Muscle Energy Techniques and Trigger Point Therapy in Asymptomatic Persons With Latent Trigger Point

NCT04360668 | Completed

• 1 other identifier: PoznanUPhyEd
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

The main objective of this study is to evaluate the effectiveness of therapy which will be a combination of Muscle Energy Technique (MET) and Trigger Point Therapy (TPT), performed bilaterally on the upper trapezius muscle in the group of asymptomatic persons with latent trigger point. The study will show whether one-time therapy has an impact on: mobility of the cervical spine, biophysical parameters (muscle tone, stiffness and elasticity) of soft tissues and pressure pain threshold of upper trapezius muscle. An additional goal will be to compare the effectiveness of the three treatments used: combination of MET with TPT, single MET and single TPT. Research hypotheses:

• The combination of MET with TPT will increase the angular ranges of basic cervical spine movements immediately after the therapy and these effects will persist the second day after the intervention.
• The combination of MET with TPT will increase the elasticity and reduce muscle tone and stiffness in the area of the upper trapezius immediately after the therapy, and these effects will persist the second day after the intervention.
• The combination of MET with TPT will increase the pressure pain threshold of upper trapezius muscle immediately after the therapy, and this effect will persist the second day after the intervention.
• The combination of MET with TPT will be more effective than single MET and single TPT methods. Muscle Energy Techniques (MET) can be defined as a group of soft tissue manipulation methods. They are a multi-task techniques that can be performed to improve the function of the musculoskeletal system and reduce pain. METs are used by clinicians who treat various myofascial and joint dysfunctions as well as a form of prevention and protection of the musculoskeletal system. Trigger point therapy (TPT) uses manual techniques such as ischemic compression (IC), positional release (PR), dry needling and soft tissue manipulations \[TP1\]. Their main purpose is to reduce or eliminate the symptoms generated by myofascial trigger points (TrPs), which are defined as severely irritated areas within the hypertonic muscle fiber band or the fascia itself. Latent TrPs are described as those that do not generate symptoms on their own. However, they can cause refered pain at the time of provocation, i.e. pressure at the place of their occurrence. In the scientific literature there are no reports on the assessment of the combination of MET with TPT

Conditions

Asymptomatic Condition

Keywords

muscle energy techniques; trigger point therapy; range of motion; soft tissue properties; pressure pain threshold; combination of therapeutic methods

Outcome Measures

Primary Outcomes (42)

• Cervical Anterior Flexion before the intervention

  Electrogoniometric measurement of the angular range of motion immediately before the intervention.

  PRE (immediately before the intervention)

• Cervical Anterior Flexion after the intervention

  Electrogoniometric measurement of the angular range of motion immediately after the intervention.

  POST (immediately after the intervention)

• Cervical Anterior Flexion on the next day after the intervention

  Electrogoniometric measurement of the angular range of motion on the next day after the intervention.

  FOLLOW-UP (the next day after the intervention)

• Cervical Posterior Flexion before the intervention

  Electrogoniometric measurement of the angular range of motion immediately before the intervention.

  PRE (immediately before the intervention)

• Cervical Posterior Flexion after the intervention

  Electrogoniometric measurement of the angular range of motion immediately after the intervention.

  POST (immediately after the intervention)

• Cervical Posterior Flexion on the next day after the intervention

  Electrogoniometric measurement of the angular range of motion on the next day after the intervention.

  FOLLOW-UP (the next day after the intervention)

• Cervical Right Flexion before the intervention

  Electrogoniometric measurement of the angular range of motion immediately before the intervention.

  PRE (immediately before the intervention)

• Cervical Right Flexion after the intervention

  Electrogoniometric measurement of the angular range of motion immediately after the intervention.

  POST (immediately after the intervention)

• Cervical Right Flexion on the next day after the intervention

  Electrogoniometric measurement of the angular range of motion on the next day after the intervention.

  FOLLOW-UP (the next day after the intervention)

• Cervical Left Flexion before the intervention

  Electrogoniometric measurement of the angular range of motion immediately before the intervention.

