Combined intervention strategies based on Myofascial trigger points for improving knee pain and function: a systematic review

Abstract

Objective: To systematically evaluate the clinical efficacy of myofascial trigger point (MTrP)-based combined interventions for knee pain and dysfunction, providing evidence for optimizing rehabilitation protocols. Method: Following PRISMA guidelines, six major databases (including PubMed and Web of Science) were searched for randomized controlled trials (RCTs) on MTrP-centered combined therapies for knee pain. Methodological quality was assessed via the PEDro scale, followed by a Narrative Synthesis. Results: Nine high-quality RCTs with 618 subjects were included. Compared to monotherapies (conventional acupuncture, exercise, physical, or pharmacological therapy), MTrP-based combined interventions significantly improved the total clinical effective rate. The intervention group demonstrated greater reductions in Visual Analog Scale (VAS) scores and superior functional improvements (Lysholm score, WOMAC index, ROM, and isokinetic muscle strength like Peak Torque [PT] and Total Work [TW]). Furthermore, serum inflammatory factors (IL-1β, TNF-α) were effectively reduced. Conclusion: MTrP-based combined interventions are safe and highly effective. By disrupting the peripheral "energy crisis" and modulating central sensitization, this approach offers a synergistic effect superior to single therapies. An integrated "release-strengthening" model, starting with MTrP therapy, is recommended for clinical knee rehabilitation.