UPPER CERVICAL MOBILIZATION VERSUS INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUE IN PATIENTS WITH LEVATOR SCAPULAE SYNDROME
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 60
- 主要终点
- pain pressure threshold of trigger points
研究概览
简要总结
the study will be conducted to answer the following research question: is there a difference between the effect of upper cervical mobilization and integrated neuromuscular inhibition technique of levator scapulae muscle in patients with levator scapulae syndrome?
详细描述
Neck pain might be usually provoked by TrPs in the upper trapezius and levator scapulae muscles The differentiation in levator scapulae MTrPs prevalence between the right and left sides may also indicate potential asymmetries in muscle use or stress, which could be relevant for diagnosis and treatment strategies.
Integrated treatment approach (INIT) for neck pain provides greater pain relief, reduces disability, improves functional ability, and improves quality of life than other treatments Cervical Spine Mobilization (CSM) by oscillatory movements and traction to the cervical segments helps to break adhesion and stretch the hypo-mobile shortened structures.
There is a gap in the available literature about the comparative effect of upper cervical mobilization and integrated neuromuscular inhibition technique (INIT) of levator scapulae muscle on neck pain, neck disability, range of motion, and cervical proprioception in levator scapulae syndrome.
60 Participants recruited from both genders will be assigned randomly into 3 equal groups Group A : will receive upper cervical mobilization plus conventional treatment .
Group B : will receive integrated neuromuscular technique, It is a technique which combines three methods (Ischemic compression- muscle energy technique- strain counter strain) plus conventional treatment .
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
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 45 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with a primary complaint of chronic neck pain (assessed by VAS) for more than 3 months.
- •Subjects with pain provocation and reduced mobility at the upper cervical segment (assessed by passive accessory intervertebral movements (PAIVMs) and reduced mobility at cervical spine (assessed by CROM) will be included in the study.
- •Participants will be recruited from both genders with age ranged from 18 to 45 years old, and BMI from 18 to 30kg/m2
排除标准
- •1) Previous spine surgery 2) Pregnant and breast feeding women 3) Diabetic patients 4) Hypertensive patients 5) Neck pain associated with cervical radiculopathy 6) Whiplash injuries 7) Cervical spine fracture 8) Vertebrobasilar insufficiency. 9) Red flags suggesting of cancer, infection, vascular insufficiency
研究组 & 干预措施
UPPER CERVICAL MOBILIZATION
All patients in group A will receive Grades I and II mobilizations and conventional physical therapy program in the form of :( hot pack, Dynamic and Isometric Neck Exercises) for four weeks.
干预措施: Upper cervical mobilization (Other)
Integrated neuromuscular inhibition technique
Group B will receive integrated neuromuscular inhibition Technique and conventional physical therapy program as in group A in the form of :( hot pack, Dynamic and Isometric Neck Exercises) for four weeks.
干预措施: Integrated neuromuscular inhibition technique (Other)
conventional treatment
Participants in group C will receive conventional physical therapy only in the form of: (superficial heat using hot pack for 10 minutes, Dynamic Neck Exercises and Isometric Neck Exercises) for four weeks
干预措施: Conventional treatment (Other)
结局指标
主要结局
pain pressure threshold of trigger points
时间窗: up to 4 weeks
The Pressure Pain Threshold (PPT) is defined as the point at which a non-painful pressure stimulus turns into a painful pressure sensation. Pressure algometry (PA) is a method described to objectify this PPT. This technique is a well-known and well-validated method to induce acute experimental pain. Different studies have been published about using this tool to evaluate pain in different locations of the body and showed high levels of reliability.
Measurement of Neck Functional Disability Level using the Arabic Version of Neck Disability Index
时间窗: up to 4 weeks
The patient will be relaxed and asked to complete the NDI before treatment and after treatment, which consists of 10 items. Each item is scored from zero (no disability) to five (total disability), with the maximum possible total score being 50. For each item, the subject asked to choose one answer that best defined his/her neck functional disability level. Scores for each item tallied and the total score will be recorded. Mean duration of the test: 3 to 7.8 minutes. Vernon and Mior presented the following interpretation
次要结局
- Measurement of cervical proprioception(up to 4 weeks)
- Range of motion assessment of cervical spine(up to 4 weeks)
研究者
Amira Ebrahem Sadek
principle investigator
Cairo University