Vascular impairment is a crucial factor associated with chronic muscle pain, but relevant research from the microcirculatory aspect is lacking. Here, we investigated the differences in neck muscle microcirculation detected through laser-doppler flowmetry (LDF) and cervical biomechanics by a videofluoroscopic image in asymptomatic participants and patients with postural neck and shoulder pain. To understand the mechanism behind the effect of myofascial treatment, transverse friction massage (TFM) was applied and the immediate effects of muscular intervention on microcirculation were monitored. In total, 16 asymptomatic participants and 22 patients (mean age = 26.3 ± 2.4 and 25.4 ± 3.2 years, respectively) were recruited. Their neck muscle microcirculation and spinal image sequence were assessed. The differences in the baseline blood flow between the asymptomatic and patient groups were nonsignificant. However, the standard deviations in the measurements of the upper trapezius muscle in the patients were significantly larger (p < 0.05). Regarding the TFM-induced responses of skin microcirculation, the blood flow ratio was significantly higher in the patients than in the asymptomatic participants (p < 0.05). In conclusion, postintervention hyperemia determined through noninvasive LDF may be an indicator for the understanding of the mechanism underlying massage therapies and the design of interventions for postural pain.

The prevalence and incidence of non-valvular atrial fibrillation (NVAF) in Taiwan increase with age. Low adherence to oral anticoagulants heightens stroke risk. This study evaluated whether advanced educational intervention could enhance dabigatran adherence in Taiwanese patients with NVAF. This multicenter clinical trial in Taiwan enrolled 873 patients aged 20-74 years and newly diagnosed with NVAF. Patients were randomized to receive advanced educational intervention or standard care only. Dabigatran adherence at 12 months was evaluated using the Morisky Medication Adherence Scale (MMAS-8), along with the proportion of subjects reporting "never/rarely forgetting to take dabigatran" at 3, 6, and 9 months, dabigatran discontinuation rate, and the safety outcomes in both groups. Both groups reached the maximum MMAS-8 median score at all visits, showing no significant differences. Adverse event rates were 3.9 % (17/441) in the standard care group, including four stroke and thromboembolic events, versus 4.2 % (18/432) in the advanced educational intervention group, with one stroke and thromboembolic event. Subgroup analysis of patients with initial MMAS-8 scores below 8 points showed a significant difference at sixth month (6 vs. 7, P = 0.011). Over 3, 6, 9, and 12 months, MMAS-8 scores improved in both groups, with the advanced educational intervention group achieving a perfect adherence by 12 months (routine group: 6, 6, 7, 7; advanced group: 6, 7, 7, 8). Advanced educational intervention significantly improved dabigatran adherence in younger patients with low initial adherence, demonstrating its potential in managing NVAF in Taiwan. NCT04532528.