Comparison of Intramuscular Electrical Stimulation Versus Dry Needling on Active Trigger Points of Adhesive Capsulitis
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 44
- 试验地点
- 1
- 主要终点
- Algometer (pressure pain threshold)
研究概览
简要总结
The aim of our study to compare DN and IMES for pressure pain threshold, ROM and the shoulder function in active trigger points with adhesive capsulitis. This study will add to the growing body of knowledge that if these two techniques yield comparable outcomes and if one technique is superior to the other, which should be the alternative of therapy. Moreover, it would add to the society as there are very limited researches done in Pakistan using needling for trigger points in adhesive capsulitis.
详细描述
In literature review 2021, they were see the short-term effect of dry needling of myofascial trigger point in patient with adhesive capsulitis. They conclude MTrPs with DN technique were improve pain, ROM, disability, and PPT along with conventional physiotherapy management among patient with adhesive capsulitis In another study 2021, in their study they were see the effect of dry needling and muscle energy technique separately in patient suffering shoulder impingement syndrome on active trigger point of infraspinatus. In their study they conclude dry needling is an effective treatment to treat the active trigger point in patient suffering from shoulder impingement syndrome In another study 2023, in their study they see impact of dry needling with electrical stimulation on pain and disability in patient with musculoskeletal shoulder pain. They do the systemic review of 5 studies to see the beneficial effect of dry needling and IMES. They conclude that the significant improvement in pain, ROM, and functional disability in patient with musculoskeletal shoulder pain In 2021 study, in their study they were see the effect of Dry Needling with percutaneous electrical nerve stimulation in patient with Myofascial neck pain. They were applying the dry needling on myofascial trigger point present in upper trapezius in patient with Myofascial neck pain They conclude that electric nerve stimulation will improve disability and pain intensity in patient with myofascial neck pain In another study 2021, in their study they see the effect of intramuscular stimulation along with dry needling in patient with adhesive capsulitis. They target the shoulder girdle muscle and paraspinal muscle (C3 to C7). They conclude that IMES and dry needling were improve pain, ROM and functional disability in patient with adhesive capsulitis In another study 2021, in their study they were target the deltoid myofascial trigger point to improve pain they conclude that dry needling and IMES were enhance blood circulation and cervical and shoulder ROM in MTrPs patient IMES and dry needling according to literature review is an effective treatment to treat the trigger points present at various points in different musculoskeletal conditions. It reduces the shoulder pain severity and upper limb disability by deactivating the active MTrPs and improve the shoulder ROM in patient with adhesive capsulitis. Hence there is lack of evidence to allow conclusions to be drawn about the effectiveness of Dry needling when compared with intramuscular electrical stimulation for adhesive capsulitis in term of pressure pain threshold and shoulder function in active trigger points
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
盲法说明
randomized
入排标准
- 年龄范围
- 40 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 40 to 60 year of both genders
- •Diagnosed patients of stage 3 Adhesive capsulitis with type I and II diabetes
- •Involvement of at least 3 shoulder girdle muscles in Active MTrPs (subscapularis, latissimus dorsi, deltoid (anterior, middle, posterior)
- •Active MTrPs in shoulder girdle muscles (subscapularis, supraspinatus, deltoid (anterior, middle, posterior), teres minor, latissimus dorsi)
- •Reproduction of the patient's symptoms at active trigger point, Taut band, Hypersensitive spot, Referred pain pattern, local twitch response
- •Minimum 60 degrees of active/passive shoulder abduction range of movement.
排除标准
- •Systemic inflammatory joint disease of shoulder joint (RA, OA polymyalgia rheumatic)
- •Cerebral Vascular Accident
- •Fibromyalgia, neurological deficits of upper limb (Nerve root entrapment, Cervical radiculopathy, Thoracic outlet syndrome)
- •History of Fracture, Dislocation, Acute soft tissue injury, Acute bursitis
- •Avascular necrosis of humeral head or visceral referred pain to shoulder
- •Pregnancy, Hypothyroidism, skin infection
- •Patients who are using Antiplatelet Therapy with in past 3 days of study
- •Extreme fear of needles
研究组 & 干预措施
Intramuscular Electrical stimulation
Myofascial trigger point would be targeted by direct intramuscular electrical stimulation by using direct electrode placement method, where anode pole and the cathode pole of the stimulator connected to the needles of the MTrPs of the shoulder girdle muscles using the alligator clip connector in which both electrodes are on the muscle belly in which anode pole at proximal end and cathode pole at the distal end along the musculotendinous junction. The special programmed comfy stim (a double channeled multipurpose electrical stimulator) was used to deliver electrical impulses with following parameters; pulse duration 80µs, frequency 100HZ, and time duration for 10 min
干预措施: intramusuar electrical stimulation (Other)
Dry Needling
DN for the MTrPs will be performed over the identified trigger points locations at a suitable angle. The needles of suitable length and thickness (30-mm), depending on the depth of the MTrPs location inserted into the shoulder girdle muscles to deactivate the active MTrPs. Subsequently, the inserted needles moved to-and-fro direction to elicit the local twitch responses, which further reaffirms the ideal placement of needle into the MTrPs. After the twitch response obtained, the dry needles were kept within the muscles approximately for 10 minutes. Dry needling was performed subscapularis, latissimus dorsi, supraspinatus, deltoid, teres minor.
干预措施: Dry needling (Other)
结局指标
主要结局
Algometer (pressure pain threshold)
时间窗: 3rd week
This tool can be used to assess the participant pressure pain at baseline ,2nd week,3rd week post assessment. Pressure pain threshold is measured at active trigger point at subscapularis, deltoid (ant, middle, post), latissimus dorsi, teres minor, supraspinatus. The PPT are measured by mean and standard deviation kg\\cm2
次要结局
- ROM Shoulder (Flexion)(3rd week)
- ROM Shoulder (Abduction)(3rd week)
- ROM Shoulder (External rotation)(3rd week)
- ROM Shoulder (Internal Rotation)(3rd week)
- American shoulder and elbow surgeons scale(3rd week)