MyotonPRO presented at the Third International Fascia Research Congress 2012
29.03.2012
The Fascia Research Group from the Division of Neurophysiology of University of Ulm and the Center for Integrative Therapy from Stuttgart presented the study results of "Assessment of Myofascial Trigger Point Release with a novel Myometer (MyotonPRO) in addition to an Algometer" at the Third International Fascia Research Congress in Vancouver 28th - 30th March 2012. In the study the MyotonPRO was used as an objective diagnostic tool to assess efficiency of Myofascial Trigger Point Release technique.
The conclusion of the study was that MyotonPRO could be used as an objective diagnostic tool to assess the efficiency of a treatment, the Myofascial Trigger Point Release technique. The study results were summarised both in a verbal as well as in a poster presentation. The results presented at the Congress generated significant interest from reputable opinion leaders, editors and expert researchers in the fascia world.
This is the first known pilot study where a Myofascial Trigger Point Release (MTR) technique was evaluated through use of an objective diagnostic device, MyotonPRO. This device gave numerical feedback about the changes of biomechanical properties (Elasticity and Stiffness) as a result of the treatment. Up to now, the absence of objective feedback has been a major problem for practitioners and researchers in the evaluation of superficial soft biological tissue. Therefore this method of myometry can be a very promising tool in evidence-based medicine and fill the gap where there is a much-needed solution.
The study poster can be downloaded from here: "Assessment of Myofascial Trigger Point Release with a novel Myometer (MyotonPRO) in addition to an Algometer"
Background
Myofascial Trigger Points (TPs) are very common and are frequently associated with chronic shoulder, arm and headache pain1. In order to assess and treat these pathologies, a prospective controlled clinical pilot study was designed to observe the effect of the MTR technique on trapezius myofascial tissues and the reduction of muscle sensitivity to pain.
The structural changes caused by MTR were measured by MyotonPRO2,3 which gives objective numerical feedback on muscle Tone and biomechanical properties (Elasticity and Stiffness)4.
The method of myometry developed for measuring superficial skeletal muscles consists of:
a) creating an external mechanical impulse;
b) recording the muscle’s response in the form of an acceleration graph; and
c) subsequent computing of Tone, Elasticity and Stiffness.
Method
On 23 patients, three sensitive TP sites were marked on each side of the upper trapezius. The three sites on the more painful side were treated with a single standardized manoeuvre of MTR technique, in four 10-minute sessions over a period of 2 weeks. Measurements at the TP site were taken pre-and post-treatment using a MyotonPRO2,3 and a pressure algometer. Analog assessment scales of pain, range of movement, stress and life quality were also recorded.
Results
The measurement taken with MyotonPRO on the treated side gave the following consistent results:
1. significant decrease in Stiffness; and
2. significant increase in Elasticity, indicated by the decrease in Logarithmic Decrement4.
Furthermore the algometer readings showed a significant decrease in patients´ sensitivity to pain. The algometer-related changes correlated to the improvements recorded in the analog scales, such as Range of Motion (ROM).
Pain scales collected before the first treatment, before the fourth treatment and four weeks post-treatment showed both a significant decrease in pain and stabilization of the reduced level of pain.
Conclusions
Myofascial Trigger Point Release has been shown in the study to be an effective method in making structural changes to myofascial tissue that leads to reduction of muscle Stiffness and increase in Elasticity. This results in reduction of chronic shoulder pain. MyotonPRO is able to measure and monitor muscle Tone, Elasticity and Stiffness easily, objectively and reliably3 throughout the course of treatment. It has been used in this study for the assessment of muscle and thus to indicate stuctural changes to myofascial tissue before and after each MTR treatment. MyotonPRO promises to be a useful instrument for monitoring of treatment efficiency and efficacy. Further studies need to be conducted to consolidate these findings as well as for the possible implementation in other medical applications4.
References
1. Myburgh C, Larsen AH, Hartvigsen. A systematic, critical review of manual palpation for identifying myofascial trigger points: evidence and clinical significance. J Arch Phys Med Rehabil 89(6): 1169-76, 2008
2. Bizzini M, Mannion AF. Reliability of a new, hand-held device for assessing skeletal muscle stiffness. Clin Biomech 18:459–461, 2003
3. Agyapong-Badu S, Aird L, Bailey L, Warner M, Samuel D, Stokes M. Reliability of measuring tone and biomechanical properties of rectus femoris and biceps brachii in community-dwelling older adults using the MyotonPRO device. British Geriatrics Society 2012
4. Li-ling Chuang, Ching-yi Wu, Keh-chung Lin. Reliability, validity and responsiveness of myotonometric measurement of muscle tone, elasticity, and stiffness in patients with stroke. Arch Phys Med Rehabil 2012; 93 (3): 532-540
