Background: The muscles associated with tension-type headache (TTH) are connected to the scalp fascia, which is firmly attached to the superciliary ridge of the frontal bone. However, there is a paucity of data on treatments for TTH that directly target the scalp fasciae. Objectives: We aimed to validate a new manual therapy to treat TTH by applying myofascial relaxation techniques to the scalp and to examine the changes in quality of life and headache characteristics after treatment. Design: pretest-posttest control group design study. Methods: Total 24 participants with TTH (10 males, 14 females) participated in the study. Manual therapy group (MT) received standard manual therapy and scalp myofascial release technique group (SMT) received scalp myofascial release technique twice per week for 4 weeks. Brief Pain Inventory (BPI) and Headache Impact Test (HIT) for quality of life, headache frequency, duration, and Visual Analog Scale (VAS) for intensity were assessed at the pre- and post-treatment. Results: There was a significant improvement within groups in headache frequency (MT P<.05, SMT P<.001), duration (MT P<.05, SMT P<.01), VAS (MT P<.01, SMT P<.001), HIT (MT P<.001, SMT P<.001), and BPI (MT P<.001, SMT P<.001) between the pre- and post-treatment. Group differences were significant for headache duration (P=.027), but the others were not. MT and SMT reduced the impact of headaches on daily life. Also Headache frequency, duration, intensity, and BPI were improved. Conclusion: MT and SMT reduced the impact of headaches on daily life. Also Headache frequency, duration, intensity, and BPI were improved. It has been suggested that both MT and SMT can be used as a non-invasive treatment to treat the TTH, and to improve the quality of life.

Background: To evaluate whether extracorporeal shock wave therapy (ESWT) in the pain point is a more effective treatment than the trigger point for myofascial pain syndrome (MPS) of the upper trapezius. Objects: The purpose of this study was to compare the most effective areas when applying extracorporeal shock wave therapy. Methods: A total of 30 patients with MPS were randomly assigned to the trigger point in the ESWT (n = 15) and pain point ESWT (n = 15) groups. Interventions in both groups were performed in one session, i.e., 2,000 shocks with 1.5 bar intensity. Pain and function were assessed using the visual analog scale (VAS) and cervical range of motion (ROM) and based on mechanical muscle properties. Statistical analysis was performed using the repeated measures two-way analysis of variance to determine the significance probability between pre- and post-test. Results: Changes in mechanical muscle properties were not statistically significant between the two groups. However, VAS and cervical ROM showed statistically significant differences at pre- and post-intervention, regardless of the group (p < 0.05). Conclusion: Although no significant difference was observed in the intervention effect, applying an extracorporeal shock wave to the pain point rather than the pain trigger point should be considered in order to save time in effectively and accurately identifying the pain trigger point and site.

Background: Many trials have been conducted the methods and types of intervention of form rollers, but no research has been done yet that mixes the methods and types of intervention. Objectives: To analyze the effects of myofascial release on the improvement of range of motion (ROM), flexibility, pain pressure threshold, and balance. Design: Randomized controlled trial. Methods: All subjects measured ROM, flexibility, pressure pain threshold, and dynamic balance by pre-test. After pre-test, subjects were randomized that static-vibration foam rolling group (n=12), dynamic-vibration foam rolling group (n=12), general foam rolling group (n=12). For the intervention, 3 sets of 90 seconds were applied to each group, and rest time was set to 60 seconds between sets. In the post-test and follow-up test after 10 minutes, all three groups were measured the ROM, flexibility, pressure pain threshold, and dynamic balance. Results: The results of comparing ROM, flexibility, pressure pain thresholds, dynamic balance ability appeared higher significant difference in the prepost- 10 minutes follow up test in comparison between time in the intragroup (P<.001). As a result of comparing the change of pre-post-10 minutes follow up, static vibration foam rolling showed higher significant difference compared to control groups (P<.001). Conclusion: Through this study, when foam rolling is applied within the same intervention time, static foam rolling can be expected to have a better effect than the existing dynamic foam rolling as well as vibration foam roller can expect better effect than general foam rolling.

