Referred Pain Patterns Infraspinatus Muscle

Not Applicable

Completed

• Conditions: Shoulder Pain
• Interventions: Other: Manual palpation; Other: Deep dry needling

• Registration Number: NCT02817269
• Lead Sponsor: Universidad Miguel Hernandez de Elche

Brief Summary

The first aim of the study will be to identify the most common ReP pattern and compare its coincidence with that described by Travell and Simons. Second, the study aim will be to verify whether there are any significant differences by sex and types of technique used in regard to the ReP pattern of TrP 2 of the infraspinatus muscle, an area described as more sensitive.Finally, the third aim of the study will be to determine whether deep dry needling will evoke the LTR and ReP more easily than manual palpation.

Detailed Description

Patients will be recruited from a university's employee and student population by advertising at the university. Patients with shoulder complaints (described as pain felt in the shoulder or upper arm) will be randomly assigned to either an manual palpation or deep dry needling group. Participants will be randomly divided into 2 groups, a deep dry needling group and manual palpation group. Visual analogue scale (VAS), referred pain (ReP) pattern and features of referred pain of the infraspinatus muscle will be all assessed post-technique.

Study Timeline

• Study First Submitted: 2016-06-21
• Study First Submitted QC: 2016-06-26
• Study First Posted: 2016-06-29
• Study Start: 2016-07
• Primary Completion: 2016-08
• Study Completion: 2016-09
• Status Verified: 2016-10
• Last Update Submitted: 2016-10-27
• Last Update Posted: 2016-10-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 96

Inclusion Criteria

• Aged between 18 and 65 years.
• To remain seated or in front of data visualization screens (tablets, computers or smartphones) for at least 4 hours a day.
• Shoulder complaints in the last six weeks.

Exclusion Criteria

• Patients with evidence of serious medical illness.
• Cognitive impairment.
• Psychosocial disorders.
• Bilateral affectation of shoulder pain.
• Pregnancy.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Manual palpation group	Manual palpation	For the manual palpation group, the reference position will be a lateral position, lying on the non affected shoulder while the affected side will be explored. The arm and elbow are flexed 90° resting on a pillow and legs placed with 90° hip and knee flexion to stabilize the body, with the head resting on a pillow to maintain body alignment. The physiotherapist will be in front of the participant and carried out the examination with flat palpation using the thumb to identify soreness taut band tried to elicit local twitch response and referred pain in the infraspinatus area. First, three attempts will be made to elicit an local twitch response (LTR) using snapping palpation if a response will be obtained. After LRT, referred pain could also be evoked by palpation.
Deep dry needling group	Deep dry needling	For the deep dry needling group, the reference position will be a lateral position, lying on the non affected shoulder while the affected side will be explored. The arm and elbow are flexed 90° resting on a pillow and legs placed with 90° hip and knee flexion to stabilize the body, with the head resting on a pillow to maintain body alignment. The physiotherapist will be in front of the participant and carried out the examination with flat palpation using the thumb to identify soreness taut before making the needle insertion. Sterile stainless steel needles (length 40mm/caliber 0.32 with a cylindrical plastic guide) will be used.

Primary Outcome Measures

Name	Time	Method
Mapping of Referred Pain Pattern	One month	The participants from both groups will ask to report whether ReP is evoked and to describe the ReP pattern using an anatomical map of the upper half of the human body divided into eighteen areas. Nine areas corresponded to the anterior part of the body and the other nine to the posterior part of the body.

Secondary Outcome Measures

Name	Time	Method
Evocation of Local Twitch Response	One month	These were assigned a numerical value of 0 (yes) or 1 (no) for better statistical handling of the data.
Subjective pain intensity: Visual Analogue Scale (VAS)	One month	The VAS for pain measures the amount of pain experienced by a subject on a continuum from 0 to 10, with 0 being no pain and 10 maximum pain.
Prevalence active trigger point	One month	Active trigger point is considered: Soreness taut band and familiar pain.