Comparison of IMES Versus DN on ATrPs of AC

Riphah International University

Status: Completed

Conditions: Shoulder Pain

Treatments: Other: Dry needling; Other: intramusuar electrical stimulation

Study type: Interventional

Funder types: Other

Identifiers

NCT06302829

RiphahIU Shafia Anjum

Details and patient eligibility

About

The aim of our study to compare DN and IMES for pressure pain threshold, ROM and the shoulder function in active trigger points with adhesive capsulitis. This study will add to the growing body of knowledge that if these two techniques yield comparable outcomes and if one technique is superior to the other, which should be the alternative of therapy. Moreover, it would add to the society as there are very limited researches done in Pakistan using needling for trigger points in adhesive capsulitis.

Enrollment: 44 patients

Sex: All

Ages: 40 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 40 to 60 year of both genders
• Diagnosed patients of stage 3 Adhesive capsulitis with type I and II diabetes
• Involvement of at least 3 shoulder girdle muscles in Active MTrPs (subscapularis, latissimus dorsi, deltoid (anterior, middle, posterior)
• Active MTrPs in shoulder girdle muscles (subscapularis, supraspinatus, deltoid (anterior, middle, posterior), teres minor, latissimus dorsi)
• Reproduction of the patient's symptoms at active trigger point, Taut band, Hypersensitive spot, Referred pain pattern, local twitch response
• Minimum 60 degrees of active/passive shoulder abduction range of movement.

Exclusion criteria

• Systemic inflammatory joint disease of shoulder joint (RA, OA polymyalgia rheumatic)
• Cerebral Vascular Accident
• Fibromyalgia, neurological deficits of upper limb (Nerve root entrapment, Cervical radiculopathy, Thoracic outlet syndrome)
• History of Fracture, Dislocation, Acute soft tissue injury, Acute bursitis
• Avascular necrosis of humeral head or visceral referred pain to shoulder
• Pregnancy, Hypothyroidism, skin infection
• Patients who are using Antiplatelet Therapy with in past 3 days of study
• Extreme fear of needles

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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44 participants in 2 patient groups

Intramuscular Electrical stimulation

Experimental group

Description:

Myofascial trigger point would be targeted by direct intramuscular electrical stimulation by using direct electrode placement method, where anode pole and the cathode pole of the stimulator connected to the needles of the MTrPs of the shoulder girdle muscles using the alligator clip connector in which both electrodes are on the muscle belly in which anode pole at proximal end and cathode pole at the distal end along the musculotendinous junction. The special programmed comfy stim (a double channeled multipurpose electrical stimulator) was used to deliver electrical impulses with following parameters; pulse duration 80µs, frequency 100HZ, and time duration for 10 min

Treatment:

Other: intramusuar electrical stimulation

Dry Needling

Active Comparator group

Description:

DN for the MTrPs will be performed over the identified trigger points locations at a suitable angle. The needles of suitable length and thickness (30-mm), depending on the depth of the MTrPs location inserted into the shoulder girdle muscles to deactivate the active MTrPs. Subsequently, the inserted needles moved to-and-fro direction to elicit the local twitch responses, which further reaffirms the ideal placement of needle into the MTrPs. After the twitch response obtained, the dry needles were kept within the muscles approximately for 10 minutes. Dry needling was performed subscapularis, latissimus dorsi, supraspinatus, deltoid, teres minor.

Treatment:

Other: Dry needling