IMMEDIATE EFFECT OF INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUE VERSUS INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUE IN PATIENT WITH SUBACUTE TRAPEZITIS- A COMPARATIVE STUDY

Ethical clearance will be obtained from institutional ethical committee & principal of Dr. Ulhas Patil college of physiotherapy. A Written informed consent form will be obtained from subject who are willing to participate.

subject will be screened according to inclusion and exclusion criteria . The aim and objective will be explained to the patient. selected participants demographic details and outcome measure will be recorded .

To check effectiveness of INIT AND INIT WITH SURGED FARADIC THREE OUTCOMES ARE USE PRE TREATMENT AND POST TREATMENT

1. NPRS

2. NDI

3. CERVICAL CONTRALATERAL RANGE OF MOTION

INIT CONSITS OF THREE METHODS

1. ISCHEMIC COMPRESSION

2. SCS

3. MET

ISCHEMIC COMPRESSION : 1)The subjects was placed in supine to reduce tension in the upper trapezius muscle.

2)Their arm was positioned in slight shoulder abduction with the elbow bent and their hand resting on their stomach.

3)Using a pincer grasp, the practitioner moved throughout the fibers of the upper trapezius and made note of any active Trigger point.

4)Once the Trigger point was identified treatment began.

5)The first technique applied was ischemic compression.

6)The therapist again utilized a pincer grasp, placing the thumb and index finger over the active Trigger point.

7. Slow, increasing levels of pressure was applied until the tissue resistance barrier was identified

8)Pressure was maintained until a release of the tissue barrier was felt.

9. At that time, pressure was again applied until a new barrier was felt.

10. This process was repeated until tension/tenderness was unable to be identified or 90 s had elapsed, whichever came first.

11)All identified Trigger point were treated.

STRAIN COUNTER STRAIN :Subject in supine position and pressure was applied at painful spot then arm was moved in to abduction and external rotation to achieve the position of comfort or ease in such a way that pain is relived or reduced from the palpated point.

This position was maintained for about 90 seconds. After which isometric contraction of the muscle was elicited in the form of MET.

MET :

Subjects randomized to the MET group received treatment as per post-isometric relaxation approach.

The subjects were placed supine and the practitioner stabilized the shoulder on the affected side with one hand, while the ear/mastoid area of the affected side was held by the opposite hand.

The head and neck were then side bent towards the contralateral side, flexed, and rotated ipsilaterally, placing the subject just short of their upper trapezius restriction barrier.

The subjects then shrugged the involved/stabilized shoulder towards the ear at a submaximal, pain-free, effort (20% of their available strength). The isometric effort was held for 7–10 s while a normal breathing rhythm was maintained.

During the relaxation phase, the head and neck were eased into increasing degrees of side bending, flexion and rotation to advance the stretch placed on the muscle. Each stretch was held for 30 s, and this was repeated for three to five repetitions.

SURGED FARADIC CURRENT :

Patient position- Patient in supine position.

Instruction- The patient should be comfortably seated/ supine lying with arm support. Patient is asked to keep the part to be treated still and relaxed and to report any increase pain or other sensation immediately.

Preparation of treatment part- The area should be clean.

Frequency: 50 HZ

Mode: SURGED FARADIC

PULSE DURATION: 0.1 – 1 microsecond

Duration: 10 Minutes.

AFTER  TREATMENT AGAIN OUTCOMES WERE MEASURED

RESULTS: THERE WAS SIGNICANT INCREASE IN RANGE OF MOTION

DECREASE IN PAIN

AND FUNCTINAL DISABILITY  WERE IMPROVED