Comparison Of Bowen's Technique And Myofascial Release Technique On Pain And Disability In Patients With Trapezitis
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 66
- Locations
- 1
- Primary Endpoint
- Neck Disability Index
Study Overview
Brief Summary
The aim of this research is to compare the effects of Bowen's technique and Myofascial Release technique on pain and disability in patients with trapezitis.Randomized controlled trials done at Islamabad Physiotherapy and Rehabilitation Centre(IPRC) and Benazir Bhutto Hospital. The sample size was 66. The subjects were divided in two groups, 33 subjects in Bowen's Technique group and 33 subjects in Myofascial Release Technique group. Study duration was of 6 months. Sampling technique applied was non probability purposive sampling technique. The patients aged 20-40 years and clinicaly diagnosed with Trapezitis(spasm,trigger points,tenderness,stiffness) were included in the study. Tools used in the study are Cervical ROMs, NPRS, NDI, Isometric Scapular Pinch Test and Lateral Scapular Slide Test.
Detailed Description
Trapezitis is a condition that involves inflammation of the trapezius muscle. The upper fibers of trapezius, being the postural muscles, are highly susceptible to overuse injuries and thus the inflammation.This results in pain that is present during the rest, is aggravated with activity and is referred to the other areas. The pain results in protective spasm of the antagonistic muscle group that also restricts the passive range of motion and makes it painful too. In people working for long hours at a desk and computers or spending many hours driving, the low level of upper trapezius activity is frequently found because of head posture during sitting and standing , which is common cause of tension and neck pain in such people.Various recent studies have hypothesized that trapezitis occurs due to muscle tissue overloading and injury, that results in involuntary shortening of localized muscle fibers. The stressed soft tissue area thus receives less glucose, oxygen and nutrients supply; subsequently high levels of metabolic waste products are accumulated. And this cascade of events ends in altered status of tissue, pain and the development of the Trigger points in the muscle.
Myofascial Release(MFR) is a soft tissue mobilization technique that is defined as " the facilitation of mechanical, neural and psycho physiological adaptive potential as interfaced via the myofascial system".MFR decreases the pain and restores the proper alignment by changing the ground substance's viscosity to more fluid state resulting in elimination of excessive pressure of fascia on the pain sensitive structures.
There is one more soft tissue technique called 'Bowen Technique' that is useful and indicated in myofascial pain. The Bowen technique is defined as:
'...dynamic system of muscle and connective tissue therapy which balances the body to allow it to heal itself. The work consists of a series of precise moves on specific points of the body. These moves are light and can be done through clothing. There are frequent and important pauses between each series of moves giving the body time to benefit from each. The technique uses positive moves that initiate a positive energy flow and negative moves that isolate this energy to a specific area' (Rentsch and Rentsch,1997) The Bowen technique was developed by late Tom Bowen in Geelong, Australia in 1950. It is a connective tissue technique that uses subtle inputs called 'Bowen moves' to the body that stimulates the body's self-healing. The Bowen moves applied are in several sets in a complete session of 15-45 minutes duration. While applying the technique, the therapist uses the thumb when the Bowen move is executed away from the patient's body and two fingers are used when the Bowen move is executed towards the patient's body. The technique can be used anywhere on the origin, insertion or the belly of the muscle and produces a physical and an energetic action.
This technique can be used to treat many types acute and chronic injuries and other health issues. It does this by using holistic approach in which body's innate healing mechanism is stimulated. This technique has been recommended in many conditions like headache, cervical pain, back pain, whiplash injury, TMJ dysfunction, herniated disk, tennis elbow, hamstring tightness and frozen shoulder, work related injuries etc.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 20 Years to 40 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Both male and female.
- •Age 20-40 years.
- •Clinically diagnosed with Trapezitis.(Spasm,stiffness,Tenderness,Trigger Points,Taut band)
- •Cummulative trauma disorder
- •Occupational overuse syndrome
Exclusion Criteria
- •Any medical conditions or diseases that could interfere with intervention performance.
- •Any traumatic neck injury
- •Cervical vertebral fracture
- •Cervical spinal cord compromise/ cervical myelopathy
- •Cervical radiculopathy
- •Cervical Spondylolisthesis
- •Any tumour
- •Any degenerative diseases
Arms & Interventions
Experimental Intervention group 1
Patient was in lying position. Therapist placed thumb on the effected side muscke. Then hooked thumb on lateral edge of muscle to apply pressure against the muscle. Took a pause. Thumb flattened in a medial direction and pluck was created in muscle.
Set of 15-20 bowen moves on upper , middle and lower fibres each with 2 mins gap between each set.
Total treatment time: 20 mins
Intervention: experimental Bowen Technique (Other)
Experimental interventional group II
Patient was in lying position. MFR applied via ulnar border of both palms while patient being in contralateral side flexion.
20 mins
Intervention: Experimental Myofacial release technique (Other)
Outcomes
Primary Outcomes
Neck Disability Index
Time Frame: 3rd day
It is a 10-item questionnaire each them of having 6 possible answers. The score of each item lies between 0 to 5, where 0 means no pain/ limitation in activities) and 5 means 'as much pain as possible or maximal limitation in activities'.\[19\] Thus the Total scores range between 0 - 50 points.
Isometric Scapular Pinch Test
Time Frame: 3rd day
In ISPT the patient actively performs maximal scapular retraction and holds it for 2 seconds. If the pain is present after 15-20 seconds or patient fails to hold it then the test is positive.
Secondary Outcomes
- Cervical Lt side flexion range of motion(3rd day)
- Cervical Rt side Rotation range of motion(3rd day)
- Cervical Lt side Rotation range of motion(3rd day)
- Lateral Scapular Slide Test(3rd day)
- NPRS(3rd day)
- Cervical flexion range of motion(3rd day)
- Cervical extension range of motion(3rd day)
- Cervical Rt side flexion range of motion(3rd day)
