Radial Extracorporeal Shockwave Therapy vs Low-Level Laser Therapy for Cervical Myofascial Pain Syndrome in Adults: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Pain Intensity Changes (Numeric Rating Scale)
研究概览
简要总结
Background and Aim: Myofascial pain syndrome (MPS) in the cervical region is one of the most common musculoskeletal disorders associated with myofascial trigger points that cause muscle pain, stiffness, and reduced range of motion, precipitated by forward head posture. Many non-invasive modalities, including low-level laser therapy (LLLT) and extracorporeal shockwave therapy (ESWT), have been reported to reduce symptoms. However, comparative effectiveness of these interventions remains unclear. This study aimed to compare the effectiveness of radial ESWT and LLLT in reducing pain and improving functional outcomes in patients with cervical MPS among the working-age adults. Methods: A randomized controlled study was conducted in a working-age adults with MPS. Fifty subjects, divided in two groups received either ESWT or LLLT. Numeric rating scale (NRS), cervical range of motion (ROM), and craniovertebral angle (CVA) were assessed before and throughout three weeks post intervention. Results: Both LLLT and ESWT showed significant (p < 0.001) changes in NRS, cervical ROM, and CVA. LLLT showed a difference in pain reduction at week three (p < 0.001) and flexion and extension ROM at week two and three (p < 0.05). Conclusion: LLLT demonstrated superior results in pain reduction at the three-week mark and produced greater increases in cervical flexion and extension ROM during the two- and three-week periods when compared with ESWT.
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 (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 59 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •men and women
- •aged 18 to 59 years old
- •sedentary activity level
- •active MTrP on the upper trapezius muscle
- •moderate pain with an NRS pain score of 4-7
- •restriction of ROM
- •CVA angle of ≤ 50°
- •All agreed to participate in this study with informed consent.
排除标准
- •patients who were unable to complete the assessment or communicate adequately based on the Indonesian version of Montreal Cognitive Assessment (MoCA-Ina)
- •experiencing neck pain caused by radicular syndrome proven with the Spurling test, distraction test and Adson test.
- •history of malignancy
- •history of blood clotting disorder
- •receiving anticoagulant therapy
- •in a emergency state (e.g., loss of consciousness, shortness of breath, active bleeding, seizures, or hyperpyrexia)
- •participants with pacemaker
- •participants undergoing other treatments (manual therapy, massage, acupuncture, dry needling, or other rehabilitation modalities) for neck pain in the previous two weeks
研究组 & 干预措施
Radial Extracorporeal Shockwave Therapy
The first group intervened with ESWT BTL-5000 SWR radial 2000-4000 pulse per session, once a week, for a duration of 10-60 minutes, for three weeks. ESWT was applied to MTrPs bilaterally at 2.5 bar, with a frequency of up to 10 Hz and an energy flux density of 0.05-0.35 mJ/mm². Ultrasound gel was applied to the skin where ESWT probes were attached.
干预措施: Radial Extracorporeal Shockwave Therapy (Device)
Low-Level Laser Therapy
The second group received LLLT with BTL 4000 a total of six times, given twice a week. LLLT was applied to palpated active MTrPs at a dose of 40-50 J and an average power of 100 mW.
干预措施: Low-Level Laser Therapy (Device)
结局指标
主要结局
Pain Intensity Changes (Numeric Rating Scale)
时间窗: 3 weeks
NRS is an instrument to evaluate pain subjectively, with 11 scores of pain, ranging from 0 "no pain" to 10 "worst pain possible." Pain intensity categorized into mild (0-3), moderate (4-6), and severe (\>7). Participants must be fully conscious, mentally competent, and able to communicate verbally. MCID in the NRS score is 1.3.21
Cervical Range of Motion
时间窗: 3 weeks
Cervical ROM was used to detect movement dysfunction on patients' necks. Limitation of ROM can be caused by pain, muscle shortening, and other structural problems. ROM was measured with a goniometer.22 Patients were positioned to measure neck flexion, extension, lateral bending, and rotation. The examiner then measured the angle formed. Normal ranges are 1) flexion: 45.9-46.8°, 2) extension: 42.7-47.4°, 3) rotation to right: 63.3-67.2°, 4) rotation to left: 65.7-67.8°, 5) lateral flexion to right: 31.5-34.9°, and 6) lateral flexion to left: 31.4-36.6°.23
次要结局
- Craniovertebral angle(3 weeks)
研究者
Tirza Z Tamin
Principal Investigator
Indonesia University