Short and Medium-term Effects of Manual Therapy on Latent Myofascial Pain

Escola Superior de Tecnologia da Saúde do Porto

Status: Completed

Conditions: Latent Myofascial Trigger Point of Upper Trapezius Muscle

Treatments: Other: Ischemic compression technique; Other: Sham technique; Other: Passive stretching technique; Other: Muscle energy technique

Study type: Interventional

Funder types: Other

Identifiers

NCT01709357

NC-001

Details and patient eligibility

About

The purpose of this study was to investigate the short and medium-term effects of three manual techniques on cervical range of motion and pressure pain sensitivity in subjects with mechanical stress, presenting latent trigger point of upper trapezius muscle.

Full description

Myofascial pain syndrome is a common non-articular musculoskeletal chronic pain which has not been yet fully understood. It is characterized by myofascial trigger point. This trigger point is clinically classified as active or latent. Some studies have demonstrated the potential relevance of latent trigger point. In fact, its presence may cause muscle activation pattern alterations, increase nociceptive sensitivity and cause sympathetic activity alterations. Nevertheless, the vast majority of individuals, even asymptomatic, have latent trigger point. High prevalence of myofascial trigger points subsists at cervical and scapular regions.

There is few data regarding myofascial trigger point physiopathology. Furthermore, a diversity of therapeutic interventions consisting of trigger point inactivation and interruption of the vicious cycle is suggested in literature. Nevertheless, the effectiveness of these different interventions in trigger points and the duration of the effects are not yet fully clarified.

Enrollment: 117 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• volunteers with 18 or more years of age
• with a palpable latent trigger point in the fibbers of the upper trapezius muscle
• with an average time of computer work of at least 2h/day.

Exclusion criteria

• with a body mass index (BMI) equal or higher than 31 kg/cm2
• with bilateral latent triggers in the fibers of the upper trapezius muscle
• have done any pharmacological therapeutic during any of the 7 days before the study or anti-coagulant therapeutics
• have done any treatment at cervical region during the month before the study
• having cardio-respiratory, neurological, neuro-musculoskeletal, oncologic or systemic pathologies
• having cognitive deficits or psychologic/psychiatric disturbances
• be pregnant
• having a clinical history of cervical, high dorsal, shoulder or cranial surgery or trauma during the prior 12 months.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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117 participants in 5 patient groups

Muscle energy technique

Experimental group

Description:

In each volunteer, the therapist identified the latent trigger point on the upper trapezius. A questionnaire about general information was performed. And the maximum homolateral side flexion of the trigger point was measured. On the following week, the blind assessor performed the pre-intervention measurements of pressure pain threshold, pressure pain perception and cervical range of motions. Next, the therapist performed the muscle energy technique of the upper trapezius muscle. Then, all measurements, before described, were repeated, by the assessor, after 10 minutes, 24 hours and one week.

Treatment:

Other: Muscle energy technique

Ischemic compression technique

Experimental group

Description:

In each volunteer, the therapist identified the latent trigger point on the upper trapezius. A questionnaire about general information was performed. And the maximum homolateral side flexion of the trigger point was measured. On the following week, the blind assessor performed the pre-intervention measurements of pressure pain threshold, pressure pain perception and cervical range of motions. Next, the therapist performed ischemic compression technique on the latent trigger point. Then, all measurements, before described, were repeated, by the assessor, after 10 minutes, 24 hours and one week.

Treatment:

Other: Ischemic compression technique

Passive stretching technique

Experimental group

Description:

In each volunteer, the therapist identified the latent trigger point on the upper trapezius. A questionnaire about general information was performed. And the maximum homolateral side flexion of the trigger point was measured. On the following week, the blind assessor performed the pre-intervention measurements of pressure pain threshold, pressure pain perception and cervical range of motions. Next, the therapist performed the passive stretching of the upper trapezius muscle. Then, all measurements, before described, were repeated, by the assessor, after 10 minutes, 24 hours and one week.

Treatment:

Other: Passive stretching technique

Sham technique

Sham Comparator group

Description:

In each volunteer, the therapist identified the latent trigger point on the upper trapezius. A questionnaire about general information was performed. And the maximum homolateral side flexion of the trigger point was measured. On the following week, the blind assessor performed the pre-intervention measurements of pressure pain threshold, pressure pain perception and cervical range of motions. Next, for the sham technique, the therapist only contacted with his hands the head and the shoulder of the subject, without executing any movement, for 30 seconds. Then, all measurements, before described, were repeated, by the assessor, after 10 minutes, 24 hours and one week.

Treatment:

Other: Sham technique

No intervention group

No Intervention group

Description:

In each volunteer, the therapist identified the latent trigger point on the upper trapezius. A questionnaire about general information was performed. And the maximum homolateral side flexion of the trigger point was measured. On the following week, the blind assessor performed the pre-intervention measurements of pressure pain threshold, pressure pain perception and cervical range of motions. Next,the subject was lying for 30 seconds, without intervention. Then, all measurements, before described, were repeated, by the assessor, after 10 minutes, 24 hours and one week.