Abstract
Objective
To determine the differences between clinical effects of electroacupuncture 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
Fifty patients (N=50) aged 25-55 years of both sexes with chronic neck pain diagnosed
with MPS (characterized by trigger points within taut bands) were randomly assigned
to 2 equal groups of 25 individuals.
Interventions
The patients in electroacupuncture group were treated with standard acupuncture and
concomitant electrical stimulation; those in biofeedback group received visual electromyography
biofeedback therapy for muscle activity and relaxation. Both groups received the intervention
2 times a week for a total of 6 sessions. Basic exercise training and medicines were
administered for all the patients.
Main Outcome Measures
Pain severity based on the visual analog scale (VAS), functional status using Neck
Disability Index (NDI), cervical range of motion (ROM) using and inclinometer, and
pressure pain threshold (PPT) using an 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 the NDI.
Results
Fifty patients (39 women, 11 men) with a mean age (years) ± SD of 39.0±5.5 and neck
pain duration (weeks) of 6.0±2.2 were analyzed. All parameters, except for PPT of
the lower trapezius and paravertebral muscles were improved significantly in both
groups, while baseline values were controlled. The primary outcome was achieved more
significantly in the acupuncture group than in the biofeedback group: 20 (80.0%) vs
10 (40.0%); rate ratio=2 with 95% confidence interval (CI), 1.19-3.36; number needed
to treat (NNT)=2.5 with 95% CI, 1.54-6.58. Advantages of acupuncture over biofeedback
were observed according to values obtained from the NDI, VAS, extension and left lateral-bending
ROM, and PPT on the left upper trapezius after the last session of intervention until
3 months (P<.05).
Conclusions
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 vs biofeedback. Thus, electroacupuncture
seems to be a better complementary modality for treatment of MPS in the neck and upper
back area.
Keywords
List of abbreviations:
CI (confidence interval), EAC (electroacupuncture), ES (electrical stimulation), MPS (myofascial pain syndrome), MTrP (myofascial trigger point), NDI (Neck Disability Index), NNT (number needed to treat), NSAID (nonsteroidal anti-inflammatory drug), PPT (pressure pain threshold), ROM (range of motion), RR (rate ratio), TrP (trigger point), VAS (visual analog scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 16, 2020
Footnotes
Supported by Physical Medicine and Rehabilitation Research Center of Tabriz University of Medical Sciences. The funding body didn’t have any role in the design of the study or collection, analysis, or interpretation of data and also in writing of the manuscript.
Clinical Trial Registration No.: IRCT20100127003217N12.
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
