On the other hand, it should be stated that this study enhanced internal validity of the studies, we performed the
investigator blind procedure, established reliability of
the measurement prior to data collection, and engaged
the within-subject with cross-over design to minimize
the heterogeneity of the subjects, and regular follow-up
intervals up to 1 hour on various physiological outcomes.
These could provide clinical information and direction
toward the therapeutic application for a musculoskeletal
condition such as MTrPs. The combined treatment of
HP and US modalities enhanced clinical benefits on the
LMTrP. The application of HP followed by US treatment
seems to promote physiological responses (i.e. VAS, TBF,
PPT, STT in 45°C) on the MTrPs better than that of the US
followed by the HP treatment. We hope that this research
could provide the potential direction toward the clinical
application for treatment of LMTrP and may be used as a
guideline for the MTrPs management