Short and Medium-term Effects of Manual Therapy on Latent Myofascial Pain

Not Applicable

Completed

• Conditions: Latent Myofascial Trigger Point of Upper Trapezius Muscle

• Registration Number: NCT01709357
• Lead Sponsor: Escola Superior de Tecnologia da Saúde do Porto

Brief Summary

The purpose of this study was to investigate the short and medium-term effects of three manual techniques on cervical range of motion and pressure pain sensitivity in subjects with mechanical stress, presenting latent trigger point of upper trapezius muscle.

Detailed Description

Myofascial pain syndrome is a common non-articular musculoskeletal chronic pain which has not been yet fully understood. It is characterized by myofascial trigger point. This trigger point is clinically classified as active or latent. Some studies have demonstrated the potential relevance of latent trigger point. In fact, its presence may cause muscle activation pattern alterations, increase nociceptive sensitivity and cause sympathetic activity alterations. Nevertheless, the vast majority of individuals, even asymptomatic, have latent trigger point. High prevalence of myofascial trigger points subsists at cervical and scapular regions.

There is few data regarding myofascial trigger point physiopathology. Furthermore, a diversity of therapeutic interventions consisting of trigger point inactivation and interruption of the vicious cycle is suggested in literature. Nevertheless, the effectiveness of these different interventions in trigger points and the duration of the effects are not yet fully clarified.

Study Timeline

• Study Start: 2011-09
• Primary Completion: 2012-03
• Study Completion: 2012-03
• Status Verified: 2012-10
• Study First Submitted: 2012-10-12
• Study First Submitted QC: 2012-10-16
• Last Update Submitted: 2012-10-16
• Study First Posted: 2012-10-18
• Last Update Posted: 2012-10-18

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 117

Inclusion Criteria

• volunteers with 18 or more years of age
• with a palpable latent trigger point in the fibbers of the upper trapezius muscle
• with an average time of computer work of at least 2h/day.

Exclusion Criteria

• with a body mass index (BMI) equal or higher than 31 kg/cm2
• with bilateral latent triggers in the fibers of the upper trapezius muscle
• have done any pharmacological therapeutic during any of the 7 days before the study or anti-coagulant therapeutics
• have done any treatment at cervical region during the month before the study
• having cardio-respiratory, neurological, neuro-musculoskeletal, oncologic or systemic pathologies
• having cognitive deficits or psychologic/psychiatric disturbances
• be pregnant
• having a clinical history of cervical, high dorsal, shoulder or cranial surgery or trauma during the prior 12 months.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Change from Baseline in Pressure pain threshold at 10 minutes after the intervention	10 minutes after the intervention	To obtain the pressure pain threshold measurements, an electronic pressure algometer was used. With the subject seated, the evaluator placed the pointer on the trigger pint with an approximate angle of 90º and an increasing pressure of approximately 1 kg/cm²/s. Subjects were told to use the word "now" whenever the sensation of pressure was replaced by a sensation of pain. At this point, the evaluator removed the algometer and the equipment recorded the maximum applied pressure.
Change from Baseline in Pressure pain threshold at 24 hours after the intervention	24 hours after the intervention	To obtain the pressure pain threshold measurements, an electronic pressure algometer was used. With the subject seated, the evaluator placed the pointer on the trigger pint with an approximate angle of 90º and an increasing pressure of approximately 1 kg/cm²/s. Subjects were told to use the word "now" whenever the sensation of pressure was replaced by a sensation of pain. At this point, the evaluator removed the algometer and the equipment recorded the maximum applied pressure.
Change from Baseline in Pressure pain threshold at one week after the intervention	one week after the intervention	To obtain the pressure pain threshold measurements, an electronic pressure algometer was used. With the subject seated, the evaluator placed the pointer on the trigger pint with an approximate angle of 90º and an increasing pressure of approximately 1 kg/cm²/s. Subjects were told to use the word "now" whenever the sensation of pressure was replaced by a sensation of pain. At this point, the evaluator removed the algometer and the equipment recorded the maximum applied pressure.

