Background
Methods
Study retrieval and screening
Database | Keywords | Number of Studies |
---|---|---|
CINAHL | (1) shoulder/ or glenohumeral/ or scapular/ or scapula/ or neck/ or cervical; (2) trigger point/ or trigger points; (3) prevalence; (4) disease/ or musculoskeletal diseases; (5) 1 and 2 and 3 and 4 | 3 |
Embase | (1) shoulder/ or glenohumeral/ or scapular/ or scapula/ or neck/ or cervical; (2) trigger point/ or trigger points; (3) prevalence; (4) disease/ or musculoskeletal diseases; (5) 1 and 2 and 3 and 4 | 2 |
Pubmed | (1) shoulder/ or glenohumeral/ or scapular/ or scapula/ or neck/ or cervical; (2) trigger point/ or trigger points (3) prevalence (4) “disease” [MeSH Terms]/ OR disease [All Fields]/ or disorder [All Fields]/ or condition [All Fields]/ or “musculoskeletal diseases” [MeSH Terms] (5) 1 and 2 and 3 and 4 | 40 |
Scopus | (1) shoulder/ or glenohumeral/ or scapular/ or scapula/ or neck/ or cervical; (2) trigger point/ or trigger points; (3) prevalence; (4) disease/ or musculoskeletal diseases; (5) 1 and 2 and 3 and 4 | 30 |
Web of Science | (1) shoulder/ or glenohumeral/ or *scapula*/ or neck/ or Cervical; (2) trigger* point*; (3) prevalence; (4) disease/ or musculoskeletal diseases; (5) 1 and 2 and 3 and 4 | 38 |
Total number of articles identified Excluding Duplicates | 113 84 |
Eligibility criteria
Risk of bias within included studies
Data extraction
Data analysis
Results
Risk of bias within included studies
Study | Reporting Bias | External Validity | Internal validity | Power | Risk of Bias | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Item 1 | Item 2 | Item 3 | Item 4 | Item 5 | Item 6 | Item 7 | Item 8 | Item 9 | Item 10 | Item 11 | Item 12 | Item 13 | Item 14 | Item 15 | Item 16 | ||
Alonso-Blanco et al., 2011 | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | ✗ | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | Low |
Bron et al., 2011 | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | ✓ | ✓ | ✗ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | Low |
Fernández-De-Las-Peñas, 2012 | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | ? | ✓ | ✓ | ✓ | ✓ | ✗ | ? | ✓ | Low |
Fernandez-Perez, 2012 | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | ? | ✓ | Low |
Hilalgo-Lozano et al., 2010 | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ? | ? | ✓ | ✓ | ✓ | ✓ | ✗ | ? | ✗ | Low |
Sari et al., 2012 | ✓ | ✓ | ✓ | ✗ | ✓ | ✓ | ✓ | ? | ? | ✗ | ✓ | ✓ | ✓ | ? | ? | ✗ | Low |
Tali et al., 2014 | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | ✓ | ✗ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ? | Low |
Characteristics of included studies
Study | Study design | Disorder(s) | Healthy Controls Group | Diagnostic Criteria Active MTrPs | Diagnostic Criteria Latent MTrPs | Assessed Muscles | Country, Setting |
---|---|---|---|---|---|---|---|
Alonso-Blanco et al., 2011 | Cross-sectional | CTTH | No | 1) Presence of a palpable taut band in a skeletal muscle. 2) Presence of a hyperirritable sensitive spot within the taut band. 3) Local twitch response elicited by the snapping palpation of the taut band. 4) Presence of referred pain in response to MTrP compression. | Not assessed | Upper Trapezius Sternocleidomastoid Temporalis Suboccipital | Spain, hospital |