  PRE (immediately before the intervention)

• Cervical Left Flexion after the intervention

  Electrogoniometric measurement of the angular range of motion immediately after the intervention.

  POST (immediately after the intervention)

• Cervical Left Flexion on the next day after the intervention

  Electrogoniometric measurement of the angular range of motion on the next day after the intervention.

  FOLLOW-UP (the next day after the intervention)

• Cervical Right Rotation before the intervention

  Electrogoniometric measurement of the angular range of motion immediately before the intervention.

  PRE (immediately before the intervention)

• Cervical Right Rotation after the intervention

  Electrogoniometric measurement of the angular range of motion immediately after the intervention.

  POST (immediately after the intervention)

• Cervical Right Rotation on the next day after the intervention

  Electrogoniometric measurement of the angular range of motion on the next day after the intervention.

  FOLLOW-UP (the next day after the intervention)

• Cervical Left Rotation before the intervention

  Electrogoniometric measurement of the angular range of motion immediately before the intervention.

  PRE (immediately before the intervention)

• Cervical Left Rotation after the intervention

  Electrogoniometric measurement of the angular range of motion immediately after the intervention.

  POST (immediately after the intervention)

• Cervical Left Rotation on the next day after the intervention

  Electrogoniometric measurement of the angular range of motion on the next day after the intervention.

  FOLLOW-UP (the next day after the intervention)

• Stiffness (S) of the upper right trapezius muscle before the intervention

  Myotonometric examination of soft tissue properties immediately before the intervention.

  PRE (immediately before the intervention)

• Stiffness (S) of the upper right trapezius muscle after the intervention

  Myotonometric examination of soft tissue properties immediately after the intervention.

  POST (immediately after the intervention)

• Stiffness (S) of the upper right trapezius muscle on the next day after the intervention

  Myotonometric examination of soft tissue properties on the next day after the intervention.

  FOLLOW-UP (the next day after the intervention)

• Stiffness (S) of the upper left trapezius muscle before the intervention

  Myotonometric examination of soft tissue properties immediately before the intervention.

  PRE (immediately before the intervention)

• Stiffness (S) of the upper left trapezius muscle after the intervention

  Myotonometric examination of soft tissue properties immediately after the intervention.

  POST (immediately after the intervention)

• Stiffness (S) of the upper left trapezius muscle on the next day after the intervention

  Myotonometric examination of soft tissue properties on the next day after the intervention.

  FOLLOW-UP (the next day after the intervention)

• Elasticity (D) of the upper right trapezius muscle muscle before the intervention

  Myotonometric examination of soft tissue properties immediately before the intervention.

  PRE (immediately before the intervention)

• Elasticity (D) of the upper right trapezius muscle after the intervention

  Myotonometric examination of soft tissue properties immediately after the intervention.

  POST (immediately after the intervention)

• Elasticity (D) of the upper right trapezius muscle on the next day after the intervention

  Myotonometric examination of soft tissue properties on the next day after the intervention.

  FOLLOW-UP (the next day after the intervention)

• Elasticity (D) of the upper left trapezius muscle before the intervention

  Myotonometric examination of soft tissue properties immediately before the intervention.

  PRE (immediately before the intervention)

• Elasticity (D) of the upper left trapezius muscle after the intervention

  Myotonometric examination of soft tissue properties immediately after the intervention.

  POST (immediately after the intervention)

• Elasticity (D) of the upper left trapezius muscle on the next day after the intervention

  Myotonometric examination of soft tissue properties on the next day after the intervention.

  FOLLOW-UP (the next day after the intervention)

• Muscle tone (F) of the upper right trapezius muscle before the intervention

  Myotonometric examination of soft tissue properties immediately before the intervention.

  PRE (immediately before the intervention)

• Muscle tone (F) of the upper right trapezius muscle after the intervention

  Myotonometric examination of soft tissue properties immediately after the intervention.

  POST (immediately after the intervention)

• Muscle tone (F) of the upper right trapezius muscle on the next day after the intervention

  Myotonometric examination of soft tissue properties on the next day after the intervention.

