Myoelectric Activity of Upper Trapezius Trigger Point

NCT04778462 | Completed DMC

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

Brief Summary

Myofascial trigger points are a muscular dysfunction at the level of the motor end-plate and the sarcoplasmic reticula that, in turn, cause a local contraction with ischemia -induced hypoxia. Along with the hypoxia, the resulting energy crisis leads to a sensation of the surrounding nociceptors . Extracorporeal shock wave therapy (ESWT) is recently considered an effective treatment for myofascial pain syndrome. It's been proved an effective in musculoskeletal disease fasciitis . It is significant since it is a non-invasive and simple treatment, easy to apply at a large surface, and has fewer side effects with low intensity even if it requires relatively high cost, ESWT has been proved to be more effective than conventional ultrasound on MTrPs in the upper trapezius muscle and showed that ESWT is more effective . It has been found that three sessions of ESWT significantly improved pain levels, neck disabilities, and the quality of life by reducing the number of MTrPs . ESWT could reduce the pain of myofascial pain syndrome by pain signal alteration, promoting angiogenesis and increasing perfusion in ischemic tissues induced by sensitization of nociceptors and muscle ischemia. Ultrasound with deep heat is used in treatment of myofascial trigger point due to the properties of achieving vasodilation, accelerating the metabolism, increasing viscoelasticity and reducing pain and muscle spasm High power pain threshold ultrasound found to be effective in many literatures in treatment of myofascial trigger point . Study was performed comparing effect of high power pain threshold ultrasound with conventional ultrasound proved that high power pain threshold is more effective in treating upper trapezius myofascial It was found in the treatment of MPS, HPPT US therapy could be considered as a reliable and more effective and has positive effect method than low-dose and conventional US therapies This study will be presented as a part of ongoing study. The ongoing study investigates the effect of different intensities of ultrasound on upper trapezius trigger points. The current study will investigate the myoelectric activities of trigger points after application of high power pain threshold ultrasound

Conditions

Trigger Point Pain, Myofascial

Outcome Measures

Primary Outcomes (3)

• surface electromyography

  change in electrical activity of Trigger points of upper trapezius using surface electromyography

  before treatment and after 2 weeks of treatment

• pressure algometer

  change in pressure pain threshold for upper trapezius trigger

  before treatment and 2 weeks after treatment

• Neck disability index

  change in the neck function scale contain 10 category each category contains six choices from zero to five ,score from zero to four no disability from five to fifteen this is mild,from fifteen to twenty-four this is moderate, from twenty-five to thirty-four this is severe

  before treatment and 2 weeks after treatment

Study Arms (3)

Extracorporeal shock wave

EXPERIMENTAL

Extracorporeal shock wave group A consist of 15 subject will receive extracorporeal shock wave and conventional treatment for trigger points for two weeks four treatment sessions

Device: extracorporeal shock wave and conventional treament

High-power pain thershold ultrasound

EXPERIMENTAL

High -power pain thershold group b consist of 15 subject will receive high power pain threshold ultrasound and conventional treatment for upper trapezius trigger points for two weeks four treatment session

Device: high pain threshold ultrasound and conventional treatment for myofascial pain syndrome trigger points

Controlled group

OTHER

controlled group consist of 15 subjects will receive conventional treatment for trigger point for two weeks

Other: conventional treatment for myofascial pain trigger point

Interventions

extracorporeal shock wave and conventional treament DEVICE

Extracorporeal shock wave for 700 impulses of 0.056 mJ/mm at a frequency of 10 Hz to the taut band and 300 impulses surrounding the taut band will be applied as low energy 2 sessions per week for 2 weeks The will be used as a radial type of shock wave therapy. Strengthening, stretching exercises and ischemic compression: 1. Isometric neck extensor exercise: 2. Isometric neck flexor exercise: 3. Isometric neck side bending muscle exercise: Stretching exercise: Passive stretching for the neck extensor muscles: Passive stretching of the neck side-bending muscles: Ischemic compression

