Attenuated Skin Blood Flow Response to Nociceptive Stimulation of Latent Myofascial Trigger Points Yang Zhang, PhD, Hong-You Ge, MD, PhD, Shou-Wei Yue,

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Attenuated Skin Blood Flow Response to Nociceptive Stimulation of Latent Myofascial Trigger Points Yang Zhang, PhD, Hong-You Ge, MD, PhD, Shou-Wei Yue, MD, PhD, Yoshiyuki Kimura, PhD, Lars Arendt-Nielsen, DrMedSci, PhD Archives of Physical Medicine and Rehabilitation Volume 90, Issue 2, Pages 325-332 (February 2009) DOI: 10.1016/j.apmr.2008.06.037 Copyright © 2009 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 1 The position of the forearms and hands and the points extracted for analysis. The hands were kept in the neutral position. Skin blood flow and temperature at the local area, midarea, and presumed referred pain area (first web) were extracted for analysis. Archives of Physical Medicine and Rehabilitation 2009 90, 325-332DOI: (10.1016/j.apmr.2008.06.037) Copyright © 2009 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 2 Resting intramuscular (upper trace) and surface (lower trace) EMG activity from latent myofascial trigger points. Archives of Physical Medicine and Rehabilitation 2009 90, 325-332DOI: (10.1016/j.apmr.2008.06.037) Copyright © 2009 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 3 Pain intensity measured with VAS after EMG-guided intramuscular injection of glutamate into latent MTrPs and non-MTrPs. *P<.05 compared with non-MTrPs. Archives of Physical Medicine and Rehabilitation 2009 90, 325-332DOI: (10.1016/j.apmr.2008.06.037) Copyright © 2009 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 4 PPT before and after pain induced by glutamate injection into latent MTrPs and non-MTrPs on the (A) ipsilateral and (B) contralateral sides. *P<.05 compared with PPT prepain. Archives of Physical Medicine and Rehabilitation 2009 90, 325-332DOI: (10.1016/j.apmr.2008.06.037) Copyright © 2009 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 5 Skin blood flow at the local area (A and B), midarea (C and D), and presumed referred pain area (E and F) on the ipsilateral and the contralateral side before, during, and after pain induced by glutamate injection into latent MTrPs and non-MTrPs. Typical laser scanning flowmetry of the forearm after glutamate injection into latent MTrPs (G) and non-MTrPs (H). *P<.05 compared with latent MTrPs. §†P<.05 compared with prepain. Abbreviations: SP, skin preparation; →, Injection site. Archives of Physical Medicine and Rehabilitation 2009 90, 325-332DOI: (10.1016/j.apmr.2008.06.037) Copyright © 2009 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 6 Skin temperature at the local area (A and B), midarea (C and D), and presumed referred pain area (E and F) on the ipsilateral and the contralateral side before, during, and after pain after glutamate injection into latent MTrPs and non-MTrPs. Abbreviation: SP, skin preparation. Archives of Physical Medicine and Rehabilitation 2009 90, 325-332DOI: (10.1016/j.apmr.2008.06.037) Copyright © 2009 American Congress of Rehabilitation Medicine Terms and Conditions