Guzman-Pavon MJ, Cavero-Redondo I, Martinez-Vizcaino V, et al. Effect of Physical Exercise Programs on Myofascial Trigger Points-Related Dysfunctions: A Systematic Review and Meta-analysis. Pain Med. 2020 Oct 4. pii: 5917822. doi: 10.1093/pm/pnaa253. (Systematic review)

OBJECTIVE: Myofascial pain syndrome is one of the primary causes of health care visits. In recent years, physical exercise programs have been developed for the treatment of myofascial trigger points, but their effect on different outcomes has not been clarified. Thus, this study aimed to assess the effect of physical exercise programs on myofascial trigger points.

METHODS: A systematic search was conducted in Pubmed, Web of Science, and Scopus. Articles analyzing the effect of physical exercise programs on pain intensity, pressure pain threshold, range of motion, and disability were included. Risk of bias was assessed using the Cochrane RoB2 tool. The DerSimonian-Laird method was used to compute the pooled effect sizes (ES) and their 95% confidence interval (95% CI) for pain intensity, pressure pain threshold, range of motion, and disability.

RESULTS: A total of 24 randomized controlled trials were included in this systematic review and meta-analysis. The pooled ES were -0.47 (95% CI = -0.61 to -0.33) for pain intensity, 0.63 (95% CI = 0.31 to 0.95) for pressure pain threshold, 0.43 (95% CI = 0.24 to 0.62) for range of motion, and -0.18 (95% CI = -0.45 to 0.10) for disability.

CONCLUSIONS: Physical exercise programs may be an effective approach in the treatment of pain intensity, pressure pain threshold, and range of motion among patients with myofascial trigger points.

Discipline Area Score
Physician 5 / 7
Rehab Clinician (OT/PT) 5 / 7
Comments from MORE raters

Rehab Clinician (OT/PT) rater

Although this meta-analysis shows positive effects of exercise on myofascial pain, pressure sensitivity, ROM, and disability, it should be noted that most of the studies that were reviewed had large amounts of variance with confidence intervals that frequently included "0."

Rehab Clinician (OT/PT) rater

In spite of the limitations identified in the study this research shows that PE may be an effective therapeutic strategy for reducing pain intensity while increasing pressure pain threshold and range of motion in individuals with MTPs.

Rehab Clinician (OT/PT) rater

The tenuous trigger point raises its head, only this time as part of a pain syndrome. No surprises for entirely predictable results established a priori, that exercise is of benefit in pain syndromes. The really interesting question is were myofascial trigger points reduced?
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