| Summary: | 碩士 === 台北醫學院 === 口腔復健醫學研究所 === 90 === It is known that myofascial pain syndrome（MPS） shares the same neural pathway with sympathetic nerve system, but the mechanisms is not clear. Sympathetic nerve system control the microcirculation of the skin. The change of the microcirculation below the skin will reflect on the temperature of the skin. Infrared thermogram can detect the changing. Abnormal infrared thermogram always match the dermotomes including upper back, lower back or extremities. Someone who suffered from MPS will be noted the sign. However, the relationship between skin temperature regulation over the area with trigger points and referred pain is still unknown. Therefore, to implement the use of infrared thermogram as a plausible tool for the clinical assessment of referred pain in MPS and treatment assessment, current study will propose a human experiment based on the thermo-changes in skin temperature for patient with MPS.
The study first compares the differences of patients with MPS and normal adult in changes respects to skin temperature, visual analog scale（VAS）, cervical range of motion（ROM）, and pain threshold on trigger point over upper trapezius muscle before and after cervical spinal mobilization. Then investigate the relation between data from skin temperature of bilateral trigger point over upper trapezius muscles and its referred pain area. Finally we analyze the correlation between the detected change of skin temperature and visual analog scale, cervical ROM and pain threshold on trigger point.
We found that: 1) The control group who had different temperature on bilateral trigger point and referred pain area before and after treatment are significantly noted by using T-test. Significant changes are also noted in temperature on bilateral trigger point and right side referred pain area before and after treatment with experimental group. Bilateral pain threshold are found differently before and after treatment. No difference found on VAS and cervical ROM between two groups. 2) High degree of positive correlation found between change of skin temperature on trigger point and its referred pain area with experimental group, but no significant finding on control group. 3) There is no significant relation on cervical ROM changes with the temperature change on bilateral trigger points in both experimental and control groups. 4) There is also no significant relation on VAS change with the temperature change on bilateral trigger points in both experimental and control groups. 5) Negative correlation was noted between change of pain threshold on right trigger point and change of skin temperature on bilateral trigger point and its referred pain area with experimental group, but no significant finding on control group. Negative relation were found between change of pain threshold on left trigger point and change of skin temperature on bilateral trigger point and only right referred pain area with experimental group, but no significant finding on control group. There is no significant relation on change of pain threshold on left trigger point with change of skin temperature on left trigger point ( p>0.05 ). But negative correlation was noted between change of pain threshold on right trigger point and change of skin temperature on bilateral trigger point and its referred pain area with control group.
According these results, we can provide a new clinical evaluative tool for MPS for comparing the differences after treatment or therapy.
Key words：Myofascial pain syndrome, Infrared thermogram, Cervical spinal mobilization, Visual analog scale, Cervical range of motion, Trigger point, Pain threshold
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