The aim of the present study was to compare the effects of Rolfing and Swedish massage. In total, 105 patients with cervical myofascial pain syndrome were divided into two groups based on the intervention: a 40-min Rolfing session (n = 52) or a 40-min Swedish massage session (n = 53). Pre- and pos-tintervention visual analog scale (VAS) scores for pain, muscle tone (Myoton F), muscle elasticity (Myoton D), and muscle stiffness (Myoton S) were measured to compare treatment effects between the two groups. The results revealed a significant decrease in the VAS score for pain, Myoton F, and Myoton S (p < .05), with no change in Myoton D (p > .05), after the intervention in the Rolfing group. Similar findings were obtained for the Swedish massage group. Intergroup comparison of the degree of improvement after the intervention revealed no significant difference for any variable. The findings suggest that both group indicated a similar decrease in pain, muscle tension, and muscle stiffness after the intervention, with no significant improvement in muscle elasticity.

Background: Scapular posterior tilt (SPT) is important in the prevention of abnormal scapular movement and pain during elevation of the arm. However, previous studies have overlooked increased upper trapezius (UT) muscle activity interrupting the normal force couple of scapular motion and compensation of levator scapulae (LS) muscle activated simultaneously with UT during SPT exercise. Objects: The purpose of this study was to compare the effects of modified SPT with depression exercise versus SPT exercise on serratus anterior (SA), lower trapezius (LT), UT, and LS muscle activities and the clavicular tilt angle, in subjects with rounded shoulder posture (RSP) and myofascial pain in the UT muscle region. Methods: Eighteen subjects with RSP were recruited and randomly allocated to 2 groups; 9 in the SPT group and 9 in the SPT with depression group. All subjects met the specific RSP criteria and had myofascial pain of UT region. Depending on the allocated group, subjects performed the assigned SPT exercise and EMG data were recorded during the each exercise. Clavicular tilt angle was defined as the angle between the line joining the medial and lateral end of the clavicle and a horizontal line. Results: The SA muscle activity was significantly greater in SPT with depression than with SPT exercise (p<.05). The UT, LS muscle activity and the clavicular tilt angle was significantly lower in SPT with depression than with SPT exercise (p<.05). Conclusion: These findings were insightful because the potential risk of pain from overactivation of the UT and LS was considered, in contrast with SPT exercise. SPT with depression exercise can be implemented as an effective method to facilitate scapular muscle activity for stability and to prevent myofascial pain in the neck and shoulder.

The purpose of this study was to compare visual analogue scale (VAS), pain threshold (PT), , and EMG gaps before and after applying transcutaneous electrical nerve stimulation (TENS) on the upper trapezius muscle at the patients with myofascial pain syndrome (MPS). The subjects were 4 men and 10 women composed of both the inpatients and outpatients who were diagnosed as MPS at Wonju Medical Center. VAS and PT measurements were performed to assess the subjective pain level. The reference voluntary contraction (RVC) test was performed for 15 seconds for normalization on the bilateral trapezius muscle using surface electromyography (sEMG). After 3-minute resting time, the EMG signal was recorded while performing a typing activity for 2 minutes and then TENS was applicated with a comfortable intensity for 10 minutes. The EMG activity of the upper trapezius muscle was recorded during typing for 2 minutes. The results of study were as follows: 1) VAS score was significantly decreased on the more painful side after treatment, however, it was not significantly different on the less painful side. 2) PT was increased after treatment on both sides, however, it was not significantly different between before and after the TENS application. 3) The EMG activity during typing was significantly decreased after treatment, and 4) The EMG gaps were significantly increased after TENS treatment compared to before it. Consequently, the study showed that TENS was effective in decreasing VAS, , and in increasing EMG gaps. The EMG gap analysis could be a useful method to measure pain in patients with MPS in the upper trapezius.

본 연구에서는 상부 승모근의 근막통증(myofascial pain syndrome; MPS)를 대상으로 이완상태에서 근 활성도를 측정해보고, 통증을 감소시키는 데 주로 이용되는 경피신경자극 치료 후 근 활성도에 어떠한 영향을 미치는지 알아보기 위해 실시하였다. 본 연구의 대상자는 근막 통증으로 진단을 받은 총 10명을 대상으로 실시하였다. 주관적 시각 척도(visual analogue scale; VAS)와 압통 역치 측정계(pressure thresh