Effects of Electrical Muscle Stimulation on Myofascial Pain Syndrome

University of Bath

Status: Completed

Conditions: Myofascial Pain Syndrome (MPS)

Treatments: Other: Sham stimulation combined with active stretching (SS+AS); Other: Trigger point pressure release (TPR); Other: The triple combination therapy of EMS+AS+TPR; Other: Transcutaneous electrical nerve stimulation (TENS); Other: The two-combination of EMS+AS; Other: Therapist-assisted Passive stretching (PS); Other: Trigger point pressure release combined with active stretching (TPR+AS)

Study type: Interventional

Funder types: Other

Identifiers

NCT07315776

EP 22 081

4961-6056 (Other Identifier)

Details and patient eligibility

About

The goal of this clinical trial is to determine if Electrical Muscle Stimulation (EMS) combined with Active Stretching (AS) (EMS+AS) and EMS+AS combined with Trigger Point Pressure Release (TPR) (EMS+AS+TPR) are effective treatments for Myofascial Pain Syndrome (MPS) in working adults. The study will also assess the safety of the EMS+AS intervention. The main questions it aims to answer are: Do EMS+AS and EMS+AS+TPR lead to greater pain reduction, increased pressure pain threshold, and improved surface electromyography (sEMG) activity when compared to standard treatments? Furthermore, what is the participant feedback regarding EMS+AS and other treatments?

Researchers will compare EMS+AS to passive stretching (PS) and TPR to see if EMS+AS and EMS+AS+TPR are effective in treating myofascial trigger points in the trapezius muscle.

Participants will receive seven interventions across a single visit, including PS, EMS+AS, TPR, TPR combined with AS (TPR+AS), EMS+AS+TPR, Sham stimulation, and Transcutaneous Electrical Nerve Stimulation (TENS). Each treatment will consist of three 10-second sets with a 10-second rest between sets, and a 2-minute break provided between different treatments. Participants will have measurements taken on changes in pain intensity, pressure pain threshold, and sEMG activity during trapezius action pre- and post-treatment. Additionally, participants will report personal information, previous MPS treatments, and baseline health status, and provide feedback on satisfaction, treatment preferences, exercise knowledge for MPS prevention, and qualitative comments. For supplementary data, we selected only the EMS+AS and TPR interventions with the same protocol to evaluate changes in range of motion and changes in trigger point size and trapezius thickness (both at rest and during stretching) via ultrasound imaging.

Full description

The main study measures included changes in pain intensity, pressure pain threshold, and sEMG activity. The supplementary study measures included ultrasound images and range of motion.

Enrollment: 65 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Participants over 18 years old with either active or latent myofascial trigger points in the trapezius muscle were diagnosed with MPS by a General Practitioner (GP).
• Participants have no history of chronic diseases (cancer, cervical nerve root compression, heart arrhythmias, including hyperthyroid, muscle weakness, seizure, skin infection at the upper back, spinal cord injury, stroke).
• Participants have ability to move the upper limbs.
• Participants reported no use of pacemakers or strong pain relievers, no allergies to metals, gels, or cleaning products, and no pre-existing severe muscle soreness.

Exclusion criteria

• Participants less 18 years old with no myofascial trigger points in the trapezius muscle.
• Participants to have history of chronic diseases (cancer, cervical nerve root compression, heart arrhythmias, including hyperthyroid, muscle weakness, seizure, skin infection at the upper back, spinal cord injury, stroke).
• Participants cannot move the upper limbs.
• Participants reported use of pacemakers or strong pain relievers, and allergies to metals, gels, or cleaning products, and pre-existing severe muscle soreness.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Triple Blind

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65 participants in 7 patient groups

Therapist-assisted Passive stretching (PS)

Active Comparator group

Description:

Passive Stretching with Therapist Assistance: The protocol consisted of three sets of stretching. Each set was performed for 10 seconds and followed by a 10-second break, totaling one minute for the single session.

Treatment:

Other: Therapist-assisted Passive stretching (PS)

The two-combination of EMS+AS

Experimental group

Description:

Electrical Muscle Stimulation (EMS) combined with Active Stretching (AS) was applied to the upper or middle trapezius muscle to facilitate muscle elongation. The protocol consisted of three sets of performing. Each set was performed for 10 seconds and followed by a 10-second break, totaling one minute for the single session.

Treatment:

Other: The two-combination of EMS+AS

Trigger point pressure release (TPR)

Active Comparator group

Description:

Trigger Point Pressure Release (TPR): TPR was directly applied to the MTP of upper or middle trapezius muscle.The protocol consisted of three sets of performing. Each set was performed for 10 seconds and followed by a 10-second break, totaling one minute for the single session.

Treatment:

Other: Trigger point pressure release (TPR)

Trigger point pressure release combined with active stretching (TPR+AS)

Other group

Description:

Trigger Point Pressure Release (TPR) combined with Active Stretching (AS) was performed either by using neck deviation for the upper trapezius muscle or by using scapula protraction for the middle trapezius muscle during TPR. The protocol consisted of three sets of performing. Each set was performed for 10 seconds and followed by a 10-second break, totaling one minute for the single session.

Treatment:

Other: Trigger point pressure release combined with active stretching (TPR+AS)

The triple combination therapy of EMS+AS+TPR

Experimental group

Description:

This triple combination therapy was applied to enhance MTP release in the upper or middle trapezius muscles. The protocol consisted of three sets of performing. Each set was performed for 10 seconds and followed by a 10-second break, totaling one minute for the single session.

Treatment:

Other: The triple combination therapy of EMS+AS+TPR

Transcutaneous electrical nerve stimulation (TENS)

Active Comparator group

Description:

Transcutaneous Electrical Nerve Stimulation (TENS) was applied on the upper or middle trapezius muscles without stretching. The protocol consisted of three sets of operating. Each set was performed for 10 seconds and followed by a 10-second break, totaling one minute for the single session.

Treatment:

Other: Transcutaneous electrical nerve stimulation (TENS)

Sham stimulation combined with active stretching (SS+AS)

Sham Comparator group

Description:

SS+AS consisted only of active stretching of the upper or middle trapezius muscle, with no electrical current applied from EMS device. Self-stretching was performed for three sets, with each 10-second stretch followed by a 10-second break, resulting in a total session time of one minute.

Treatment:

Other: Sham stimulation combined with active stretching (SS+AS)