The importance of the local twitch response during needling interventions in spinal pain associated with myofascial trigger points: a systematic review and meta-analysis

Objective: To compare the clinical effects of needling interventions eliciting local twitch responses (LTRs) versus needling without eliciting LTRs when applied to muscle trigger points (TrPs) associated with spinal pain of musculoskeletal origin. Databases and data treatment: Electronic databases were searched for randomized or non-randomized clinical trials where one group received needling intervention where LTRs were elicited and was compared with another group receiving the same intervention without elicitation of LTRs in spinal pain disorders associated with TrPs. Outcomes included pain intensity, pain-related disability, and pressure pain thresholds. The risk of bias (RoB) was assessed using the Cochrane risk of bias tool or ROBINS-I tool, methodological quality was assessed with the PEDro score, and quality of evidence was evaluated using the GRADE approach. Results: Six trials were included. The application of a needling intervention eliciting LTRs was associated with a significant reduction in pain intensity immediately after treatment (mean difference (MD): −2.03 points, 95% confidence interval (CI): −3.77 to −0.29; standardized MD (SMD): −1.35, 95% CI: −2.32 to −0.38, p = 0.02) when compared to the same needling intervention without elicitation of LTRs. No effect at short-term follow-up (MD: −0.20 points, 95% CI: −1.46 to 1.06, p = 0.75) was observed. No significant differences based on elicitation or non-elicitation of LTRs were found in related disability (SMD: −0.05, 95% CI: −0.41 to 0.30, p = 0.77) or pressure pain thresholds (MD: 23.39 kPa, 95% CI: −13.68 to 60.47, p = 0.22). Discussion: Low-level evidence suggests an immediate effect of obtaining LTRs during needling interventions on pain intensity, with no significant effects on related disability or pressure pain sensitivity in spinal pain disorders associated with muscle TrPs. Registration number: OSF Registry— https://doi.org/10.17605/OSF.IO/5ZX9N

Risk Factors for Increased Online Gambling during COVID-19 Lockdowns in New Zealand: A Longitudinal Study

Recent research investigating changes in gambling behaviors during periods of COVID-19 social restrictions, such as enforced lockdowns, are somewhat limited by methodology, being generally cross-sectional in nature and with participant samples recruited via online panels. The present study overcame these limitations via a secondary analysis of data collected in 2012 and 2015 from a New Zealand (NZ) longitudinal gambling study, with questions related to gambling behaviors due to COVID-19 lockdown periods included in an additional data collection, of participants who had previously scored as a risky gambler, during 2020/21. Almost one-quarter of online gamblers increased their gambling during lockdown with this most likely to be on overseas gambling sites, instant scratch card gambling and Lotto. The only sociodemographic risk factor for increased online gambling was higher education. Behavioral risk factors included being a current low risk/moderate risk/problem gambler, a previously hazardous alcohol drinker or past participation in free-to-play gambling-type games. These past behaviors could act as trigger points for health services or family and friends to monitor a person’s gambling behaviors during lockdown, or future stressful periods when usual terrestrial gambling opportunities are curtailed or unavailable, and to support safer gambling practices.

On the Use of Ensemble Predictions for Parametric Typhoon Insurance

Parametric typhoon insurances are an increasingly used financial tool to mitigate the enormous impact of tropical cyclones, as they can quickly distribute much-needed resources, e.g., for post-disaster recovery. In order to optimise the reliability and efficiency of parametric insurance, it is essential to have well-defined trigger points for any post-disaster payout. This requires a robust localised hazard assessment for a given region. However, due to the rarity of severe, landfalling tropical cyclones, it is difficult to obtain a robust hazard assessment based on historical observations. A recent approach makes use of unrealised, high impact tropical cyclones from state-of-the-art ensemble prediction systems to build a physically consistent event set, which would be equivalent to about 10,000 years of observations. In this study, we demonstrate that (1) alternative trigger points of parametric typhoon insurance can be constructed from a local perspective and the added value of such trigger points can be analysed by comparing with an experimental set-up informed by current practice; (2) the estimation of the occurrence of tropical cyclone-related losses on the provincial level can be improved. We further discuss the potential future development of a general tropical cyclone compound parametric insurance.