Bron et al., 2011 | Cross-sectional | SP | No | 1) A nodule in a taut band of skeletal muscle. 2) Painful on compression 3) May produce referred pain or sensations 4) Pain recognised by patient as “familiar” | 1) A nodule in a taut band of skeletal muscle. 2) Painful on compression 3) May produce referred pain or sensations 4) Pain not recognizable to patient | Upper/middle/lower trapezius Infraspinatus Supraspinatus Subscapularis Teres minor and major Anterior/middle/posterior deltoids Pectoralis major and minor Biceps brachii Triceps brachii Scalene Subclavius | Spain, primary care practice. |
Fernandez-Perez et al., 2012 | Cross-sectional cohort | Acute WAD | Yes | 1) Palpable taut band within a skeletal muscle 2) Presence of a hypersensitive spot in the taut band 3) Local twitch re-sponse elicited by the snapping palpation of the taut band 4) Production of referred pain in response to MTrP manual compression. 5) If referred pain of symptoms reported by the patient is recognized as familiar | 1) Palpable taut band within a skeletal muscle 2) Presence of a hypersensitive spot in the taut band 3) Local twitch re-sponse elicited by the snapping palpation of the taut band 4) Production of referred pain in response to MTrP manual compression. 5) Symptoms produced are not familiar to the patient | Temporalis Masseter Upper trapezius Levator scapulae Sternocleidomastoid Scalene | Spain, primary care |
Fernández-De-Las-Peñas, 2012 | Cross-sectional | Non-specific pain | No | 1) Presence of a palpable taut band within a skeletal muscle. 2) Presence of a hyperirritable spot in the taut band. 3) Local twitch response elicited by the snapping palpation of the taut band (when possible). 4) Presence of referred pain in response to compression. MTrPs were considered active when the local and referred pains evoked by compression reproduced clinical pain symptoms and also the participant recognized the pain as familiar. | MTrPs were considered latent when the local and the referred pain elicited by digital compression did not reproduce symptoms familiar to the participant. | Temporalis Masseter Upper trapezius Sternocleidomastoid Splenius capitis Oblique capitis inferior Levator scapulae Scalene Pectoralis major Deltoid Infraspinatus Extensor carpi radialis brevis Extensor carpi radialis longus Eetensor digitorum communis Supinator | Spain, Department of PT, OT, rehab and physical medicine. |
Hidalgo-Lozano et al., 2010 | Case-control | Unilateral shoulder impingement | Yes | 1) Presence of a palpable taut band in a skeletal muscle 2) Presence of a hyperirritable tender spot within the taut band 3) Local twitch response elicited by the snapping palpation of the taut band 4) Presence of referred pain in response to MTrP compression. 5) Local and the referred pain evoked by digital compression reproduced the pain symptoms (both in location and pain sensation) and the subject recognized the pain as familiar pain | 1) Presence of a palpable taut band in a skeletal muscle 2) Presence of a hyperirritable tender spot within the taut band 3) Local twitch response elicited by the snapping palpation of the taut band 4) Presence of referred pain in response to MTrP compression. 5) Local and referred pain elicited by digital compression did not reproduce symptoms familiar to the subjects | Levator scapulae Supraspinatus Infraspinatus Subscapularis Pectoralis major Biceps brachii | Spain, setting unclear |
