In the medication group, the patient took 400 mg ibuprofen
three times a day after each meal and performed muscle
stretching 2 minutes every day for 5 days. The medication
was prescribed by a licensed medical doctor. The primary
outcome was pain intensity rated with a visual analog scale
(VAS). The secondary outcomes included the PPT, tissue
hardness, and CROM. These secondary outcome measures
were measured by a physical therapist that was blinded
with respect to the group allocation of the patients. The pain
intensity was measured with a VAS. The patients were asked
to rate the intensity of pain at the time of measurement and
then marked an “X” on a 10-cm-long straight line that had
the numbers 0 (indicating on pain at all) to 10 (indicating
the most severe pain) marked on it from left to right. The
PPT was measured using a tissue hardness meter/algometer
(OE-220,ITO Co.,Ltd., Tokyo, Japan) with a pressure tip
having a 1 cm diameter. Pressure was exerted vertically at a
constant speed (1 kg/sec) on a TrP of the upper back and was
gradually increased until the patients felt pain and pushed a
button on to the algometer. Then the applied pressure was
recorded. This process was done 3 times, and the reading
were averaged for statistical analysis. Measurement of tissue
hardness was performed using the tissue hardness meter/
algometer (OE-220, ITO Co.,Ltd., Tokyo, Japan) equipped
with a 10-cm diameter plastic disc and the measuring tool
was adjusted to the tissue hardness measuring mode. The
device has a preset pressure sensor, and the displacement
of the 1-cm pressure tip with respect to the disc indicates
the tissue hardness. Pressure was gradually and vertically
exerted from the handle of the tool onto the painful pressure
point to be examined until a beep sounded from the tool, and
the tissue hardness was then automatically recorded. This
was carried out 3 times, and the readings were averaged for
statistical analysis. The CROM of the patients was measured
with a CROM goniometer, and the measurements included
flexion, extension, left lateral flexion, and right lateral flexion.
Each motion was measured 3 times, and the readings
were averaged for statistical analysis. A reliability study was
performed for each outcome measure before the study using
10 upper back pain patients to measure the pain intensity
(VAS, intraclass correlation coefficient [ICC] =0.97), PPT
(ICC=0.92), tissue hardness, and CROM (ICC=0.97). All
outcomes measures showed a high degree of correlation with
an ICC over 0.90
In the medication group, the patient took 400 mg ibuprofenthree times a day after each meal and performed musclestretching 2 minutes every day for 5 days. The medicationwas prescribed by a licensed medical doctor. The primaryoutcome was pain intensity rated with a visual analog scale(VAS). The secondary outcomes included the PPT, tissuehardness, and CROM. These secondary outcome measureswere measured by a physical therapist that was blindedwith respect to the group allocation of the patients. The painintensity was measured with a VAS. The patients were askedto rate the intensity of pain at the time of measurement andthen marked an “X” on a 10-cm-long straight line that hadthe numbers 0 (indicating on pain at all) to 10 (indicatingthe most severe pain) marked on it from left to right. ThePPT was measured using a tissue hardness meter/algometer(OE-220,ITO Co.,Ltd., Tokyo, Japan) with a pressure tiphaving a 1 cm diameter. Pressure was exerted vertically at aconstant speed (1 kg/sec) on a TrP of the upper back and wasgradually increased until the patients felt pain and pushed abutton on to the algometer. Then the applied pressure wasrecorded. This process was done 3 times, and the readingwere averaged for statistical analysis. Measurement of tissuehardness was performed using the tissue hardness meter/algometer (OE-220, ITO Co.,Ltd., Tokyo, Japan) equippedwith a 10-cm diameter plastic disc and the measuring toolเปลี่ยนความแข็งของเนื้อเยื่อที่วัดโหมด การอุปกรณ์ที่มีเซนเซอร์แรงดันที่ตั้งไว้ และที่ย้ายความดัน 1 ซม. ระบุคำแนะนำเกี่ยวกับดิสก์ความแข็งของเนื้อเยื่อ ความดันถูกค่อย ๆ และแนวตั้งนั่นเองจากจับของเครื่องมือลงบนความกดดันเจ็บปวดจุดสามารถตรวจสอบจนกระทั่งเสียงเตือนที่ไพเราะจากเครื่องมือ และความแข็งของเนื้อเยื่อเป็นโดยอัตโนมัติ นี้เป็น 3 ครั้งนำออก และค่าเบนช์สำหรับการวิเคราะห์ทางสถิติ เสนอผู้ป่วยที่มีวัดมี goniometer เสนอ และการประเมินรวมงอ นามสกุล งอข้างซ้าย และด้านข้างขวางอเคลื่อนไหวแต่ละที่มีวัด 3 ครั้ง และค่าเบนช์สำหรับวิเคราะห์ทางสถิติ ศึกษาความน่าเชื่อถือดำเนินการสำหรับแต่ละวัดผลก่อนการเรียนโดยใช้10 บริเวณหลังปวดผู้ป่วยวัดความรุนแรงของอาการปวด(VAS ค่าสัมประสิทธิ์สหสัมพันธ์ intraclass [ICC] = 0.97), PPT(ICC = 0.92), ความแข็งของเนื้อเยื่อ และเสนอ (ICC = 0.97) ทั้งหมดวัดผลพบว่าสัมพันธ์กับระดับสูงICC เป็นมากกว่า 0.90
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