儿康复的一种有效方法和手段。     

TRP channels and ASICs mediate mechanical hyperalgesia in models of inflammatory muscle pain and delayed onset muscle soreness

The roles of ion channels in sensory neurons were examined in experimental models of muscle pain in the rat. Rats were injected with 50 microl of 4% carrageenan or subjected to an eccentric exercise (ECC) of the gastrocnemius muscle (GM). The Randall-Selitto and von Frey tests were performed on the calves to evaluate mechanical hyperalgesia of the muscle. The changes in expression of four genes and proteins of ion channels in dorsal root ganglia were examined using quantitative PCR and immunohistochemistry, respectively. Effects of antagonists to transient receptor potential (TRP) channels and acid sensing ion channels (ASICs) on the mechanical hyperalgesia induced by carrageenan injection or ECC were evaluated. The mechanical hyperalgesia was observed 6-24h after carrageenan injection and 1-3 days after ECC in the Randall-Selitto test. Infiltrations of the inflammatory cells in the GM were seen in carrageenan-injected animals but not in those subjected to ECC. Expressions of genes and proteins in sensory neurons showed no changes. Intramuscular injection of antagonists to TRPV1 showed an almost complete suppressive effect on ECC-induced muscle hyperalgesia but not a carrageenan-induced one. Antagonists to TRP channels and ASICs showed suppressive effects for both carrageenan- and ECC-induced muscle hyperalgesia. The carrageenan injection and ECC models are useful models of acute inflammatory pain and delayed onset muscle soreness (DOMS), respectively, and the time course and underlying etiology might be different. TRP channels and ASICs are closely related to the development of muscle mechanical hyperalgesia, and TRPV1 is involved in ECC-induced DOMS.