Effect of ultrasound-guided extracorporeal shock wave on neck-shoulder myofascial pain syndrome
Bibliographic record
Abstract
Objective To explore the clinical efficacy and safety of ultrasound-guided extracorporeal shock wave in the treatment of the neck-shoulder myofascial pain syndrome. Methods A total of 60 patients with neck and shoulder muscle fascia pain syndrome admitted to the outpatient department of Jiangsu Subei People's Hospital and the First Affiliated Hospital of Suzhou University from January 2017 to June 2018 were prospectively divided into treatment group and the control group according to the random number table, each group had 30 cases, the control group received infrared, transcutaneous electrical nerve stimulation, massage and other routine rehabilitation training, the treatment group had additional ultrasound guided guided shock wave treatment, 2 times a week, continuous treatment for 3 week under the basis of the control group. The McGill pain questionnaire (MQG) and the neck disability index (NDI) were used to evaluate the function of the two groups before and after the first treatment and after 3 weeks. The hardness of the neck and shoulder fascia (Emean value) and thickness (mm) were evaluated by shear wave ultrasound elastography. Results The PRI-T scores of the two groups before treatment, after the first treatment, and after 3 weeks of treatment were (8.1±3.2)/(7.9±3.3), (4.3 ±2.6)/(5.2±2.5), (1.1±1.3)/(3.3±1.4) points, the difference between the two groups was statistically significant (F=2.368, F=1.985, P<0.05). There was significant difference between the groups (t=1.985, P<0.05). The VAS scores were: (6.2±2.3)/(6.4±2.4), (4.4±2.1)/(4.9±2.3), (2.6±1.3)/(3.2±1.7) points, before and after treatment, the differences between the two groups were statistically significant (F=2.315, F=1.876, P<0.05). The difference between the groups was statistically significant (t=1.752, P<0.05). The PPI scores were (2.6±0.8)/(2.5±0.7), (1.3±0.6)/(1.6±0.4), (0.4±0.3)/(0.9±0.6) points. The difference before and after treatment between the two groups was statistically significant (F=2.056, F=1.988, P<0.05), and the intergroup difference was statistically significant (t=1.680, P<0.05). The NDI were (43.2±2.9)/(42.9±2.8), (26.7±3.4)/(31.1±3.3), (11.4±3.2)/(23.3±3.4) points, and the differences before and after treatment between the two groups were statistical significance (F=3.689, F=3.002, P<0.05), the intergroup comparison was statistically significant (t=1.680, P<0.05). After 3 weeks of the treatment, the hardness and thickness of the trapezius fascia were improved from (18.4±4.3)/(17.9±4.4) kPa and (7.9±0.8)/(7.8±0.8) mm before treatment to (6.5±2.8)/(9.7±3.2) kPa and (4.6±0.5)/(5.4±0.7) mm, the difference was statistically significant (t=6.325, t=5.256, t=2.589, t=2.014, P< 0.05), and the treatment group were better than the control group, difference was statistically significant (t=2.652, t=1.801, P<0.05). The hardness and thickness of the levator fascia of the two groups were improved, from (14.7±3.4)/(14.9±3.1) kPa and (6.7±0.6)/(6.8±0.5) mm before treatment to (5.9±2.4)/(8.1±3.7) kPa and (4.8±0.6)/(5.1±0.6) mm, the difference were statistically significant (t=4.585, t=3.652, t=1.982, t=1.710, P<0.05). The treatment group were better than the control group, and the difference was statistically significant (t=2.655, t=1.699, P<0.05). The hardness and thickness of the rhomboid fascia of the two groups were improved, from (10.3±4.2)/(11.1±3.8) kPa and (6.0±0.7)/(6.4±0.6) mm to (4.2±1.3)/(6.4±2.8) kPa and (4.7±0.3)/(5.6±0.6) mm, the difference were statistically significant (t=4.602, t=4.055, t=2.621, t=1.986, P<0.05), and the treatment group were better than the control group, difference was statistically significant (t=2.540, t=1.729, P<0.05). Conclusion Ultrasound-guided extracorporeal shock wave can effectively relieve the pain of neck-shoulder myofascial pain syndrome, improve the function of neck and the shoulder. Meanwhile, the application of shear-wave ultrasonic elastography can provide accurate diagnosis and treatment, which is worthy of clinical application. Key words: Myofascial pain syndromes; Extracorporeal shockwave therapy; Trigger points; Musculoskeletal ultrasound
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".