Dry Needling Versus Graston Technique in Active Myofascial Trigger Points on Upper Trapezius

NCT03946995 | Completed DMC

• 1 other identifier: RiphahIU Kiran Haq
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

This study will compare the effects dry needling and Graston technique in active myofascial trigger points on upper trapezius. Half of the study participants will receive dry needling whereas other half will receive Graston technique.

Conditions

Trigger Points

Keywords

Trigger Area; Myofascial Pain Syndromes; Instrument assisted soft tissue tecnique

Outcome Measures

Primary Outcomes (6)

• Numeric Pain Rating Scale (NPRS)

  Numeric Pain Rating Scale (NPRS) is used to assess pain. It scores ranges from 0-10, 0 means No pain and 10 means Severe pain. Patient will be asked to verbally report the pain score.

  Baseline

• Numeric Pain Rating Scale (NPRS)

  Numeric Pain Rating Scale (NPRS) is used to assess pain. It scores ranges from 0-10, 0 means No pain and 10 means Severe pain. Patient will be asked to verbally report the pain score.

  Post 2nd week

• cervical range of motion (CROM)

  A cervical range of motion (CROM) inclinometer will be use to assess cervical range of motion in flexion, extension, left right lateral flexion and left-right rotation. Participants will be seated upright and asked to actively move their neck in each direction.

  Baseline

• cervical range of motion (CROM)

  A cervical range of motion (CROM) inclinometer will be use to assess cervical range of motion in flexion, extension, left right lateral flexion and left-right rotation. Participants will be seated upright and asked to actively move their neck in each direction.

  Post 2nd week

• Myofascial Diagnostic Scale (MDS)

  It is a scale using the signs of a Myofascial trigger point as indicators to assess the extent to which the patient suffers from Myofascial Pain Syndrome. The signs include: referred pain in the zone of reference, local twitch response, palpable taut band, and focal or spot tenderness. Spot tenderness or soft tissue tenderness consisted of five grades or indicators: grade 0 - no tenderness = 0, grade 1 - tenderness to palpation without grimace or flinch = 1, grade 2 - tenderness with grimace and/or flinch to palpation = 2, grade 3 - tenderness with withdrawal = 3, grade 4 - withdrawal to non-noxious stimuli = 4. The presence of a local twitch response and the presence of a palpable taut band were indicated by a score of 4 on the scale. The presence of referred pain was indicated by a score of 5. A total score of 9 or more was indicative of active trigger points.

  Baseline

• Myofascial Diagnostic Scale (MDS)

  It is a scale using the signs of a Myofascial trigger point as indicators to assess the extent to which the patient suffers from Myofascial Pain Syndrome. The signs include: referred pain in the zone of reference, local twitch response, palpable taut band, and focal or spot tenderness. Spot tenderness or soft tissue tenderness consisted of five grades or indicators: grade 0 - no tenderness = 0, grade 1 - tenderness to palpation without grimace or flinch = 1, grade 2 - tenderness with grimace and/or flinch to palpation = 2, grade 3 - tenderness with withdrawal = 3, grade 4 - withdrawal to non-noxious stimuli = 4. The presence of a local twitch response and the presence of a palpable taut band were indicated by a score of 4 on the scale. The presence of referred pain was indicated by a score of 5. A total score of 9 or more was indicative of active trigger points.

  Post 2nd Week

Secondary Outcomes (2)

• Neck Disability Index (NDI)

  Baseline

• Neck Disability Index (NDI)

  Post 2nd week

Study Arms (2)

Dry needling

EXPERIMENTAL

Dry needling will be applied on active myofascial trigger points in upper trapezius along with conservative physical therapy management.

Other: Dry Needling Group

Graston

ACTIVE COMPARATOR

Graston Technique will be applied on active myofascial trigger points in upper trapezius along with conservative physical therapy management.

Other: Graston Technique Group

Interventions

Dry Needling Group OTHER

Hot Pack will be applied on upper trapezius muscles before session for general relaxation for 7-10 minutes. Generalized Stretching and strengthening neck exercises will be performed. Then after wearing gloves and appropriate personal protective measures, a thin filiform needle will be inserted which will penetrate into the skin and stimulate underlying myofascial trigger points. The treatment will be continued for 2 weeks with 2 sessions per week.

Dry needling

Graston Technique Group OTHER

Hot Pack will be applied on upper trapezius muscles before session for general relaxation for 7-10 minutes. Generalized Stretching and strengthening neck exercises will be performed. Later, lubricant will be applied to the skin, and Graston technique will be applied using instrument over the active myofascial trigger points in upper trapezius. The treatment will be continued for 2 weeks with 2 sessions per week.

Graston

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Patient with non-specific pain in neck (acute and sub-acute)
• Age: 20-40 years
• Patient agrees to use the dry needling or Graston exclusively

You may not qualify if:

• Patients that were using any medication to reduce the pain and/or have any effect in the skeleton muscle.
• Patient taking other treatment in the same period of research.
• Patients having malignancy, tuberculosis, spinal cord injury, neurodegenerative diseases radiculopathies and hematoma.
• Patients on anticoagulants.
• Patient with chronic neck pain.

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Rawal General and Dental Hospital,

Islamabad, 44000, Pakistan

Location

Related Publications (4)

• Gerber LH, Shah J, Rosenberger W, Armstrong K, Turo D, Otto P, Heimur J, Thaker N, Sikdar S. Dry Needling Alters Trigger Points in the Upper Trapezius Muscle and Reduces Pain in Subjects With Chronic Myofascial Pain. PM R. 2015 Jul;7(7):711-718. doi: 10.1016/j.pmrj.2015.01.020. Epub 2015 Feb 4.

  PMID: 25661462 BACKGROUND

• Dunning J, Butts R, Mourad F, Young I, Flannagan S, Perreault T. Dry needling: a literature review with implications for clinical practice guidelines. Phys Ther Rev. 2014 Aug;19(4):252-265. doi: 10.1179/108331913X13844245102034.

  PMID: 25143704 BACKGROUND

• Wang G, Gao Q, Hou J, Li J. Effects of Temperature on Chronic Trapezius Myofascial Pain Syndrome during Dry Needling Therapy. Evid Based Complement Alternat Med. 2014;2014:638268. doi: 10.1155/2014/638268. Epub 2014 Oct 14.

  PMID: 25383083 BACKGROUND

• Gattie ER, Cleland JA, Snodgrass SJ. Dry Needling for Patients With Neck Pain: Protocol of a Randomized Clinical Trial. JMIR Res Protoc. 2017 Nov 22;6(11):e227. doi: 10.2196/resprot.7980.

  PMID: 29167092 BACKGROUND

MeSH Terms

Conditions

Myofascial Pain Syndromes

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases

Study Officials

• Huma Riaz

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: This is a single blinded randomized controlled trial in which patients will be randomized into groups by sealed envelope method.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: There will be two treatment groups of participants, One group will receive Dry Needling whereas other will receive Graston technique for treatment of Myofascial Trigger points.

Study Record Dates

• First Submitted: May 9, 2019
• First Posted: May 13, 2019
• Study Start: March 19, 2019
• Primary Completion: June 30, 2019
• Study Completion: June 30, 2019
• Last Updated: August 9, 2019

Record last verified: 2019-08

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)