To evaluate the effect of Neuromuscular Reeducation technique along with sustain ischemic compression on upper trapezius myofascial trigger points regarding pain , muscle length.
Design
Two arm parallel group randomised trial with blinded postoperative care and outcome assessment
Settings and conduct
Data was collected from physiotherapy OPD of Railway Rehabilitation center, Railway General Hospital Pakistan.
Subject recruitment occurred between Feb 2017 to July 2017 (6 Months)
49 patients having trigger point in upper trapezius muscle were included in the study and placed into 2 groups (24 in control group “A” , 25 in experimental group “B”)
Non –probability convenient sampling technique was used to collect sample. Patients were randomly assigned using toss coin method.
Participants/Inclusion and exclusion criteria
INCLUSION CRITERIA :
• Age 18‑55 years, both genders,
• Pain more than 5 on NPRS
• Reduced cervical lateral flexion to the opposite side and Painful upper trapezius trigger point
• Hypersensitive taut band in Upper fiber of trapezius
• Jump sign identification through patient vocalization or withdrawal symptom
EXCLUSION CRITERIA:
• Recent traumatic history of cervical spine or shoulder region
• Diagnosed Fibromyalgia syndrome
• Whiplash injury
• Malignancy
• Skin infections or open wound in the site of upper trapezius
Intervention groups
1. Moist HOT PACK: (5-8mins) at the start of treatment
2. Ultrasound: Frequency:1- 3 MHz, Intensity: 1-1.4 W/cm2, Time: 8-10 minutes, Mode
3. Ischemic compression: Appropriate amount of sustained pressures was applied for 90 sec and 3-5 times within one session.
4. NMR technique 3-5 times in each session.
5. Stretching & Home Plan: 3 sets of 10 repetition with 10 seconds hold (targeted muscles)
Main outcome variables
Outcomes were measured by ROM(Goniometer),NPRS scores at baseline and last treatment session
General information
Reason for update
Acronym
NMR
IRCT registration information
IRCT registration number:IRCT20190924044861N1
Registration date:2019-09-27, 1398/07/05
Registration timing:retrospective
Last update:2019-09-27, 1398/07/05
Update count:0
Registration date
2019-09-27, 1398/07/05
Registrant information
Name
KINZA ANWAR
Name of organization / entity
THE UNIVERSITY OF LAHORE,ISLAMABAD CAMPUS,PAKISTAN
Country
Pakistan
Phone
+92 51 5537867
Email address
kinza.anwar29@gmail.com
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2017-01-05, 1395/10/16
Expected recruitment end date
2017-06-15, 1396/03/25
Actual recruitment start date
2017-02-07, 1395/11/19
Actual recruitment end date
2017-07-20, 1396/04/29
Trial completion date
2017-07-20, 1396/04/29
Scientific title
Effect of Neuromuscular Reeducation on Myofascial Trigger Point in Cervical Pain patients
Public title
Neuromuscular Reeducation on Myofascial Trigger Point
Purpose
Health service research
Inclusion/Exclusion criteria
Inclusion criteria:
Pain more than 5 on NPRS
Reduced cervical lateral flexion to the opposite side and Painful upper trapezius trigger point
Hypersensitive taut band in Upper fiber of trapezius
Jump sign identification through patient vocalization or withdrawal symptom
Exclusion criteria:
Recent traumatic history of cervical spine or shoulder region
Diagnosed Fibromyalgia syndrome
Whiplash injury
Malignancy
Skin infections or open wound in the site of upper trapezius
Age
From 18 years old to 55 years old
Gender
Both
Phase
N/A
Groups that have been masked
Participant
Investigator
Sample size
Target sample size:
70
Actual sample size reached:
49
Randomization (investigator's opinion)
Randomized
Randomization description
The subjects were randomly divided into 2 groups ( control group A and experimental group B) by coin toss method using convenient sampling technique and informed consent was taken from each patient participated in the study.Among them 25 patients were randomly allocated to each group.
Blinding (investigator's opinion)
Double blinded
Blinding description
In the present study both physical therapist and patients(participants) were blind.Patients were randomly allocated to both groups.
Placebo
Not used
Assignment
Other
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Research Ethical Committee,Riphah College of Rehabilitation Sciences,Islamabad,Pakistan.
Street address
Riphah International University Islamabd City Campus 7th Avenue, Sector G-7/4, Islamabad
City
ISLAMABAD
Postal code
47311
Approval date
2016-12-29, 1395/10/09
Ethics committee reference number
00177
Health conditions studied
1
Description of health condition studied
cervical pain due to myofascial trigger points(MTRPs)
ICD-10 code
M70.8
ICD-10 code description
Other soft tissue disorders related to use, overuse and pressure
Primary outcomes
1
Description
Goniometer for upper trapezius Range of motion(muscle length)
Timepoint
before intervention and after 2 weeks of intervention
Method of measurement
Goniometer for upper trapezius Range of motion(muscle length)placed goniometer in upper fibers of trapezius and ask to perform the movement, measure the ROM and then compare it with intact side.
Secondary outcomes
1
Description
Numeric Pain rating Scale(NPRS) for pain assessment scores
Timepoint
NPRS scores before treatment than after 2 weeks of treatment
Method of measurement
NPRS score beyond 5 were assessed before intervention and compare it after 2 weeks
Intervention groups
1
Description
Control group:Moist HOT PACK: (5-8mins) at the start of treatment 2. Ultrasound: Frequency:1- 3 MHz, Intensity:1- 1.4 W/cm2, Time: 8-10 minutes,3. Ischemic compression: Appropriate amount of sustained pressures was applied for 90 sec and 3-5 times within one session.4. Stretching & Home Plan : 3 sets of 10 repetition with 10 seconds hold
Category
Treatment - Other
2
Description
Intervention group:1. Moist HOT PACK: (5-8mins) at the start of treatment 2. Ultrasound: Frequency:1- 3 MHz, Intensity: 1-1.4 W/cm2, Time: 8-10 minutes, 3. Ischemic compression: Appropriate amount of sustained pressures was applied for 90 sec and 3-5 times within one session.4. NMR technique 3-5 times in each session.5. Stretching & Home Plan: 3 sets of 10 repetition with 10 seconds hold (targeted muscles)
Category
Other
Recruitment centers
1
Recruitment center
Name of recruitment center
Railway Rehabilitation center, Pakistan Railway Hospital,Westrdige,Rawalpind,Pakistan