Development of Semantic Analysis Software Tool for Solving Problems of Text Formalization

Problem of safety ensuring of children and underage adolescents in Web–space is becoming increasingly acute. Younger generation information security is the state of children and adolescents protection, in which there is no risk associated with harm to their health and (or) physical, mental, spiritual, moral development from destructive information. This article describes the development of new software product that allows analyzing text from files, Web sites, pages, applications, etc. Analog programs were reviewed; modern text recognition algorithms were described. Screenshots and flowchart of software parts designed functioning for semantic text analysis in Web space are presented. Any Web page is file with extension, and after analyzing, it is possible to evaluate the information and classify it by topics, as well as to determine whether there is destructive content. In the presented study, the software tool was developed for semantic analysis and formalization of text. Exact trigger points from 26 to 30 times evaluate the algorithm functioning. With accuracy of up to 80%, it can be argued that algorithm is suitable for determining the orientation of article and content of ideas expressed in it, taking into account duality of model.

Effects of dry needling in lower extremity myofascial trigger points: systematic review

Objective: This systematic review was conducted to explore the current evidences on effects of trigger point dry needling as a treatment strategy on pain and range of motion among the subjects with lower extremity myofascial trigger areas. Methods: A systematic review was performed and searched databases including Cochrane Library, PubMed, SPORTDiscus and PEDro. PRISMA guidelines were followed. Inclusion and exclusion of studies were made according to PICOS format. Ten studies were recruited for assessment based on eligibility. Cochrane Risk of Bias tool was used to assess the Randomized and Non-Randomized controlled trials and the methodological assessment was also performed using PEDro 10-point scale. Data synthesis was performed by Vote Counting Method as a descriptive tool. Results: Seven of the total ten studies deemed High score on PEDro and three were scored Fair on the scale. Each of the ten studies documented improvement in the pain over time with the dry needling strategy. None of the studies targeted the other outcomes like anxiety and sleep disturbances related with myofascial trigger points. Conclusion: On basis of the best evidences available dry needling seems to be effective in pain reduction related to lower extremity myofascial trigger points. Evidence also suggests that there is not much positive effect of myofascial trigger point dry needling on depression, anxiety, muscular strength and quality of life. Keywords: Acupuncture therapy, Dry Needling, Lower extremity, Myofascial trigger points Continuous....

A comparison of efficacy of diclofenac patch and physical therapy techniques in the treatment of patients with myofascial pain disorder of the upper trapezius

Objective: This study was conducted to find the best treatment in treating the patients of myofascial syndrome for this purpose two treatment options were compared to rule out the best option of treatment in minimizing the pain, enhancing the cervical movement and in determining the pressure pain threshold of MTrp. Material and methodology: It was a comparative study. Total 60 patients were randomly allocated to each group of treatment. We compared two treatments, treatment A of 30 patients was physical therapy and 30 patients of treatment B was diclofenac patch. For seven days, these patches were applied three times per day to the MTrP area of the upper trapezius muscle. The fix’s sufficiency and security boundaries were evaluated before it was used (day 0), three days later (day 3), and six days later (day 6). Chi square test was used for checking association of treatments and different attributes of patients. Results: There is significance association was found between demographic characteristics and treatments groups with p-values less than 0.05. There is significance difference effect between both treatments using VAS pain scale and cervical active Rom and PPT of MTRP using p-value less 0.05. These results shows that physical therapy treatment effects are batter as compare to diclofenac patch. Conclusion: Physical therapy techniques and the diclofenac patch have both been shown to be helpful but significant results are shown by Group A in treating trigger points of upper trapezius by normalizing the pathophysiological reasons of trigger points of this region. Physical therapy techniques are more helpful in reducing pain and in achieving cervical movement.

YouTube as a Source of Patient Information on Myofascial Pain Syndrome

Introduction Myofascial pain syndrome is a local disorder characterised by pathological myofascial constrictions and trigger points. One of the most popular sources of internet-based information for patients is YouTube, which provides a lot of videos related to myofascial pain syndrome, making it one of the top clinical conditions searched for on the site. This study aimed to examine the quality of the YouTube video content on myofascial pain syndrome. Method This study was designed as a cross-sectional study and used the YouTube video sharing website as the main source of data. A search of the relevant videos was performed by entering the words “myofascial pain syndrome” in June 2021. Video characteristics were recorded, and the quality of the videos was assessed according to the Journal of the American Medical Association (JAMA) benchmark criteria, the DISCERN Scale and the Global Quality Scale. Results A total of 322 videos were evaluated, 186 of which were subjected to analysis after applying the inclusion/exclusion criteria. The videos were categorised into groups, with 10 (5.4%) falling into the high-quality group, 16 (8.6%) into the intermediate quality group, and 160 (86%) into the low-quality group. The findings from the study showed that the most popular videos, the highest number of video likes and the highest number of video views were in the intermediate group, while the high-quality group had the lowest popularity level, number of video likes and number of video views (p ˂ 0.05). Conclusions Although there are videos with high-quality content on YouTube offering guidance to patients about the disease, it is important to keep in mind that inaccurate and deficient information about the disease may also be present on this platform.