Sari et al., 2012 | Case-control | Cervical Radiculopathy | Yes | 1) Presence of a palpable taut band in a skeletal muscle 2) Presence of hypersensible tender spot in the taut band 3) Local twitch response elicited by the snapping palpation of the taut band 4) Reproduction of the typical referred pain pattern of the MTrP in response to compression; and 5) Spontaneous presence of the typical referred pain pattern and/or patient recognition of the referred pain as familiar. If all of the aforementioned criteria were present the MTrP was considered active | 1) Presence of a palpable taut band in a skeletal muscle 2) Presence of hypersensible tender spot in the taut band 3) Local twitch response elicited by the snapping palpation of the taut band 4) Reproduction of the typical referred pain pattern of the MTrP in response to compression | Trapezius, multifidus, splenius capitis, levator scapulae, rhomboid major, and rhomboid minor | Turkey, Outpatient clinic |
Tali et al., 2014 | Case-control | Episodic migraines | Yes | 1) Palpable taut band within a skeletal muscle 2) Presence of a hypersensitive spot in the taut band 3) Local twitch response elicited by the snapping palpation of the taut band 4) Production of referred pain in response to MTrP manual compression. 5) If the MTrP were palpated and produced a headache, familiar or not, it was referred to as an “active MTrP”. | 1) Palpable taut band within a skeletal muscle 2) Presence of a hypersensitive spot in the taut band 3) Local twitch response elicited by the snapping palpation of the taut band 4) Production of referred pain in response to MTrP manual compression. 5) If the MTrP were palpated and produced local or radiated pain it was referred to as a “latent MTrP”. | Sternocleidomastoid Upper trapezius | Israel, Physiotherapy Department |
Study | Stage and type of disorder | Patients Sample, n | Sex, % Female | Age (y), Mean ± SD or % | Other Characteristics, Mean ± SD or % | Healthy Controls Sample, n | Sex, % Female | Age (y), Mean ± SD or % | Other Characteristics, Mean ± SD or % |
---|---|---|---|---|---|---|---|---|---|
Alonso-Blanco et al., 2011 | Chronic TTH | 20 Children (6–12 years) 20 Adults (18–47 years) | 50% female | Children = 8 ± 2 years Adults = 41 ± 11 years | PH(years)- Children = 1.6 ± 0.8 Adults = 8.6 ± 6.5 HI (NPRS)- Children = 5.0 ± 1.2 Adults = 5.9 ± 1.1 HD (hours/days)- Children = 4.8 ± 2.6 Adults = 7.3 ± 2 HF(days/week)- Children = 4.0 ± 0.9 Adults = 4.3 ± 0.9 | 0 | Not assessed | Not assessed | Not assessed |
Bron et al., 2011 | Chronic SP | 72 patients | 69% Female | 43.9 ± 12.3 years | Duration- 6–9 months = 23% 9–12 months = 19% 1–2 years = 18% 2–5 years = 19% > 5 years = 19% Recurrence rate- 1st = 36% 2nd = 26% 3rd > = 37% | 0 | Not assessed | Not assessed | Not assessed |
Fernandez-Perez et al., 2012 | Acute WAD | 20 participants aged over 20 years | 50% women | 28.7 ± 12.4 (22.9,34.4) | Height, cm: 170.0 ± 10.6 (165.0,175.0) Weight kg: 67.7 ± 16.3 (60.1,75.4) Time from accident, d: 26.6 ± 3.8 (24.8,28.4) Current pain (NPRS): 6.2 ± 2.6 (5.0, 7.5) Worst pain (NPRS): 8.0 ± 2.0 (7.0, 8.9) Lowest pain (NPRS): 3.3 ± 2.9 (1.9, 4.7) | 20 | 50% female | 29.1 ± 12.2 (23.3, 34.8) | Height cm: 160.7 ± 39.1 (142.3, 179.0) Weight kg: 64.1 ± 23.3 (53.2, 75.1) |
