Analyzing Positional Release Therapy and Dry Needling to Improve Pain and Function in Levator Scapulae Syndrome
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 102
- 试验地点
- 1
- 主要终点
- VAS Visual Analogue Scale VAS Visual Analogue Scale
研究概览
简要总结
Levator scapulae syndrome (LSS) is a common musculoskeletal disorder that affects people in a variety of vocations, especially those that require extended static postures and repetitive motions. It is frequently characterized by persistent neck and shoulder pain. Among them, cosmetics professionals Desk top professional and are particularly vulnerable because of the nature of their employment, which involves tasks like prolonged, uncomfortable postures that lead to muscular imbalance.along them Levator Scapulae Syndrome (LSS) is quite common in manual laborers because of heavy lifting, overhead reaching, and repetitive lifting. This results in significant discomfort, stiffness, and limited neck movement due to persistent muscular tension, decreased flexibility, and trigger points in the neck and upper back.
详细描述
Following the screening, participants will be randomized to receive the experimental or the controlled treatment in a1:1 ratio. Computer-generated random numbers will be used for Randomization. After obtaining the basic information, a unique code will be provided to each included patient. The outcome assessor will be blinded to the type of treatment. Patients and investigator could not be blinded due to the nature of treatment. Group "A "(experimental group) will receive Positional Release Technique on Levator Scapulae (Both if Necessary) Group "B" (control group) will receive (control group) will receive Dry needling treatment ,along with Neck strengthening exercises.
All patients will be Assessed for Pain , ROM and Functional Activities at base line and after 4 weeks.
Visual Analogue Scale(VAS) and CROM will be used for pain and ROM respectively.Neck Disability Index (NDI), Oxford Scale, ) will be used for Muscle strength and Daily life disaility Global Rating for patient's assessment of their own progress or decline during a particular course of treatment. and finaly EuroQol-5D (EQ-5D) to evaluate health-related quality of life. Mobility, self-care, routine activities, pain/discomfort, and anxiety/depression are the five main variables that are assessed.
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)
入排标准
- 年龄范围
- 18 Years 至 40 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •18-40 years Willing to participate Having Positive Levator scapulae Test -
排除标准
- •Any history related to spinal surgery, Previous administration of epidural injections. Neck pain due to specific pathology, Neurological deficits (Myelopathy) and Clinical disorder contraindicated to exercise
研究组 & 干预措施
Positional Release Technique PRT
Group "A"(experimental group) will receive Positional Release Technique on Levator scapulae (may be both if necessary).along with Neck strengthening exercises.
Patient will be in supine lying with the elbows to the side of the upper body therapist sitting behind stabilizing superior border of scapula, with other hand holding the occiput region. Palpating tender points around superior-medial border of scapula and with occipital hand move the head and neck towards painful side. Pressure will be applied to a Pain perception of 10 and than Physiotherapis MOve the Neck in Different combilation of Movemnt Like Flexion , Side bending Rotation or Extension untill Patient start to feel a minimum releif of Tender point of 75 %. three sets on each side with 30 seconds hold on tender point. A rest of 15 seconds will be given between all sets. Following exercises will be given Rowing, horizontal abduction, shrug, horizontal abduction with ER, prone shoulder extension
干预措施: Positional release Technique (Other)
Positional Release Technique PRT
Group "A"(experimental group) will receive Positional Release Technique on Levator scapulae (may be both if necessary).along with Neck strengthening exercises.
Patient will be in supine lying with the elbows to the side of the upper body therapist sitting behind stabilizing superior border of scapula, with other hand holding the occiput region. Palpating tender points around superior-medial border of scapula and with occipital hand move the head and neck towards painful side. Pressure will be applied to a Pain perception of 10 and than Physiotherapis MOve the Neck in Different combilation of Movemnt Like Flexion , Side bending Rotation or Extension untill Patient start to feel a minimum releif of Tender point of 75 %. three sets on each side with 30 seconds hold on tender point. A rest of 15 seconds will be given between all sets. Following exercises will be given Rowing, horizontal abduction, shrug, horizontal abduction with ER, prone shoulder extension
干预措施: Dry Needling (Other)
Active Comparator: Dry Needling Therapy
Group "B" (control group) will receive Dry needling treatment consisting along with Neck strengthening exercises.