  FOLLOW-UP (the next day after the intervention)

• Muscle tone (F) of the upper left trapezius muscle before the intervention

  Myotonometric examination of soft tissue properties immediately before the intervention.

  PRE (immediately before the intervention)

• Muscle tone (F) of the upper left trapezius muscle after the intervention

  Myotonometric examination of soft tissue properties immediately after the intervention.

  POST (immediately after the intervention)

• Muscle tone (F) of the upper left trapezius muscle on the next day after the intervention

  Myotonometric examination of soft tissue properties on the next day after the intervention.

  FOLLOW-UP (the next day after the intervention)

• Pressure pain threshold (PPT) of the upper right trapezius muscle before the intervention

  Examination of the first discomfort threshold using an algometer immediately before the intervention.

  PRE (immediately before the intervention)

• Pressure pain threshold (PPT) of the upper right trapezius muscle after the intervention

  Examination of the first discomfort threshold using an algometer immediately after the intervention.

  POST (immediately after the intervention)

• Pressure pain threshold (PPT) of the upper right trapezius muscle on the next day after the intervention

  Examination of the first discomfort threshold using an algometer on the next day after the intervention.

  FOLLOW-UP (the next day after the intervention)

• Pressure pain threshold (PPT) of the upper left trapezius muscle before the intervention

  Examination of the first discomfort threshold using an algometer immediately before the intervention.

  PRE (immediately before the intervention)

• Pressure pain threshold (PPT) of the upper left trapezius muscle after the intervention

  Examination of the first discomfort threshold using an algometer immediately after the intervention.

  POST (immediately after the intervention)

• Pressure pain threshold (PPT) of the upper left trapezius muscle on the next day after the intervention

  Examination of the first discomfort threshold using an algometer on the next day after the intervention.

  FOLLOW-UP (the next day after the intervention)

Study Arms (3)

Muscle Energy Technique combined with Trigger Point Therapy

EXPERIMENTAL

For this group of participants, combined therapy (Muscle Energy Technique with Trigger Point Therapy) will be used

Other: Muscle Energy Technique (MET) combined with Trigger Point Therapy (TPT)

Muscle Energy Technique

ACTIVE COMPARATOR

For this group of participants, a single method (Muscle Energy Technique) will be used

Other: Muscle Energy Technique (MET)

Trigger Point Therapy

ACTIVE COMPARATOR

For this group of participants, a single method (Trigger Point Therapy) will be used

Other: Trigger Point Therapy (TPT)

Interventions

Muscle Energy Technique (MET) OTHER

The Contract-Relax Agonist-Contract (CRAC) technique will be used, which belongs to the broad MET group. The participant will be in the supine position. The therapist will set the cervical segment in the lateral flexion until a slight soft tissue tension is felt. The technique will consist of two stages. In the first phase (contraction phase), the upper trapezius will be activated against the therapist's resistance (shoulder girdle elevation) - 10 seconds. Then the person undergoing the procedure breathes in and out deeply. Then 10 seconds of antagonist group contraction (shoulder girdle depression) will be performed. Next, the therapist will passively move the participant's shoulder girdle towards the depression. Then the second phase will follow (stretching phase), during which the participant will passively lie in the back position for 30 seconds. Both phases will make up the therapeutic cycle. Each participant will have 5 cycles on each side of the upper trapezius.

Muscle Energy Technique

Trigger Point Therapy (TPT) OTHER

The technique of Positional Release (PR) will be used, which is one of the broadly understood Trigger Point Therapy. It will consist in compressing the trigger point with a simultaneous shortening of muscle attachments (slight lateral flexion towards the relaxed muscle). The muscle on both sides will be treated. The pressure exerted by the therapist's pincer grip will be acceptable to the patient. The duration of the technique will be 2 minutes for each muscle. While performing this technique, the participant will passively lie on his back.

Trigger Point Therapy

Muscle Energy Technique (MET) combined with Trigger Point Therapy (TPT) OTHER

For this type of intervention, TPT will first be performed on both sides of the upper trapezius muscle, followed by MET, which will also be performed bilaterally. The detailed method of performing the applied therapeutic techniques for the combined procedure will be identical as in the case of isolated (single) methods.

