Impact of Visceral Manipulation Versus Integrated Neuromuscular Inhibition Technique in Shoulder Impingement Syndrome

Not Applicable

Not yet recruiting

• Conditions: Shoulder Impingement
• Interventions: Other: visceral manipulation; Other: integrated neuromuscular inhibition

• Registration Number: NCT06271720
• Lead Sponsor: Noha Elserty

Brief Summary

This study will be conducted To evaluate the effect of Visceral Manipulation versus Integrated Neuromuscular Inhibition Technique on the upper fiber of trapezius on pain intensity, pain threshold, shoulder range of motion, and function in shoulder impingement syndrome

Detailed Description

HYPOTHESES

It will be hypothesized that:

1. There will be no statistically significant effect of Visceral Manipulation on the upper fiber of the trapezius on pain intensity, pain threshold, shoulder range of motion, or function in shoulder impingement syndrome

2. There will be no statistically significant effect of the Integrated Neuromuscular Inhibition Technique on the upper fiber of the trapezius on pain intensity, pain threshold, shoulder range of motion, or function in shoulder impingement syndrome.

3. There will be no statistically significant difference in the effect of visceral manipulation versus the integrated neuromuscular inhibition technique on the upper fiber of the trapezius on pain intensity, pain threshold, shoulder range of motion, and function in shoulder impingement syndrome.

This study will be conducted to answer the following questions:

Is there an effect of Visceral Manipulation versus Integrated Neuromuscular Inhibition Technique on the upper fiber of the trapezius on pain intensity, pain threshold, shoulder range of motion, and function in shoulder impingement syndrome?

Study Timeline

• Study First Submitted: 2024-01-19
• Status Verified: 2024-02
• Study First Submitted QC: 2024-02-15
• Last Update Submitted: 2024-02-15
• Study First Posted: 2024-02-22
• Last Update Posted: 2024-02-22
• Study Start: 2024-03
• Primary Completion: 2024-05
• Study Completion: 2024-05

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 75

Inclusion Criteria

• -active myofascial trigger points in the upper trapezius muscle, and chronic Pain lasting more than 12 weeks
• BMI between 25 and 30 Kg/m².

Exclusion Criteria

• a previous fracture in the cervical spine or shoulder surgery
• acute inflammatory condition.
• Malignant tumor.
• Multiple osteophytes.
• Cervical posture abnormalities.
• Osteoporosis.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
visceral manipulation	visceral manipulation	Palpation will be applied and the pressure will directly to the skin, into the direction of restriction just until resistance (tissue barrier) is felt. Once found, the collagenous barrier will be engaged for 90 to 120 seconds for each technique without sliding over the skin or forcing the tissue until the fascia complex starts to yield and a sensation of softening is achieved.
integrated neuromuscular inhibition	integrated neuromuscular inhibition	The practitioner first identifies TrPs to be treated within the upper trapezius muscle. The subjects will be placed in a supine position. Their arm will be positioned in slight shoulder abduction with the elbow bent and their hand resting on their stomach. Using a pincer grasp, the practitioner will move throughout the fibers of the upper trapezius and make note of any active TrPs. Once the TrPs were identified, treatment began. The first technique applied will be ischemic compression. The therapist again utilized a pincer grasp, placing the thumb and index finger over the active TrP. Slow, increasing levels of pressure will be applied until the tissue resistance barrier is identified. The pressure will be maintained until a release of the tissue barrier is felt. At that time, pressure will again be applied until a new barrier is felt. This process will be repeated until tension or tenderness is unable to be identified or 90 seconds have elapsed.

Primary Outcome Measures

Name	Time	Method
pain intensity	pre treatment and after 4 weeks	pain intensity will be measured by a visual analog scale, the scale is marked from 0 to 10 while 0 represents no pain and 10 represents intolerable pain
pain pressure threshold	pre treatment and after 4 weeks	pressure threshold measured by pressure algometer
shoulder functional level	pre treatment and after 4 weeks	The functional level of the shoulder will be measured by shoulder pain and disability index. the index consists of subscales that measure how much shoulder pain interferes with the functional activity of daily living
shoulder range of motion	pre treatment and after 4 weeks	shoulder flexion and abduction range of motion will be measured by inclinometer