Patient will be in prone lying with the elbows adducted the upper body weight rests on the elbows, for further enhancement patient flexes the neck and lets the shoulder girdle relax. A pillow will be placed under shoulder to protrude scapula, exposing the super medial border for palpation and Introducing needles from a superior to inferio posterior angle to avoid lung lobe. With therapist wearing glove Alcohol swaps will be used to clean the area to be treated, A 30-40mm (0.32-0.35 gauge) needle will be used depending on body size.
Following exercises will be given Rowing, horizontal abduction, shrug, horizontal abduction with ER, prone shoulder extension
干预措施: Positional release Technique (Other)
Active Comparator: Dry Needling Therapy
Group "B" (control group) will receive Dry needling treatment consisting along with Neck strengthening exercises.
Patient will be in prone lying with the elbows adducted the upper body weight rests on the elbows, for further enhancement patient flexes the neck and lets the shoulder girdle relax. A pillow will be placed under shoulder to protrude scapula, exposing the super medial border for palpation and Introducing needles from a superior to inferio posterior angle to avoid lung lobe. With therapist wearing glove Alcohol swaps will be used to clean the area to be treated, A 30-40mm (0.32-0.35 gauge) needle will be used depending on body size.
Following exercises will be given Rowing, horizontal abduction, shrug, horizontal abduction with ER, prone shoulder extension
干预措施: Dry Needling (Other)
结局指标
主要结局
VAS Visual Analogue Scale VAS Visual Analogue Scale
时间窗: Baseline and After Four weeks of Treatment
The visual analogue scale is used for measurement of pain intensity. It is a continuous scale. It comprises a horizontal/vertical 10 centimeters or 100 millimeters line. The higher scores shows higher pain intensity and lower scores shows lower pain intensity.Left Anchor (0 cm): Represents "No pain" and The Right Anchor (100 cm): Represents "Worst possible pain". Increase in cm indicate worsening of the pain.
The Oxford Muscle Scale
时间窗: Baseline and After Four weeks of Treatment
The Oxford muscular Scale, sometimes called the Medical Research Council or MRC scale, as a standardized instrument to measure muscular strength and power, Evaluate and grade manual muscle strength and power on a standardized scale from 0 to 5. Where 0 Means No contraction (lowest) and grade 5 (highest) muscle exhibits normal strength and can move through a full range of motion against maximal, firm resistance. Increase in Grades represent Improving in Strength and recovery while decrease in grade shows weakness and decline in strength.
Cervical Range of Motion (CROM) Universal Goniometery
时间窗: Baseline and After Four weeks of Treatment
The cervical spine's (neck's) functional mobility is determined using the Cervical Range of Motion (CROM) test. It determines how far a person can move their head in various directions, to assist diagnose neck discomfort, evaluate the healing process following an accident, and monitor the course of rehabilitation.Cervical goniometry is the clinical method of measuring neck mobility using a standard handheld universal goniometer. The goniometer's stationary arm always tracks a fixed reference line relative to the ground or torso. The moving arm follows the structural movement of the skull. Measures CROM in degrees. Increase in degrees denote improvement and increase ROM
EuroQol-5D (EQ-5D)
时间窗: Baseline and After Four weeks of Treatment
Measure generic health-related quality of life (HRQoL). It is one of the most widely used Patient-Reported Outcome Measures (PROMs) globally. The EQ-5D descriptive system is a preference-based HRQL measure with one question for each of the five dimensions that include mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The EQ-5D questionnaire also includes a Visual Analog Scale (VAS), by which respondents can report their perceived health status with a grade ranging from 0 (the worst possible health status) to 100 (the best possible health status).
次要结局
- Neck Disability Index (NDI)(Baseline and After Four weeks of Treatment)
- Global Rating of Change (GRC)(Baseline and After Four weeks of Treatment)
研究者
Iram Iqbal Shamsi
Assistant Professor PT
University of Karachi