Secondary Outcome Measures

Name	Time	Method
Change from Baseline in Cervical flexion at 10 minutes after the intervention	10 minutes after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical flexion actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical extension at 10 minutes after the intervention	10 minutes after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical extension actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical side flexion (homo-lateral of trigger point) at 10 minutes after the intervention	10 minutes after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical side flexion (homo-lateral of trigger point)actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical rotation (homo-lateral of trigger point) at 10 minutes after the intervention	10 minutes after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical rotation (homo-lateral of trigger point)actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical side flexion (contra-lateral of trigger point) at 10 minutes after the intervention	10 minutes after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical side flexion (contra-lateral of trigger point)actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical rotation (contra-lateral of trigger point) at 10 minutes after the intervention	10 minutes after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical rotation (contra-lateral of trigger point)actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Pressure pain perception at 10 minutes after the intervention	10 minutes after the intervention	For the determination of th pressure pain perception, with the subject seated, the evaluator placed the pointer on the point of upper trapezius muscle with an angle of 90º and an increasing pressure of 1 kg/cm²/s until the pressure reached 2,5 kg/cm² and it was maintained for 5 seconds. Then the subject would characterize the level of pain through a visual analog scale), which had a ruler with a numerical scale of 0 to 10, being 0 "no pain or discomfort" and 10 "worse pain ever felt".
Change from Baseline in Cervical flexion at 24 hours after the intervention	24 hours after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical flexion actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical extension at 24 hours after the intervention	24 hours after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical extension actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical side flexion (homo-lateral of trigger point) at 24 hours after the intervention	24 hours after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical side flexion (homo-lateral of trigger point)actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical rotation (homo-lateral of trigger point) at 24 hours after the intervention	24 hours after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical rotation (homo-lateral of trigger point)actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical side flexion (contra-lateral of trigger point) at 24 hours after the intervention	24 hours after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical side flexion (contra-lateral of trigger point)actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical rotation (contra-lateral of trigger point) at 24 hours after the intervention	24 hours after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical rotation (contra-lateral of trigger point)actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Pressure pain perception at 24 hours after the intervention	24 hours after the intervention	For the determination of th pressure pain perception, with the subject seated, the evaluator placed the pointer on the point of upper trapezius muscle with an angle of 90º and an increasing pressure of 1 kg/cm²/s until the pressure reached 2,5 kg/cm² and it was maintained for 5 seconds. Then the subject would characterize the level of pain through a visual analog scale), which had a ruler with a numerical scale of 0 to 10, being 0 "no pain or discomfort" and 10 "worse pain ever felt".
Change from Baseline in Cervical flexion at one week after the intervention	one week after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical flexion actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical extension at one week after the intervention	one week after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical extension actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical side flexion (homo-lateral of trigger point) at one week after the intervention	one week after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical side flexion (homo-lateral of trigger point)actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical rotation (homo-lateral of trigger point) at one week after the intervention	one week after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical rotation (homo-lateral of trigger point)actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical side flexion (contra-lateral of trigger point) at one week after the intervention	one week after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical side flexion (contra-lateral of trigger point)actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Cervical rotation (contra-lateral of trigger point) at one week after the intervention	one week after the intervention	A cervical range of motion instrument was used to measure the cervical ranges of motion. Each subject performed cervical rotation (contra-lateral of trigger point)actively until the maximum available amplitude three times, and the evaluator read the values on the inclinometer on the plane of the performed movement.
Change from Baseline in Pressure pain perception at one week after the intervention	one week after the intervention	For the determination of th pressure pain perception, with the subject seated, the evaluator placed the pointer on the point of upper trapezius muscle with an angle of 90º and an increasing pressure of 1 kg/cm²/s until the pressure reached 2,5 kg/cm² and it was maintained for 5 seconds. Then the subject would characterize the level of pain through a visual analog scale), which had a ruler with a numerical scale of 0 to 10, being 0 "no pain or discomfort" and 10 "worse pain ever felt".

Trial Locations

Locations (1)

Escola Superior de Tecnologia da Saúde do Porto; 🇵🇹 Vila Nova de Gaia, Porto, Portugal