Fernández-De-Las-Peñas, 2012 | NSP | 16 Blue collar workers 19 White collar worker | Blue = 62% Female White = 75% female | Blue = 44 ± 13 years White = 44 ± 14 years | PH (months)- Blue = 13.2 ± 5.3 White = 9.1± 5.5 MP (NPRS)- Blue = 5.0 ± 2.5 White = 3.8 ± 2.6 | 0 | Not Assessed | Not Assessed | Not Assessed |
Hidalgo-Lozano et al., 2010 | ULSIStage of condition unclear | 12 patients | 42% female | 25 ± 9 years | 10 | 50% female | 26 ± 8 years | ||
Sari 2012 | Acute and chronic Cervical radiculopathy | 244 | 52% female | 44.6 ± 10.3 years | BMI (kg/m2)- 26.28 ± 5.25 Social status: Married 70%, single 23%, widow 7% Education: University 40%, high school 38%, primary education 18%, uneducated 4% Occupation: Housewife 32%, worker 25%, retired 13%, student 9%, officer 8%, nurse 5%, other 8% Major trauma history 15.6% | 122 | N/A | 43.8 ± 9.8 years | N/A |
Tali et al., 2014 | EM Stage unclear | 20 Physical therapy students | 90% female | 24.95 ± 1.79 years | BMI (kg/m2): 21.68 ± 2.62 HF (days in the past 3 months): 6.60 ± 5.88 AS (NPRS): 6.45 ± 1.50 | 20 Physical Therapy students | 85% female | 25.65 ± 1.42 years. | BMI (kg/m2)- 21.69 ± 2.08 |
Alonso-Blanco et al., 2011 | Bron et al., 2011 | Fernandez-Perez et al., 2012 | Fernández-De-Las-Peñas, 2012 | Hidalgo-Lozano et al., 2010 | Sari, 2012 | Tali et al., 2014 | Hidalgo-Lozano et al., 2010 | |||
---|---|---|---|---|---|---|---|---|---|---|
Sample | Adults (N = 20) | Children (N = 20) | White collar (N = 19) | Blue collar (N = 16) | ||||||
Information regarding right or left side | Do not specify left and right | Do not specify left and right | Do not specify left and right | Do not specify left and right | ||||||
Muscles | ||||||||||
Left Temporalis | 55 | 70 | 20 | 5.3 | 6.3 | |||||
Right Temporalis | 65 | 75 | 10 | 5.3 | 6.3 | |||||
Right SCM | 30 | 25 | 5 | 21.1 | 6.3 | 5 | ||||
Left SCM | 40 | 10 | 30 | 21.1 | 18.8 | 10 | ||||
Left Upper Trapezius | 35 | 20 | 30 | 63.2 | 56.3 | 13.5 | 25 | |||
Right Upper Trapezius | 80 | 15 | 35 | 63.2 | 68.8 | 45 | ||||
Suboccipital muscles | 100 (bilateral) | 80 (bilateral) | OCI- left = 31.6. right = 31.6 SC- left = 15.8. right = 21.1 | OCI- left = 12.5. right = 25 SC- left = 31.3. right = 37.5 | ||||||
Middle Trapezius | 43.1 | |||||||||
Lower Trapezius | 37.5 | |||||||||
Left Infraspinatus | 77.8 | 31.6 | 37.5 | 41.7 | 41.7 | |||||
Right Infraspinatus | 21.1 | 43.8 | ||||||||
Supraspinatus | 34.7 | 66.7 | 66.7 | |||||||
Subscapularis | 40.3 | 41.7 | 41.7 | |||||||
Teres minor | 47.2 | |||||||||
Teres major | 36.1 | |||||||||
Left Deltoid | Posterior- 44.4 Middle- 50 Anterior- 47.2 | 5.3 | 18.8 | |||||||
Right Deltoid | 10.5 | 12.5 | ||||||||
Left Pectoralis major | 26.4 | 5.3 | 18.8 | 16.7 | 16.7 | |||||
Right Pectoralis major | 18.8 | 18.8 | ||||||||
Pectoralis minor | 30.6 | |||||||||
Biceps Brachii | 20.8 | 16.7 | 16.7 | |||||||
Triceps Brachii | 19.4 | |||||||||
Left Scalene | 16.7 | 20 | 21.1 | 12.5 | ||||||
Right Scalene | 30 | 15.8 | 2.3 | |||||||
Subclavius | 25 | |||||||||
Left Masseter | 10 | 15.8 | 0 | |||||||
Right Masseter | 0 | 5.3 | 0 | |||||||
Left Levator scapulae | 55 | 31.6 | 25 | 41.7 | 16.3 | 41.7 | ||||
Right Levator scapulae | 65 | 36.8 | 12.5 | |||||||
Splenius capitis | 14.7 | |||||||||
Rhomboid minor | 14.3 | |||||||||
Rhomboid major | 10.2 | |||||||||
Multifidus | 8.6 |