Review Triggerpunktbehandlung

Zusammenfassung

Schmerz durch Triggerpunkte wird im klinischen Alltag durch verschiedene Interventionen wie Sprühen und Dehnen, ischämische Kompression, postisometrische Relaxation und trockenes Nadeln behandelt. Da es keine Übereinkunft bezüglich des Nutzens und der Effektivität dieser unterschiedlichsten Interventionen gibt, wird in diesem Review die aktuelle Studienlage dargestellt. Es erfolgt die elektronische Suche von randomisierten, kontrollierten Studien in der Pubmed Bibliothek unter Ausschluss von Reviews oder Interventionsbezug ohne konkrete Umsetzung. Arbeiten bezüglich Sprühen und Dehnen sowie postisometrischer Relaxation konnten nicht eingeschlossen werden, es ergaben sich 14 relevante Studien zu ischämischer Kompression und trockenem Nadeln. Erfasst wurden u. a. epidemiologische Daten, Messparameter (Outcome), zugrunde liegende Messverfahren und deren Messzeitpunkte sowie das behandelte Areal. Bis auf eine Arbeit findet sich bei sämtlichen Studien nach Behandlung eine Verbesserung der Messparameter, was die grundsätzliche Wirksamkeit von ischämischer Kompression und trockenem Nadeln belegt. Die Heterogenität der Studien, die eine allgemeingültige Aussage über die Praktikabilität im klinischen Alltag erschwert, zeigt sich besonders in der Umsetzung der Therapie an sich. Weitere Studien, die sich vor allem am allgemeinen Konsens bezüglich Outcome orientieren, sollten für Sprühen und Dehnen und postisometrische Relaxation durchgeführt werden.

Abstract

Pain by myofascial triggerpoints is, in clinical practice, treated by different interventions such as spray and stretch, ischemic compression, postisometric relaxation and dry needling. Since there is no agreement about the effectiveness and sufficiency of these various treatments, this review showed the momentary status of studies. The research was performed in the electronic database pubmed, it determined randomised trials excluding reviews and a lack of specific intervention. No inclusion was possible to RCT`s with reference to spray and stretch and postisometric relaxation, while 14 studies of ischemic compression and dry needling were eligible and included. All but one RCT showed an improvement of outcome measures proving the fundamental effectiveness of ischemic compression and dry needling. Concerning the feasibility in clinical routine, the heterogneity in practice of intervention shows the difficulty to find a general conclusion. Regarding the methods of spray and stretch and postisometric relaxation, there is a need of further studies with an agreed set of measured outcomes.

Schlüsselwörter

Triggerpunkte - Trockenes Nadeln - Ischämische Kompression - Sprühen und Dehnen - postisometrische Relaxation

Key words

trigger points - dry needling - ischemic compression - spray and stretch - postisometric relaxation

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