None listed
Conditions
Brief summary
Myofascial trigger points are hyperirritable spots located in a taut band of skeletal muscle. Prevalence of this disease in the asymptomatic population is approximately 50%. Several modalities of treatment are used to inactivate trigger points. Not sufficient evidence to show which is the most effective. The aim of this paper was to compare the immediate effects of combination therapy (i.e. US and TENS) with manual therapy (spray and stretch plus trigger point compression) on upper trapezius latent trigger points. Our hypothesis is that combination therapy (US and TENS) is as effective as the gold standard, manual therapy. Participants will be asymptomatic people with LTP at one side of upper trapezius. After assessed for eligibility and confirmed the participation of the subjects, pain intensity (using a visual analogic scale) and pressure pain threshold (PPT) will evaluated. Subjects will be allocated into three groups: Combination therapy (CT), Manual Therapy (MT) and Sham group. Restricted randomization by blocking will be used: block 1 (evaluated VAS= 3-5), block 2 (evaluated VAS= 5.1-7) and block 3 (evaluated VAS= 7.1-10) as to minimize differences between intervention groups. The patients will be treated for a single session. Visual analogic scale (VAS) and pressure pain threshold (PPT) will be measured immediately after treatment.
Interventions
Subjects will be randomly assigned to one of three study groups, (two intervention groups (1 and 3) and one sham group (2)).
Each intervention will be conducted by an experienced physiotherapist, who must establish a priori if a TrP is present in the middle of the more horizontal fibers of the upper trapezius muscle. Therapy will be performed only on this TrP.
Intervention group 1 (Combination therapy group):
Combination therapy will consist in a single session of 90 seconds simultaneous app
Subjects will be randomly assigned to one of three study groups, (two intervention groups (1 and 3) and one sham group (2)). Each intervention will be conducted by an experienced physiotherapist, who must establish a priori if a TrP is present in the middle of the more horizontal fibers of the upper trapezius muscle. Therapy will be performed only on this TrP. Intervention group 1 (Combination therapy group): Combination therapy will consist in a single session of 90 seconds simultaneous application of US combined with TENS. Subjects will be seated in forward position and resting their arms on a treatment table. Medicarin Megasonic 707 machine will be used. Parameters for US will be: US continuous mode, 0.2W/cm2, US head 6cm2, with a semi static application on the LTP, with no additional pressure. Parameters for TENS will be: asymmetrical biphasic waveform, pulse duration 150 microsecond, frequency 100Hz, intensity searching sensitive stimulus with no motor response. Intervention group 3 (Manual therapy): Manual intervention will consist on the application of trigger point pressure release plus spray and stretch. The whole intervention will last approximately 10 minutes (2 minutes trigger point pressure release plus 8 minutes spray and stretch. The trigger point pressure release is performed as a painless but uncomfortable barrier-release technique, applying a perpendicular pressure in the TrP until the patient perceives pain. This pressure is maintained until the pain disappears. At that moment, the pressure is raised again until it reaches a new barrier. to perform spray and stretch technique the operator should gently lengthen the muscle until it reaches a barrier and then hold that degree of tension. Then, with a vapocoolant spray the operator should apply it over the lenght of the muscle in a series of parallel sweeps in the direction of pain pattern. Sweeps of the spray are extended to cover the referred pain pattern of that muscle. After cooling the muscle, a new stretching position until a new the barrier must be reached. Alternate the application of spray with stretch 3 times.
Sponsors
Olga Velasco-Roldan
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 55 Years
Healthy volunteers
Yes
Inclusion criteria
Subjects who, without suffering from any other pathology or alteration, present latent trigger points in the upper fibers of the trapezium.
Exclusion criteria
- Being physical therapist - Suffering systemic diseases, history of spinal surgery, vertebral fracture, pelvis fracture or lower limb fracture. - Suffering from pathological deviation of the spine or other conditions that may cause trigger points - Presence of cervical and dorsal pain and/or presence of active trigger points - Patients with any contraindication that prevents the application of electrophysical agents.
Outcome results
None listed