Tensiomyography, sonoelastography, and mechanosensitivity differences between active, latent, and control low back myofascial trigger points: A cross-sectional study

César Calvo-Lobo, Ignacio Diez-Vega, Beatriz Martínez-Pascual, Silvia Fernández-Martínez, Mónica de la Cueva-Reguera, Gerson Garrosa-Martín, David Rodríguez-Sanz, César Calvo-Lobo, Ignacio Diez-Vega, Beatriz Martínez-Pascual, Silvia Fernández-Martínez, Mónica de la Cueva-Reguera, Gerson Garrosa-Martín, David Rodríguez-Sanz

Abstract

The myofascial pain syndrome (MPS) is considered the most common musculoskeletal condition. The lumbopelvic pain (LPP) is established as one of the most prevalent musculoskeletal disorders. Nevertheless, previous research has not yet studied the contractibility changes by tensiomyography between myofascial trigger point (MTrP) types and normal tissue. Therefore, the aim of this study was to determine the tensiomyography, sonoelastography, and pressure pain threshold (PPT) differences between the palpation area of active and latent MTrPs with regards to control points in the lumbar erector spinae muscles of subjects with LPP. A cross-sectional descriptive study was performed. A convenience sample of 60 points (20 active MTrPs, 20 latent MTrPs, and 20 control points) was registered bilaterally in the lumbar erector spinae muscles from subjects with nonspecific LPP. The palpation order of active MTrPs, latent MTrPs, or control points was randomized for each side. The outcome assessors were blinded to the order or point type. The outcome measurements order for each point was sonoelastography manual strain index, tensiomyography, and PPT, separated by 15 minutes. Five contractile objective parameters were: maximal radial displacement (Dm), contraction time (Tc), sustain time (Ts), delay time (Td), and half-relaxation time (Tr). Tensiomyography parameters did not show any statistically significant difference (P > 0.05) between active MTrPs, latent MTrPs, and control points. Nevertheless, PPT and sonoelastography showed statistically significant differences (P < 0.05) between all point types, except for active and latent MTrPs PPT comparison (P = 0.091). Regarding the active MTrPs, a moderate positive correlation was observed between PPT and Dm (P = 0.047; τB = 0.450). Considering the control points, a moderate positive correlation was shown between sonoelastography and Td (P = 0.044; τB = 0.328). The tensiomyography contractile properties did not seem to show differences, while the sonoelastography and mechanosensitivity presented a higher stiffness and a lower PPT, respectively, between the palpation area of active and latent MTrPs with regards to control points in the lumbar erector spinae muscles of subjects with LPP. Considering the correlations, further research is needed regarding the muscle contractile properties modifications under MPS treatments, especially Dm in active MTrPs and Td in normal sites.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Tensiomyography software used to determine the displacement–time curves.
Figure 2
Figure 2
Tensiomyography electrodes and digital displacement transducer placed perpendicular to the muscle belly.
Figure 3
Figure 3
Linear transducer used to assess the sonoelastography manual strain index.
Figure 4
Figure 4
The manual strain index, from 0-soft (S) to 6-hard (H) was calculated by means of the software provided by the ultrasound system. The white arrows show the 3 highest index in the green color region of the horizontal axis, at 2 to 4, 4 to 6, and 6 to 8 seconds, used for the analyses data.
Figure 5
Figure 5
Pressure pain threshold (PPT) evaluation on the lumbar erector spinae muscles.
Figure 6
Figure 6
Box-plots to illustrate the sonoelastography difference between active myofascial trigger points (MTrPs), latent MTrPs, and control points. ∗The manual strain index (from 0-soft to 6-hard) was applied.
Figure 7
Figure 7
Box-plots to illustrate the PPT difference between active MTrPs, latent MTrPs, and control points. MTrPs = myofascial trigger points, PPT = pressure pain threshold.

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