Description
Work-related muscle disorders are a main cause of missed work, globally, and arecostly for public health systems. However, development of musculoskeletal tissue diagnostics
is lagging compared to other tissues and organs. Myofascial trigger points
(MTP) are unique muscle tissue phenomenon that are challenging to address due to
a lack of objective assessment methodology. This study seeks to meet this need by
devising a non-invasive, objective methodology for evaluating musculoskeletal tissue
following intervention or physical provocation, specific to the anterior forearm region.
In Aim 1, current literature on MTP pathophysiology informs a multi-modal assessment
approach, including: 1) pain pressure threshold (PPT), 2) power Doppler (PD)
ultrasound, 3) strain elastography (SE), and 4) surface electromyography (sEMG).
In Aim 2, controlled ultrasound image acquisition and standardization techniques are
developed for imaging muscle tissue with PD (Aim 2a) and SE (Aim 2b) . These
techniques improved differentiability of vascularity and compliance estimation after
physical provocation or intervention. In Aim 3, the multi-modal approach is implemented
in a human pilot study (n=34) investigating MTP response to osteopathic
manipulative treatment, compared to rest and light exercise. Positive trends and significant
changes are detected after OMT and rest. PPT significantly increased after
OMT (p = 0.021). Tissue compliance significantly increase after rest (p ≪ 0.0001)
and after OMT( p = 0.002). Principal component analysis finds 9 of 13 outcome
measures to be salient features of MTP treatment effect. The data suggests high
and low responders, yielding insights for improved patient screening and study design
for future work. With further optimization and development, this method may be
applied to a broad array of clinical scenarios for musculoskeletal tissue evaluation
directed towards amelioration of neuromuscular symptoms.
Details
Title
- Multi-modal Assessment of Myofascial Trigger Point Response to Osteopathic Manipulation in the Anterior Forearm
Contributors
- Pedapati, Chandhana (Author)
- Makin, Inder Raj S. (Thesis advisor)
- Muthuswamy, Jitendran (Thesis advisor)
- Kodibagkar, Vikram D. (Committee member)
- Buneo, Christopher A. (Committee member)
- Towe, Bruce (Committee member)
- Arizona State University (Publisher)
Date Created
The date the item was original created (prior to any relationship with the ASU Digital Repositories.)
2024
Resource Type
Collections this item is in
Note
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Partial requirement for: Ph.D., Arizona State University, 2024
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Field of study: Biomedical Engineering