title: Physical therapy intervention in patients with non-cardiac chest pain following a recent cardiac event: A randomized controlled trial.
abstract: OBJECTIVE
  To assess the effect of two different physical therapy interventions in patients with stable coronary heart disease and non-cardiac chest pain.
  
  
  METHODS
  A randomized controlled trial was carried out at a university hospital in Norway. A total of 30 patients with known and stable coronary heart disease and self-reported persistent chest pain reproduced by palpation of intercostal trigger points were participating in the study. The intervention was deep friction massage and heat pack versus heat pack only. The primary outcome was pain intensity after the intervention period and 3 months after the last treatment session, measured by Visual Analogue Scale, 0 to 100. Secondary outcome was health-related quality of life.
  
  
  RESULTS
  Treatment with deep friction massage and heat pack gave significant pain reduction compared to heat pack only (-17.6, 95% confidence interval: -30.5, -4.7; p < 0.01), and the reduction was persistent at 3 months' follow-up (-15.2, 95% confidence interval: -28.5, -1.8; p = 0.03). Health-related quality of life improved in all three domains in patients with no significant difference between groups.
  
  
  CONCLUSIONS
  Deep friction massage combined with heat pack is an efficient treatment of musculoskeletal chest pain in patients with stable coronary heart disease.
authors.affiliation: Department of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Astrid T
authors.initials: AT
authors.lastname: Berg
authors.affiliation: Department of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Signe N
authors.initials: SN
authors.lastname: Stafne
authors.affiliation: Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Aud
authors.initials: A
authors.lastname: Hiller
authors.affiliation: Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Stig A
authors.initials: SA
authors.lastname: Slørdahl
authors.affiliation: Department of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Inger-Lise
authors.initials: IL
authors.lastname: Aamot
keywords: Deep friction massage; chest pain; myofascial trigger point