Muscle Energy Technique combined with Trigger Point Therapy

Eligibility Criteria

• Age: 19 Years - 21 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• right-handed people
• amateur practicing symmetrical sports (eg. swimming, running, cycling, gym, roller skates)
• asymptomatic subjects (without pain symptoms of the cervical spine and shoulder girdle)
• occurrence of latent trigger point of the upper trapezius muscle

You may not qualify if:

• age above 21 years
• no latent trigger point on the upper trapezius muscle
• pain in the cervical spine or shoulder girdle
• any neurological symptoms in the upper limb
• previous operations in the cervical spine or shoulder girdle
• practicing asymmetrical sports
• professional sports

Sponsors & Collaborators

• Poznan University of Physical Education: lead

Study Sites (1)

Poznan University of Physical Education, Department of Biology and Anatomy, Department of Motor Organ Rehabilitation

Poznan, Wielkopolska, 61-871, Poland

Location

Related Publications (20)

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• Munoz-Munoz S, Munoz-Garcia MT, Alburquerque-Sendin F, Arroyo-Morales M, Fernandez-de-las-Penas C. Myofascial trigger points, pain, disability, and sleep quality in individuals with mechanical neck pain. J Manipulative Physiol Ther. 2012 Oct;35(8):608-13. doi: 10.1016/j.jmpt.2012.09.003.

  PMID: 23158466 RESULT

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  PMID: 23993756 RESULT

• Yoo WG. Comparison of the Symmetry of Right and Left Lateral Cervical Flexion and Rotation and the Cervical FRR in Young Computer Workers. J Phys Ther Sci. 2014 May;26(5):783-4. doi: 10.1589/jpts.26.783. Epub 2014 May 29.

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• Yeganeh Lari A, Okhovatian F, Naimi Ss, Baghban AA. The effect of the combination of dry needling and MET on latent trigger point upper trapezius in females. Man Ther. 2016 Feb;21:204-9. doi: 10.1016/j.math.2015.08.004. Epub 2015 Aug 14.

  PMID: 26304789 RESULT

• Sadria G, Hosseini M, Rezasoltani A, Akbarzadeh Bagheban A, Davari A, Seifolahi A. A comparison of the effect of the active release and muscle energy techniques on the latent trigger points of the upper trapezius. J Bodyw Mov Ther. 2017 Oct;21(4):920-925. doi: 10.1016/j.jbmt.2016.10.005. Epub 2016 Oct 21.

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MeSH Terms

Conditions

Asymptomatic Diseases

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Michał Wendt, PhD

  Poznan University of Physical Education

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Participants will not know which research group they will belong to. Each participant will draw a number that will be specific to the given research group. The investigator will also not know which group the participant belongs to (he will only use the participant's number). The outcomes assessor will not know which group is experimental and which are active comparators (they will be marked numerically instead of using a name). The correct course of the study will be supervised by a person who acts as a coordinator.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD

Model Details: The first stage will involve recruitment. 60 people will be gathered based on the qualifying and disqualifying criteria. This group of participants will be randomized. Each participant will draw a number that will determine the assignment to a specific group (MET plus TPT group, single MET or single TPT group). Preliminary measurements will be collected before the intervention. Each participant will have a specific intervention depending on which research group they belong to. The therapist will be responsible for performing the given therapeutic technique. Immediately after the intervention and on the second day, data will be collected by the researcher. The person conducting the function of coordinator will supervise the proper conduct of the scientific research. The collected data will be analyzed by the outcomes assessor.

Study Record Dates

• First Submitted: April 18, 2020
• First Posted: April 24, 2020
• Study Start: April 29, 2020
• Primary Completion: May 12, 2020
• Study Completion: May 12, 2020
• Last Updated: May 14, 2020

Record last verified: 2020-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: Data will be available from June 2020.
• Access Criteria: Available to all researchers

Locations

PL (1)