Also known as: extracorporeal shock wave

Extracorporeal shock wave

high pain threshold ultrasound and conventional treatment for myofascial pain syndrome trigger points DEVICE

will be applied in continuous mode, with the probe placed directly on the TrP and held motionless. To elicit threshold pain, the US probe will be kept static on the TrP. Intensity gradually will be increased to the level of maximum pain the patient could bear. It will be kept at that level for 3 to 4 seconds, then will be reduced to the half-intensity level for another 15 seconds. This procedure was repeated 3 times.the intensity of US will be dependent on the patient's level of pain. intensity will be applied in the range of 0.5 to 2.0 Watt per/cm2. Patients continually report their pain level and its localization and nature High-power pain threshold US will be applied 4 times, with a 3-day interval 2 sessions per week for 2 weeks . 1)Isometric neck extensor exercise2)Isometric neck flexor exercise3)Isometric neck side bending muscle exercise,Stretching exercise:Passive stretching for the neck extensor muscles ,stretching of the neck side-bending muscles,Ischemic compression

Also known as: HPPT

High-power pain thershold ultrasound

conventional treatment for myofascial pain trigger point OTHER

Strengthening, stretching exercises and ischemic compression: 1. Isometric neck extensor exercise: 2. Isometric neck flexor exercise: 3. Isometric neck side bending muscle exercise: Stretching exercise: Passive stretching for the neck extensor muscles: Passive stretching of the neck side-bending muscles: Ischemic compression

Controlled group

Eligibility Criteria

• Age: 20 Years - 26 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Both genders will be included with their age between
• Symptoms of active TrPs unilateral on at least one side of the upper fiber of trapezius muscle presence of at least one trigger point symptoms lasting from 0 to 2 weeks age
• Subjects have pain at rest, local twitch response, jump sign, limited range of motion and referred pain lies over the lateral aspect of the upper trapezius fiber and superiorly to the ipsilateral occiput .

You may not qualify if:

• patients who had medication or other therapies for myofascial pain syndrome (Ji Hm et al., 2012) (2)
• patients who had neurological deficits involving the upper limbs, advance osteopathic or arthropathic disorders of the cervical spine or the shoulder of the investigated side
• contraindication of ESWT such as hypertension, coagulopathy, ulcer, recent severe hemorrhage, neoplasm, renal insufficiency, severe hepatic disease, epilepsy, cutaneous pathology, central pain, pregnancy and mental retardation
• The presence of previously diagnosed disease such as (diabetes mellitus, fibromyalgia, hormonal disorder hypothyroidism, hyperthyroidism and rheumatoid arthritis

Sponsors & Collaborators

• MTI University: lead

Study Sites (1)

Faculty of physical therapy modern University for technology and science

Cairo, 002, Egypt

Location

MeSH Terms

Conditions

Myofascial Pain Syndromes

Interventions

Extracorporeal Shockwave Therapy

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases

Intervention Hierarchy (Ancestors)

Ultrasonic Therapy; Diathermy; Hyperthermia, Induced; Therapeutics; Physical Therapy Modalities; Rehabilitation

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principle investigator

Model Details: 1. sixty subjects from both genders with their age between 20 and 26 years old 2. Symptoms of active TrPs unilateral on at least one side of the upper fiber of trapezius muscle presence of at least one trigger point symptoms lasting from 0 to 2 weeks age 3. The patients will be randomly assigned into three different groups Group (A) will receive extracorporeal shock wave plus stretch, strength exercise and ischemic compression Group (B) will receive high-power pain threshold ultrasound plus stretch, strength exercise and ischemic compression Group (C) will receive conventional treatment (stretch, strength exercise and ischemic compression.

Study Record Dates

• First Submitted: February 18, 2021
• First Posted: March 3, 2021
• Study Start: February 15, 2020
• Primary Completion: April 1, 2021
• Study Completion: April 14, 2021
• Last Updated: May 26, 2021

Record last verified: 2021-05

Locations

EG (1)