Short and Medium-term Effects of Manual Therapy on Latent Myofascial Pain
- Conditions
- Latent Myofascial Trigger Point of Upper Trapezius Muscle
- Interventions
- Other: Muscle energy techniqueOther: Passive stretching techniqueOther: Sham techniqueOther: Ischemic compression technique
- 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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 117
- 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.
- 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
- Arm && Interventions
Group Intervention Description Muscle energy technique Muscle energy technique In each volunteer, the therapist identified the latent trigger point on the upper trapezius. A questionnaire about general information was performed. And the maximum homolateral side flexion of the trigger point was measured. On the following week, the blind assessor performed the pre-intervention measurements of pressure pain threshold, pressure pain perception and cervical range of motions. Next, the therapist performed the muscle energy technique of the upper trapezius muscle. Then, all measurements, before described, were repeated, by the assessor, after 10 minutes, 24 hours and one week. Passive stretching technique Passive stretching technique In each volunteer, the therapist identified the latent trigger point on the upper trapezius. A questionnaire about general information was performed. And the maximum homolateral side flexion of the trigger point was measured. On the following week, the blind assessor performed the pre-intervention measurements of pressure pain threshold, pressure pain perception and cervical range of motions. Next, the therapist performed the passive stretching of the upper trapezius muscle. Then, all measurements, before described, were repeated, by the assessor, after 10 minutes, 24 hours and one week. Sham technique Sham technique In each volunteer, the therapist identified the latent trigger point on the upper trapezius. A questionnaire about general information was performed. And the maximum homolateral side flexion of the trigger point was measured. On the following week, the blind assessor performed the pre-intervention measurements of pressure pain threshold, pressure pain perception and cervical range of motions. Next, for the sham technique, the therapist only contacted with his hands the head and the shoulder of the subject, without executing any movement, for 30 seconds. Then, all measurements, before described, were repeated, by the assessor, after 10 minutes, 24 hours and one week. Ischemic compression technique Ischemic compression technique In each volunteer, the therapist identified the latent trigger point on the upper trapezius. A questionnaire about general information was performed. And the maximum homolateral side flexion of the trigger point was measured. On the following week, the blind assessor performed the pre-intervention measurements of pressure pain threshold, pressure pain perception and cervical range of motions. Next, the therapist performed ischemic compression technique on the latent trigger point. Then, all measurements, before described, were repeated, by the assessor, after 10 minutes, 24 hours and one week.
- 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