literature review

Uvod: Igelna desenzibilizacija je postopek, pri katerem se z uporabo tankih filamentskih iglic prebode koža in stimulira spodaj ležeče miofascialne prožilne točke, mišično in vezivno tkivo. Namen postopka je izboljšanje živčno-mišično-skeletne bolečine ter gibalnih ovir. Miofascialne prožilne točke so prekomerno vzdražena žarišča v skeletni mišici povezana z otipljivimi in lokalno občutljivimi točkami v napetih pasovih mišičnih snopov, mišičnem tkivu ali ovojnici. Neravnovesja se pojavijo zaradi telesne preobremenitve, poškodbe, udarca, podhladitve mišice, obolenj visceralnih organov ter psihične obremenitve in stresa. Vzdražena prožilna točka je eden od najpogostejših vzrokov bolečine pri posamezniku, kot del vsakodnevnega življenja. Namen: Namen diplomskega dela je pregled literature o učinkovitosti obravnave miofascialnih prožilnih točk z igelno desenzibilizacijo. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo s kritičnim pregledom literature. Uporabili smo raziskave v časovnem okvirju od 2014 do 2018. Literatura je bila iskana v slovenskem in angleškem jeziku s ključnimi besedami miofascialne prožilne točke, igelna desenzibilizacija, evidence-based physiotherapy, effectiveness, trigger point therapy, dry needling, myofascial pain in randomized controlled trial, v podatkovnih bazah DiKUL, MEDLINE, CINAHL, COBISS, PubMed, ScienceDirect, PEDro, Cochrane Library, Google Scoolar, BioMed Central, NCBI in JOSPT. V analizo smo vključili 10 raziskav. Raziskave so bile ovrednotene na podlagi lestvice za ocenjevanje metodološke kakovosti kliničnih poskusov in lestvice za tveganje pristranskosti raziskav. Rezultati: Analiza rezultatov, pri desetih vključenih raziskavah, je potrdila učinkovitost obravnave miofascialnih prožilnih točk s tehniko igelne desenzibilizacije z visoko oceno po PEDro lestvici ter nizkim tveganjem pristranskosti po RoB lestvici. Uporabljena so bila različna merila izidov in obdobja meritev. Igelna desenzibilizacija je bila v raziskavah primerjana z različnimi fizioterapevtskimi programi in postopki. Razprava in zaključek: Ugotovljena je učinkovitost igelne desenzibilizacije prožilnih točk, kot samostojna terapija ali dodatna ostalim fizioterapevtskim postopkom. Iglanje prožilne točke zmanjša bolečino, stopnjo nezmožnosti funkcije in poveča obseg gibljivosti, na podlagi različnih mehanizmov.Introduction: Dry needling is an effective therapy and skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular and connective tissues for the management of neuromusculoskeletal pain and movement impairments. Myofascial trigger points are hyperirritable spots in skeletal muscles associated with palpable nodules in the taut band of muscle fibers. Imbalances occur due to physical overload, injury, shock, hypothermia of the muscles, visceral disorders and psychological load and stress. Hypersensitive trigger points are one of the most common causes of pain in individual, as part of everyday life. Purpose: The purpose of the diploma work is to review the literature on the management of myofascial trigger point therapy with dry needling technique. Methods: In the diploma work we used a descriptive method with critical literature review. We used studies in the time frame from 2014 to 2018. The literature was searched in slovene and english language with the key words of myofascial trigger point, needle desensitization, evidence-based physiotherapy, effectiveness, trigger point therapy, dry needling, myofascial pain and randomized controlled trial, in databases DiKUL, MEDLINE, CINAHL, COBISS, PubMed, ScienceDirect, PEDro, Cochrane Library, Google Scoolar, BioMed Central, NCBI and JOSPT. We included 10 studies in the analysis. The research was evaluated on the basis of a scale for assessing the methodological quality of clinical trials and a scale for the risk of bias of research. Results: The analysis of the results in ten included studies confirmed the effectiveness of treating myofascial trigger points with dry needling technique - high quality of PEDro score and low risk of bias from RoB scale. Different measurement criteria and periods were used in included studies. Dry needling has been compared with different physiotherapy programs and procedures. Discussion and conclusion: The effectiveness of trigger point dry needling was determined, as an independent therapy or additional to other physiotherapeutic procedures. Needling the trigger point reduces pain, the degree of function inability and increases the range of motion, based on various mechanisms