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Mechanical pain sensitivity of deep tissues in children--possible development of myofascial trigger points in children.

Han TI, Hong CZ, Kuo FC, Hsieh YL, Chou LW, Kao MJ - BMC Musculoskelet Disord (2012)

Bottom Line: The results showed that, for all children in this study, the mean PPT values was significantly lower (p < 0.05) at the assumed A-TrP site (site A) than at the other two sites, and was significantly lower (p < 0.05) at the assumed MTrP site (site B) than at the control site (site C).The changes in sensitivity, or the development for these trigger points, may not be related to the activity level of children aged 7-11 years.Further investigation is still required to identify the exact timing of the initial occurrence of a-Trps and latent MTrPs.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Physical Medicine and Rehabilitation, Taipei City Hospital, Taipei, Taiwan.

ABSTRACT

Background: It is still unclear when latent myofascial trigger points (MTrPs) develop during early life. This study is designed to investigate the mechanical pain sensitivity of deep tissues in children in order to see the possible timing of the development of latent MTrPs and attachment trigger points (A-TrPs) in school children.

Methods: Five hundreds and five healthy school children (age 4- 11 years) were investigated. A pressure algometer was used to measure the pressure pain threshold (PPT) at three different sites in the brachioradialis muscle: the lateral epicondyle at elbow (site A, assumed to be the A-TrP site), the mid-point of the muscle belly (site B, assumed to be the MTrP site), and the muscle-tendon junction as a control site (site C).

Results: The results showed that, for all children in this study, the mean PPT values was significantly lower (p < 0.05) at the assumed A-TrP site (site A) than at the other two sites, and was significantly lower (p < 0.05) at the assumed MTrP site (site B) than at the control site (site C). These findings are consistent if the data is analyzed for different genders, different dominant sides, and different activity levels.

Conclusions: It is concluded that a child had increased sensitivity at the tendon attachment site and the muscle belly (endplate zone) after age of 4 years. Therefore, it is likely that a child may develop an A-Trp and a latent MTrP at the brachioradialis muscle after the age of 4 years. The changes in sensitivity, or the development for these trigger points, may not be related to the activity level of children aged 7-11 years. Further investigation is still required to identify the exact timing of the initial occurrence of a-Trps and latent MTrPs.

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Related in: MedlinePlus

Sites of measurement.
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Figure 1: Sites of measurement.

Mentions: The same measurement methods were followed for the identification of the three sites on the brachioradialis muscle as previously described [19]. At first, the distance between the lateral epicondyle and the styloid process was measured. The midpoint of this distance was considered as the junction of the muscle and tendon. The assumed MTrP (site B) was approximately placed proximally at a point one-third the distance between this junction site and the lateral epicondyle [1]. It is located at the most prominent portion of the muscle belly (endplate zone). The assumed A-TrP (site A) was the most proximal portion of the lateral epicondyle, i.e., the region just above the original site of hand/finger extensors, because the exact origin of the brachioradialis is difficult to identify. As shown in Figure 1, these three sites were measured for pressure pain threshold using a pressure algometer: Site A is the assumed A-TrP site, Site B is the assumed MTrP site, and Site C, the muscle-tendon junction site, acted as the control site.


Mechanical pain sensitivity of deep tissues in children--possible development of myofascial trigger points in children.

Han TI, Hong CZ, Kuo FC, Hsieh YL, Chou LW, Kao MJ - BMC Musculoskelet Disord (2012)

Sites of measurement.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3298468&req=5

Figure 1: Sites of measurement.
Mentions: The same measurement methods were followed for the identification of the three sites on the brachioradialis muscle as previously described [19]. At first, the distance between the lateral epicondyle and the styloid process was measured. The midpoint of this distance was considered as the junction of the muscle and tendon. The assumed MTrP (site B) was approximately placed proximally at a point one-third the distance between this junction site and the lateral epicondyle [1]. It is located at the most prominent portion of the muscle belly (endplate zone). The assumed A-TrP (site A) was the most proximal portion of the lateral epicondyle, i.e., the region just above the original site of hand/finger extensors, because the exact origin of the brachioradialis is difficult to identify. As shown in Figure 1, these three sites were measured for pressure pain threshold using a pressure algometer: Site A is the assumed A-TrP site, Site B is the assumed MTrP site, and Site C, the muscle-tendon junction site, acted as the control site.

Bottom Line: The results showed that, for all children in this study, the mean PPT values was significantly lower (p < 0.05) at the assumed A-TrP site (site A) than at the other two sites, and was significantly lower (p < 0.05) at the assumed MTrP site (site B) than at the control site (site C).The changes in sensitivity, or the development for these trigger points, may not be related to the activity level of children aged 7-11 years.Further investigation is still required to identify the exact timing of the initial occurrence of a-Trps and latent MTrPs.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Physical Medicine and Rehabilitation, Taipei City Hospital, Taipei, Taiwan.

ABSTRACT

Background: It is still unclear when latent myofascial trigger points (MTrPs) develop during early life. This study is designed to investigate the mechanical pain sensitivity of deep tissues in children in order to see the possible timing of the development of latent MTrPs and attachment trigger points (A-TrPs) in school children.

Methods: Five hundreds and five healthy school children (age 4- 11 years) were investigated. A pressure algometer was used to measure the pressure pain threshold (PPT) at three different sites in the brachioradialis muscle: the lateral epicondyle at elbow (site A, assumed to be the A-TrP site), the mid-point of the muscle belly (site B, assumed to be the MTrP site), and the muscle-tendon junction as a control site (site C).

Results: The results showed that, for all children in this study, the mean PPT values was significantly lower (p < 0.05) at the assumed A-TrP site (site A) than at the other two sites, and was significantly lower (p < 0.05) at the assumed MTrP site (site B) than at the control site (site C). These findings are consistent if the data is analyzed for different genders, different dominant sides, and different activity levels.

Conclusions: It is concluded that a child had increased sensitivity at the tendon attachment site and the muscle belly (endplate zone) after age of 4 years. Therefore, it is likely that a child may develop an A-Trp and a latent MTrP at the brachioradialis muscle after the age of 4 years. The changes in sensitivity, or the development for these trigger points, may not be related to the activity level of children aged 7-11 years. Further investigation is still required to identify the exact timing of the initial occurrence of a-Trps and latent MTrPs.

Show MeSH
Related in: MedlinePlus