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Effect of physical training on function of chronically painful muscles: a randomized controlled trial
Andersen LL, Andersen CH, Zebis MK, Nielsen PK, Sogaard K, Sjogaard G
Journal of Applied Physiology 2008 Dec;105(6):1796-1801
clinical trial
3/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Pain and tenderness of the upper trapezius muscle is frequent in several occupational groups. The objective of this study is to investigate the effect of three contrasting interventions on muscle function and pain in women with trapezius myalgia. A group of employed women (n = 42) with a clinical diagnosis of trapezius myalgia participated in a 10-wk randomized controlled intervention: specific strength training of the neck/shoulder muscles, general fitness training performed as leg bicycling, or a reference intervention without physical activity. Torque and electromyography (EMG) were recorded during maximal shoulder abductions in an isokinetic dynamometer at 60, 60, 0, and 180 degrees/s. Furthermore, a submaximal reference contraction with only the load of the arms was performed. Significant changes were observed only in the specific strength training group. Pain decreased by 42 to 49% (p < 0.01 to 0.05). Whereas the EMG activity of the unaffected deltoid remained unchanged during the maximal contractions, an increase in EMG amplitude (42 to 86%; p < 0.001 to 0.05) and median power frequency (19%; p < 0.001) were observed for the painful trapezius muscle. Correspondingly, torque increased by 1853% (p < 0.001 to 0.05). EMG during the reference contraction decreased significantly for both the trapezius and deltoid muscles (p < 0.01). In conclusion, specific strength training relieves pain and increases maximal activity specifically of the painful trapezius muscle, leading to increased shoulder abduction strength in women with trapezius myalgia. Furthermore, decreased relative workload may indirectly augment pain reduction.

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