Myofascial Pain Syndrome
Conditions
Keywords
Tele-rehabilitation, Myofascial Release, Self-Myofascial Release,, Rhomboid Trigger Points, Neck Pain, Postural Correction, cervical retraction, scapular retraction, Upper Trapezius & Levator Scapulae Stretch
Brief summary
This randomized controlled trial aims to assess the effectiveness of tele-rehabilitation, including self-myofascial release and exercise therapy, in reducing pain, improving functional range of motion, and decreasing neck disability in patients with rhomboid trigger points associated with myofascial pain syndrome.
Detailed description
Rhomboid myofascial pain syndrome is a common yet often underreported musculoskeletal condition characterized by the presence of myofascial trigger points within the rhomboid muscles. These trigger points produce localized and referred pain, reduced range of motion, and functional limitations that can significantly affect daily activities. The condition is strongly associated with poor posture, prolonged sitting, and repetitive upper limb activities, particularly among individuals with sedentary lifestyles and high occupational demands. Evidence indicates a high prevalence of rhomboid trigger points, with many individuals experiencing moderate pain that interferes with their routine work and overall quality of life. Biomechanically, sustained postural stress such as forward head posture and rounded shoulders increases the load on scapular stabilizing muscles, leading to muscle fatigue, microtrauma, and the development of trigger points. These changes contribute to altered scapular kinematics, muscle imbalance, and restricted movement. Self-myofascial release techniques have been shown to reduce pain sensitivity, improve circulation, and restore muscle function, making them an effective approach for managing myofascial pain. Tele-rehabilitation has emerged as a practical and accessible method for delivering physiotherapy interventions remotely, allowing patients to perform guided exercises and self-myofascial release without the need for frequent in-person visits. This is particularly beneficial for individuals with busy schedules or limited access to healthcare services. This randomized controlled trial aims to evaluate the effectiveness of tele-rehabilitation, incorporating self-myofascial release and exercise therapy, in reducing pain intensity, improving functional range of motion, and decreasing neck disability in patients with rhomboid trigger points associated with myofascial pain syndrome. The study also seeks to determine the feasibility of tele-rehabilitation as a convenient and sustainable alternative to conventional physiotherapy for managing rhomboid-related musculoskeletal pain.
Interventions
OTHERTele-rehabilitation (ET + Self-Myofascial Release)
1. Self-Myofascial Release: Using a tennis ball against the wall targeting rhomboid region (5 mintues in total). 2. Stretching Exercises: Upper trapezius and levator scapulae stretch (30 seconds hold × 5 repetitions). 3. Postural correction Exercises: cervical retraction and shoulder blade squeezing /retraction ( 5 repetitions). 4. Postural and ergonomic education . 5. Mode of Delivery: Live/video-guided tele-rehabilitation sessions.
OTHERConventional Myofascial Release Treatment
1. Manual Myofascial Release: Therapist performe myofascial release on rhomboid trigger points.( 5 mintues in total) 2. Stretching Exercises: Upper trapezius and levator scapulae stretch (30 seconds hold × 5 repetitions). 3. Postural correction Exercises: cervical retraction and shoulder blade squeezing /retraction ( 5 repetitions). 4. Postural and ergonomic education .
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 35 Years
Healthy volunteers
No
Inclusion criteria
* Participants falling in this category would be recruited into the study. * Age 18-35 years * Both Genders: Male and Female * Paitents experiencing Neck and upper back pain due to active trigger points.(16) According to Travell and Simons (1999)criteria, active myofascial trigger points (MTrPs) are identified. * NPRS ≥4 * Presence of maximum one or more than one MTrPs in the Romboids muscle. * Prolong sitting at least 6 hours per day. * Access to a device with internet connection ( for tele rehabilitation group).
Exclusion criteria
* Participants falling in this category would be excluded from the study. * Participants fall in this category would be excluded of the study. * Patients currently taking analgesics (painkillers) or muscle relaxants. * Any inflammatory pathology, neurological impairment, and cervical tumor. * Other deformities such as scoliosis or torticollis. * Spinal Injuries and any other co morbidity. * Any surgery, trauma, fracture and fall. * Pregnancy. * Patient unwilling to comply follow up schedule. * Patient involvement in another interventional study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Inclinometer for functional range of motion | 2 weeks | An inclinometer is a reliable and valid instrument used to measure cervical range of motion (ROM) in flexion, extension, rotation, and lateral flexion. It provides objective and reproducible angular measurements of spinal movement. Studies have reported excellent intra-rater and inter-rater reliability (ICC = 0.85-0.98) for cervical motion assessment using a dual inclinometer. |
| Numeric Pain Rating Scale (NPRS) | 2 weeks | The Numerical Pain Rating Scale (NPRS) is a simple, reliable, and valid tool used to assess pain intensity. It consists of an 11-point scale ranging from 0 to 10.The NPRS shows strong construct and concurrent validity when compared with other established pain assessment tools.The NPRS has demonstrated excellent test-retest reliability (r = 0.95) is across various musculoskeletal and rehabilitation populations |
| Neck Disability Index (NDI) | 2 weeks | The Neck Disability Index (NDI) is a standardized questionnaire used to assess the impact of neck pain on daily activities. It consists of 10 items, each scored from 0 to 5, with higher scores indicating greater disability. The NDI has shown excellent reliability (ICC = 0.89-0.94) and strong validity for evaluating functional limitations in patients with neck and upper back pain. |
Countries
Pakistan
Contacts
CONTACTMaria Khalid, MSOMPT
PRINCIPAL_INVESTIGATORMaria khalid, MSOMPT
Riphah International University
Outcome results
None listed