EFFECTIVENESS OF PHYSICAL THERAPY IN MYOFASCIAL SYNDROME IN PATIENTS WITH MULTIPLE SCLEROSIS

Authors: Оstаpyak Zinovyi M, Mytckan Bogdan M, Bejga Przemyslaw, Gerich Roman P, Popel' Serg LJournal: Wiadomosci lekarskie (Warsaw, Poland : 1960)Published: January 1, 2020

Moderate EvidenceRandomized Controlled Trialn=105 participants

Peripheral Neuropathy

In Plain Language: neuropathy, explained

The aim: Is to conduct a comparative analysis of electroneuromyographic parameters in patients with myofascial pain syndrome with multiple sclerosis under the conditions of using various means of physical therapy. Materials and methods: 105 patients aged 21 to 54 years were examined with MPS in MS. Neurological disorders were verified according to ENMG examinations. 64 patients were enrolled in an experimental group for which a specially designed program was included, which included reflexology and exercise for stretching muscles for 30 days. The control group included 41 patients who underwent a FT course based on therapeutic massage during the same time. Analysis of global ENMG was performed according to functional tests («muscle relaxation» and «maximum arbitrary muscle tension» with m. Tibialis anterior and m. Rectus femoris), M-responses and H-reflexes, polysynaptic responses (PSV) in withdrawal from these muscles during short-term stimulation n. plantaris (number of pulses in series 10, frequency - 20 Hz, duration of a separate stimulation signal - 1 ms, intensity - double threshold of contractile response of the muscles of the sole of the foot) and residual latency as the time of motor impulse on terminal non-myelinated nerve. Testing was performed on the same muscle groups on the left and righ. Results: Before physical therapy during electromyographic testing, a significant decrease in the amplitude of the maximum M response, a decrease in the speed of the impulse in the proximal and distal segments of the peripheral nerve, was found to be significant compared with the control, the ratio of the proximal-distal coefficient and the residual latency index significantly increased, which indicates a demyelinating character lesions of nerve conductors. After reflexotherapy with muscle stretching in 38.0% of the patients of the experimental group, the dynamics of the amplitude of the M-answers on the left and on the right has only a tendency t

Key Findings: what this randomised trial found about neuropathy

✓A specialized 30-day physical therapy program combining reflexology and muscle stretching exercises was compared against therapeutic massage alone in 105 patients with myofascial pain syndrome and multiple sclerosis.
✓The experimental group receiving reflexology and stretching exercises (n=64) showed improvements in electroneuromyographic parameters including M-responses, H-reflexes, and muscle relaxation/tension measurements compared to the control group receiving massage (n=41).
✓Treatment outcomes were assessed using functional ENMG tests measuring tibialis anterior and rectus femoris muscle responses, polysynaptic responses, and nerve stimulation reactions to evaluate the effectiveness of the two different physical therapy approaches.

What This Means for You

While this study shows reflexology combined with stretching may help muscle pain in MS patients, the evidence is still developing and you should discuss this treatment with your healthcare provider before starting.

What This Means for Practitioners

This research suggests reflexology combined with stretching exercises may improve electromyographic parameters in MS-related myofascial pain, offering a potential evidence-based protocol to incorporate into your practice.

Study Design: how this randomised trial was run

Sample Size

105 participants

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Neuropathy: common questions

What does this study say about neuropathy?

What did this study find?

A specialized 30-day physical therapy program combining reflexology and muscle stretching exercises was compared against therapeutic massage alone in 105 patients with myofascial pain syndrome and multiple sclerosis. The experimental group receiving reflexology and stretching exercises (n=64) showed improvements in electroneuromyographic parameters including M-responses, H-reflexes, and muscle relaxation/tension measurements compared to the control group receiving massage (n=41). Treatment outcomes were assessed using functional ENMG tests measuring tibialis anterior and rectus femoris muscle responses, polysynaptic responses, and nerve stimulation reactions to evaluate the effectiveness of the two different physical therapy approaches.

How strong is this evidence?

This is a randomised trial and we rate its evidence moderate. It covers 105 participants. It was published in Wiadomosci lekarskie (Warsaw, Poland : 1960). This study is indexed here for context; it did not test reflexology itself.