Myofascial Pain Syndrome
Conditions
Keywords
Integrated Neuromuscular Inhibition Technique, Active Release Technique, Muscle Energy Technique, Ischemic Compression
Brief summary
The goal of this clinical trial is to determine whether two manual therapy techniques-Integrated Neuromuscular Inhibition Technique (INIT) and Active Release Technique (ART)-can reduce pain, improve neck range of motion, and decrease functional disability in adults with upper trapezius myofascial trigger points. The main questions it aims to answer are: Does INIT reduce pain, improve ROM, and reduce functional disability more effectively than ART? Does ART provide similar or different treatment benefits compared to INIT? Researchers will compare INIT with ART to see which technique produces greater improvements in pain, ROM, and functional disability. Participants will: Receive treatment sessions of either INIT or ART. Undergo assessment of pain, cervical range of motion, and functional disability before and after the intervention.
Detailed description
Myofascial trigger points in the upper trapezius are a common cause of neck pain, restricted cervical mobility, and functional limitations. Manual therapy techniques are frequently used to deactivate trigger points and improve muscle function, but evidence comparing specific techniques remains limited. This study investigates two commonly used interventions: the Integrated Neuromuscular Inhibition Technique (INIT), which combines sustained pressure, muscle energy technique, and stretching; and the Active Release Technique (ART), which involves movement-based soft tissue release. Both techniques target trigger point sensitivity and muscle tightness but use different mechanisms. Participants with diagnosed upper trapezius trigger points will be randomly assigned to receive either INIT or ART. Each group will follow a structured treatment protocol over a defined period. Pain intensity, cervical range of motion, and functional disability will be measured at baseline and after the intervention using validated outcome tools. The study aims to provide comparative evidence on which technique offers greater clinical effectiveness for reducing pain, improving cervical mobility, and enhancing function in individuals with upper trapezius trigger points. Results may assist clinicians in selecting more effective manual therapy strategies for managing myofascial pain.
Interventions
OTHERGroup A
Participants will receive treatment three times per week for 6 weeks. Each session will begin with a moist hot pack for 10 minutes followed by TENS for 15 minutes to relax the muscles and reduce pain. After this preparation, participants will receive 15 minutes of Integrated Neuromuscular Inhibition Technique, including ischemic compression, strain-counterstrain, and muscle energy technique, applied to the identified myofascial trigger points.
OTHERGroup B
Participants will receive treatment three times per week for 6 weeks. Each session will begin with a moist hot pack for 10 minutes and TENS for 15 minutes to prepare the tissues. This will be followed by 15 minutes of Active Release Technique, including repeated active passes, targeted fiber release, and mild stretching, applied to the upper trapezius myofascial trigger points.
Sponsors
Lahore University of Biological and Applied Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Presence of active trigger points in the upper trapezius muscle. * Forward Head Posture (measured by craniovertebral angle). * Pain duration less than 3 months.
Exclusion criteria
* History of trauma or surgery involving the cervical spine or shoulder * Neurological disorders (e.g., cervical radiculopathy) * Systemic conditions like diabetes or rheumatoid arthritis * Use of corticosteroids * Fibromyalgia, Thoracic Outlet Syndrome, Temporomandibular Joint Disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Goniometer (Range of Motion) | Assessment at baseline, after 3rd and 6th weeks. | The Universal Goniometer (UG) will be used to assess Active Cervical Range of Motion (ACROM) in multiple planes. This reliable tool allows physical therapists to measure joint angles accurately, both with and without assistance. In this study, it will be employed to evaluate cervical spine movement as an objective outcome measure of participants' range of motion. |
| Numeric Pain Rating Scale (NPRS) | Assessment at baseline, after 3rd and 6th weeks. | The NPRS questionnaire is composed of an 11-point scale from 0 to 10. The patient chooses the most compatible value for the force of pain they have experienced in the last 24 h, with "0" meaning no pain and "10" meaning intense pain. The patient has to mark the score on the questionnaire according to the pain intensity he/she is experiencing. |
| Neck Disability Index (NDI) | Assessment at baseline, after 3rd and 6th weeks. | The Neck Disability Index (NDI) is a ten-item questionnaire that assesses disability associated with neck pain and whiplash. There are four items that relate to subjective symptomatology (pain intensity, headache, concentration, and sleeping) and six items that relate to activities of daily living (lifting, work, driving, recreation, personal care, and reading). The questionnaire requires only 5-10 minutes to complete and score, and requires no special training to administer. |
Countries
Pakistan
Outcome results
None listed