OBJECTIVE To determine the differences between clinical effects of electro-acupuncture and biofeedback therapy in addition to conventional treatment in patients with cervical Myofascial Pain Syndrome (MPS). DESIGN Randomized clinical trial. SETTING Physical medicine and rehabilitation clinic of a university hospital. PARTICIPANTS 50 patients aged 25-55 years old of both genders with chronic neck pain diagnosed to have MPS (characterized by trigger points within taut bands) were randomly assigned into two equal groups of 25 individuals. INTERVENTIONS The patients in electroacupuncture group were treated with standard acupuncture concomitant electrical stimulation and those in biofeedback group received visual EMG-biofeedback therapy for muscle activity and relaxation. Both groups received the intervention 2 times a week for a total of 6 sessions. Basic exercise trainings and medicines were administered for all the patients. OUTCOME MEASURES Pain severity based on Visual Analogue Scale (VAS), functional status using Neck Disability Index (NDI), cervical Range of Motion (ROM) using inclinometer and Pressure Pain Threshold (PPT) using algometer were evaluated before and at 3 and 12 weeks after the treatment. Primary outcome was defined as 20% reduction in the 3-month neck pain and dysfunction compared to baseline, assessed through NDI. RESULTS 50 patients (39 women, 11 men) with an average age of 39.0 (5.5) years old and neck pain duration of 6.0(2.2) weeks were analyzed. All parameters, except for PPT of lower trapezius and paravertebral muscles were improved significantly in both groups, while baseline values were controlled. Achieving primary outcome was significantly more in acupuncture group compared to biofeedback group: 20 (80.0%) versus 10 (40.0%); RR = 2 with 95% CI = 1.19 to 3.36; NNT = 2.5 with 95% CI = 1.54 to 6.58. Advantages of the acupuncture over biofeedback were observed according to values obtained from NDI,VAS, extension and left lateral bending ROM and PPT on left upper trapezius after the last session of intervention until 3 months (P < 0.05). CONCLUSION Both electroacupuncture and biofeedback therapies were found to be effective in management of MPS when integrated with conventional treatment. However, intergroup differences showed priority of acupuncture in some parameters versus biofeedback. Thus, electro-acupuncture seems to be a better complementary modality for treatment of MPS in neck and upper back area.

中文翻译：

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电针和生物反馈治疗颈部和上背部肌筋膜疼痛的相对有效性：一项随机临床试验"

目的探讨电针与生物反馈疗法联合常规治疗颈椎肌筋膜疼痛综合征（MPS）患者的临床疗效差异。设计 随机临床试验。设置某大学医院的物理医学和康复诊所。参与者 50 名年龄在 25-55 岁的患有慢性颈部疼痛的慢性颈部疼痛患者被诊断为患有 MPS（以绷紧带内的触发点为特征）被随机分配到两个相等的组，每组 25 人。干预 电针组患者采用标准针刺伴随电刺激治疗，生物反馈组患者接受视觉肌电-生物反馈治疗肌肉活动和放松。两组均每周接受 2 次干预，共 6 次。对所有患者进行了基本的运动训练和药物治疗。结果测量基于视觉模拟量表 (VAS) 的疼痛严重程度、使用颈部残疾指数 (NDI) 的功能状态、使用倾角计的颈椎活动度 (ROM) 和使用痛觉计的压力疼痛阈值 (PPT) 在第 3 周和第 12 周进行评估治疗后。主要结果定义为与基线相比，3 个月的颈部疼痛和功能障碍减少 20%，通过 NDI 评估。结果 分析了平均年龄为 39.0（5.5）岁、颈部疼痛持续时间为 6.0（2.2）周的 50 名患者（39 名女性，11 名男性）。除了下斜方肌和椎旁肌的 PPT 外，所有参数在两组中都有显着改善，而基线值得到控制。与生物反馈组相比，针灸组获得的主要结果显着更多：20 (80.0%) 比 10 (40.0%)；RR = 2，95% CI = 1.19 至 3.36；NNT = 2.5，95% CI = 1.54 到 6.58。根据在最后一次干预后直到 3 个月从左斜方肌的 NDI、VAS、伸展和左侧弯曲 ROM 和 PPT 获得的值，观察针刺相对于生物反馈的优势（P < 0.05）。结论当与常规治疗相结合时，电针和生物反馈疗法均被发现对 MPS 的管理有效。然而，组间差异显示针灸在某些参数上优于生物反馈。因此，电针似乎是治疗颈部和上背部 MPS 的更好补充方式。20 (80.0%) 对 10 (40.0%)；RR = 2，95% CI = 1.19 至 3.36；NNT = 2.5，95% CI = 1.54 到 6.58。根据在最后一次干预后直到 3 个月从左斜方肌的 NDI、VAS、伸展和左侧弯曲 ROM 和 PPT 获得的值，观察针刺相对于生物反馈的优势（P < 0.05）。结论当与常规治疗相结合时，电针和生物反馈疗法均被发现对 MPS 的管理有效。然而，组间差异显示针灸在某些参数上优于生物反馈。因此，电针似乎是治疗颈部和上背部 MPS 的更好补充方式。20 (80.0%) 对 10 (40.0%)；RR = 2，95% CI = 1.19 至 3.36；NNT = 2.5，95% CI = 1.54 到 6.58。根据在最后一次干预后直到 3 个月从左斜方肌的 NDI、VAS、伸展和左侧弯曲 ROM 和 PPT 获得的值，观察针刺相对于生物反馈的优势（P < 0.05）。结论当与常规治疗相结合时，电针和生物反馈疗法均被发现对 MPS 的管理有效。然而，组间差异显示针灸在某些参数上优于生物反馈。因此，电针似乎是治疗颈部和上背部 MPS 的更好补充方式。根据在最后一次干预后直到 3 个月从左斜方肌的 NDI、VAS、伸展和左侧弯曲 ROM 和 PPT 获得的值，观察针刺相对于生物反馈的优势（P < 0.05）。结论当与常规治疗相结合时，电针和生物反馈疗法均被发现对 MPS 的管理有效。然而，组间差异显示针灸在某些参数上优于生物反馈。因此，电针似乎是治疗颈部和上背部 MPS 的更好补充方式。根据在最后一次干预后直到 3 个月从左斜方肌的 NDI、VAS、伸展和左侧弯曲 ROM 和 PPT 获得的值，观察针刺相对于生物反馈的优势（P < 0.05）。结论当与常规治疗相结合时，电针和生物反馈疗法均被发现对 MPS 的管理有效。然而，组间差异显示针灸在某些参数上优于生物反馈。因此，电针似乎是治疗颈部和上背部 MPS 的更好补充方式。结论当与常规治疗相结合时，电针和生物反馈疗法均被发现对 MPS 的管理有效。然而，组间差异显示针灸在某些参数上优于生物反馈。因此，电针似乎是治疗颈部和上背部 MPS 的更好补充方式。结论当与常规治疗相结合时，电针和生物反馈疗法均被发现对 MPS 的管理有效。然而，组间差异显示针灸在某些参数上优于生物反馈。因此，电针似乎是治疗颈部和上背部 MPS 的更好补充方式。