Comparative Analysis of Different Physiotherapy Interventions on Craniovertebral Angle in Individuals With Myofascial Pain Syndrome and Radiculopathy: a Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 100
- 试验地点
- 2
- 主要终点
- Craniovertebral (CV) Angle
研究概览
简要总结
Myofascial pain syndrome (MPS) and radiculopathy are prevalent musculoskeletal conditions that afflict a substantial portion of the population, causing significant discomfort and impairments in daily functioning. MPS is characterized by localized muscle pain, trigger points, and referred pain, often accompanied by stiffness and restricted range of motion. A common feature shared by individuals with MPS and radiculopathy is the presence of postural abnormalities and balance impairments . The craniovertebral angle, which reflects the relationship between the head and neck, is often compromised in these individuals due to muscle imbalances, pain-related guarding, and structural changes in the spine. Various physiotherapy modalities, including dry needling, manual mobilization and soft tissue release, trigger point therapy, stretching, cupping therapy, and electrotherapy, have been utilized in clinical practice, but their relative efficacy in improving the craniovertebral angle and alleviating symptoms in individuals with MPS and radiculopathy has not been comprehensively compared. Understanding the underlying mechanisms and comparative effectiveness of various physiotherapy interventions is essential for guiding evidence-based clinical decision-making and optimizing treatment outcomes for individuals with MPS and radiculopathy. By elucidating the effects of different treatment modalities on the craniovertebral angle and associated outcomes, this research endeavor aims to contribute to the development of more tailored and effective physiotherapy approaches for improving the well-being of individuals affected by these debilitating musculoskeletal conditions.
详细描述
Myofascial pain syndrome (MPS) and radiculopathy are prevalent musculoskeletal conditions that afflict a substantial portion of the population, causing significant discomfort and impairments in daily functioning. Myofascial pain syndrome (MPS) is characterized by localized muscle pain, trigger points, and referred pain, often accompanied by stiffness and restricted range of motion. Radiculopathy, on the other hand, involves dysfunction or compression of spinal nerve roots, resulting in symptoms such as radiating pain, numbness, and weakness along the affected nerve pathway. Both conditions can profoundly impact an individual's quality of life, leading to limitations in activities of daily living, work-related tasks, and recreational activities.
A common feature shared by individuals with Myofascial pain syndrome (MPS) and radiculopathy is the presence of postural abnormalities and balance impairments. The craniovertebral angle, which reflects the relationship between the head and neck, is often compromised in these individuals due to muscle imbalances, pain-related guarding, and structural changes in the spine. The alteration in the craniovertebral angle can exacerbate symptoms, contribute to muscle tension, and impede proper biomechanical function, further exacerbating the overall discomfort and functional limitations experienced by affected individuals.
The clinical examination of individuals with cervical spine disorders routinely encompasses assessment of posture, mobility, strength, and neuromuscular function. Among these, forward head posture (FHP)-characterized by anterior displacement of the head relative to the trunk-has been recognized as a key contributor to cervical dysfunction, neck pain, and related impairments. FHP is frequently implicated in a wide spectrum of musculoskeletal and neurological concerns, including temporomandibular disorders, headaches, visual disturbances, tinnitus, and altered electromyographic activity of craniofacial muscles, all of which can reduce sleep quality and daily function.
Anatomically, FHP involves extension of the upper cervical segments (C1-C3) and flexion of the lower cervical and upper thoracic segments, resulting in altered biomechanics and increased stress on the cervical musculature and joint. In addition, increased thoracic kyphosis is often associated with or predictive of FHP.
The craniovertebral angle (CVA), defined between a horizontal line through C7 and a line from C7 to the tragus of the ear, remains one of the most clinically accessible and valid quantitative indicators of FHP. A lower CVA represents a more pronounced forward head position, while higher angles reflect better postural alignment.
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
- Triple (Participant, Care Provider, Outcomes Assessor)
入排标准
- 年龄范围
- 20 Years 至 40 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age: Participants must be between 20 and 40 years old.
- •Gender: Both genders, Male and Female have equal chance of selection as participant in the study.
- •Diagnosis: Participants must have a confirmed diagnosis of myofascial pain syndrome (MPS), altered cervical posture, restricted range of motion of cervical spine due to muscular spasm etc, altered craniovertebral angle, pain in cervical region or upper extremity and/or radiculopathy by a qualified healthcare professional, based on standardized diagnostic criteria (e.g., clinical examination, imaging studies).
- •Severity: Participants should have mild to moderate symptoms of MPS and/or radiculopathy, as determined by the assessing healthcare provider.
- •Willingness to Participate: Participants must be willing and able to comply physically and mentally with the study procedures, including attending scheduled physiotherapy sessions and completing outcome assessments.
- •Informed Consent: Participants will have to provide written informed consent mendatorily to be selected as participant in the study after receiving detailed information about the study aims, procedures, potential risks, and benefits.
排除标准
- •Severe Comorbidities: Participants with severe comorbidities or medical conditions that may interfere with their ability to participate in the study or confound the interpretation of results will be excluded. C1, C2 compression... vertigo
- •Surgeries: Participants who have undergone surgeries in the cervical or head region in past will be excluded due to potential confounding effects on outcomes.
- •Pregnancy: Pregnant individuals will be excluded from the study due to the potential risks associated with certain physiotherapy modalities and the need for specialized considerations in this population.
- •Contraindications: Participants with contraindications to specific physiotherapy modalities included in the study protocol (e.g., contraindications to dry needling, electrotherapy) will be excluded to ensure participant safety.
- •Inability to Attend Sessions: Participants who are unable to attend scheduled physiotherapy sessions due to logistical constraints (e.g., transportation issues, scheduling conflicts) will be excluded.
- •Cognitive Impairment: Participants with significant cognitive impairment or communication difficulties that may impede their ability to understand and follow study instructions will be excluded.
- •Participation in Other Research: Participants who are currently participating in other research studies involving treatment interventions for MPS and/or radiculopathy will be excluded to avoid potential confounding effects on outcomes and treatment adherence.
- •Malignancies: participants suffering from any kind of malignancies will be excluded from the study.
- •Trauma: Participants having a history of trauma and fractures in head and neck region will also be excluded from the study.
结局指标
主要结局
Craniovertebral (CV) Angle
时间窗: Four Weeks
Angle between horizontal line crossing spinous process of C7 and line joining the same with tragus of ear. it is assessed using digital photography and then calculating angle using MicroDiCom Software.
Pain Severity
时间窗: Four weeks
Pain severity will be checked by Numeric Pain Rating Scale (NPRS). this scale consists of 0-10 values with 0 being no pain and 10 being the worst possible pain. Increasing pain scores show high severity of pain and decreasing/less scores show less severity of pain.
次要结局
- Balance(Four weeks)