Assessment of Myofascial Trigger Points with ultrasound: a methodology combining external vibration with Power Doppler Imaging and B-mode
Herrero, Pablo (Universidad de Zaragoza) ; Lapuente-Hernández, Diego (Universidad de Zaragoza) ; Blanco, Teresa (Universidad de Zaragoza) ; Casas, Roberto (Universidad de Zaragoza) ; Valera-Garrido, Fermín ; Minaya-Muñoz, Francisco ; Gomes Monres, Jose ; Gómez-Trullén, Eva María (Universidad de Zaragoza)
Resumen: Introduction: This case series explores a novel methodology for identifying myofascial trigger points (MTrPs) by integrating Doppler and B-mode ultrasound with externally applied vibratory stimulation. The study aims to address the current lack of accessible and objective tools for MTrP assessment in clinical settings.
Case presentation: Five participants were included: four healthy individuals and one post-stroke patient. A custom-designed vibration device was developed to apply mechanical stimulation to the gastrocnemius medialis muscle, while ultrasound imaging was collected using a standardized setup. To optimize vibration signal detection within muscle tissue, different configurations of the electrodes transmitting the vibration and the Doppler modes (Color Doppler and Power Doppler Imaging (PDI)) were tested.
Results: PDI demonstrated superior sensitivity to vibration-induced muscle responses compared to conventional Color Doppler. A consistent pattern was identified among healthy participants. This pattern consisted of well-defined, non-vibratory zones surrounded by vibratory regions, corresponding to hypoechoic areas on B-mode ultrasound. These findings are suggestive of MTrPs and distinct from other stiff anatomical structures, such as fascia, tendons, or fibrotic tissue, which appear hyperechoic. In the stroke patient, pathological muscle adaptations reduced the consistency and visibility of vibratory stimulus propagation; however, MTrP-compatible areas were still identified. Notably, dry needling altered the Doppler signal in this case, attenuating the previously observed pattern.
Conclusions: This proof-of-concept study demonstrates the feasibility and reproducibility of a cost-effective assessment protocol that uses conventional ultrasound modes. Combining PDI, B-mode, and vibration may improve the objective identification of MTrPs and expand capabilities in musculoskeletal practice.
Idioma: Inglés
DOI: 10.63360/ipmm.v1.e18
Año: 2025
Publicado en: Invasive Physiotherapy and Musculoskeletal Medicine 1 (2025), e18 [14 pp.]
ISSN: 3101-0105
Financiación: info:eu-repo/grantAgreement/ES/DGA/B54-23R
Financiación: info:eu-repo/grantAgreement/ES/DGA/T27-23R
Tipo y forma: Article (Published version)
Área (Departamento): Área Educación Física y Depor. (Dpto. Fisiatría y Enfermería)
Área (Departamento): Área Tecnología Electrónica (Dpto. Ingeniería Electrón.Com.)
Área (Departamento): Área Fisioterapia (Dpto. Fisiatría y Enfermería)
Área (Departamento): Área Expresión Gráfica en Ing. (Dpto. Ingeniería Diseño Fabri.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
Exportado de SIDERAL (2025-12-04-14:39:26)
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Case presentation: Five participants were included: four healthy individuals and one post-stroke patient. A custom-designed vibration device was developed to apply mechanical stimulation to the gastrocnemius medialis muscle, while ultrasound imaging was collected using a standardized setup. To optimize vibration signal detection within muscle tissue, different configurations of the electrodes transmitting the vibration and the Doppler modes (Color Doppler and Power Doppler Imaging (PDI)) were tested.
Results: PDI demonstrated superior sensitivity to vibration-induced muscle responses compared to conventional Color Doppler. A consistent pattern was identified among healthy participants. This pattern consisted of well-defined, non-vibratory zones surrounded by vibratory regions, corresponding to hypoechoic areas on B-mode ultrasound. These findings are suggestive of MTrPs and distinct from other stiff anatomical structures, such as fascia, tendons, or fibrotic tissue, which appear hyperechoic. In the stroke patient, pathological muscle adaptations reduced the consistency and visibility of vibratory stimulus propagation; however, MTrP-compatible areas were still identified. Notably, dry needling altered the Doppler signal in this case, attenuating the previously observed pattern.
Conclusions: This proof-of-concept study demonstrates the feasibility and reproducibility of a cost-effective assessment protocol that uses conventional ultrasound modes. Combining PDI, B-mode, and vibration may improve the objective identification of MTrPs and expand capabilities in musculoskeletal practice.
Idioma: Inglés
DOI: 10.63360/ipmm.v1.e18
Año: 2025
Publicado en: Invasive Physiotherapy and Musculoskeletal Medicine 1 (2025), e18 [14 pp.]
ISSN: 3101-0105
Financiación: info:eu-repo/grantAgreement/ES/DGA/B54-23R
Financiación: info:eu-repo/grantAgreement/ES/DGA/T27-23R
Tipo y forma: Article (Published version)
Área (Departamento): Área Educación Física y Depor. (Dpto. Fisiatría y Enfermería)
Área (Departamento): Área Tecnología Electrónica (Dpto. Ingeniería Electrón.Com.)
Área (Departamento): Área Fisioterapia (Dpto. Fisiatría y Enfermería)
Área (Departamento): Área Expresión Gráfica en Ing. (Dpto. Ingeniería Diseño Fabri.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original. Exportado de SIDERAL (2025-12-04-14:39:26)
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Este artículo se encuentra en las siguientes colecciones:
Articles > Artículos por área > Expresión Gráfica de la Ingeniería
Articles > Artículos por área > Educación Física y Deportiva
Articles > Artículos por área > Tecnología Electrónica
Articles > Artículos por área > Fisioterapia
Record created 2025-12-04, last modified 2025-12-04