Comparison of IMES Versus DN on ATrPs of AC

NCT06302829 | Completed

• 1 other identifier: RiphahIU Shafia Anjum
• Study Type: interventional
• Target: 44
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of our study to compare DN and IMES for pressure pain threshold, ROM and the shoulder function in active trigger points with adhesive capsulitis. This study will add to the growing body of knowledge that if these two techniques yield comparable outcomes and if one technique is superior to the other, which should be the alternative of therapy. Moreover, it would add to the society as there are very limited researches done in Pakistan using needling for trigger points in adhesive capsulitis.

Conditions

Shoulder Pain

Keywords

trigger points; range of motion; dry needling; disability

Outcome Measures

Primary Outcomes (1)

• Algometer (pressure pain threshold)

  This tool can be used to assess the participant pressure pain at baseline ,2nd week,3rd week post assessment. Pressure pain threshold is measured at active trigger point at subscapularis, deltoid (ant, middle, post), latissimus dorsi, teres minor, supraspinatus. The PPT are measured by mean and standard deviation kg\\cm2

  3rd week

Secondary Outcomes (5)

• ROM Shoulder (Flexion)

  3rd week

• ROM Shoulder (Abduction)

  3rd week

• ROM Shoulder (External rotation)

  3rd week

• ROM Shoulder (Internal Rotation)

  3rd week

• American shoulder and elbow surgeons scale

  3rd week

Study Arms (2)

Intramuscular Electrical stimulation

EXPERIMENTAL

Myofascial trigger point would be targeted by direct intramuscular electrical stimulation by using direct electrode placement method, where anode pole and the cathode pole of the stimulator connected to the needles of the MTrPs of the shoulder girdle muscles using the alligator clip connector in which both electrodes are on the muscle belly in which anode pole at proximal end and cathode pole at the distal end along the musculotendinous junction. The special programmed comfy stim (a double channeled multipurpose electrical stimulator) was used to deliver electrical impulses with following parameters; pulse duration 80µs, frequency 100HZ, and time duration for 10 min

Other: intramusuar electrical stimulation

Dry Needling

ACTIVE COMPARATOR

DN for the MTrPs will be performed over the identified trigger points locations at a suitable angle. The needles of suitable length and thickness (30-mm), depending on the depth of the MTrPs location inserted into the shoulder girdle muscles to deactivate the active MTrPs. Subsequently, the inserted needles moved to-and-fro direction to elicit the local twitch responses, which further reaffirms the ideal placement of needle into the MTrPs. After the twitch response obtained, the dry needles were kept within the muscles approximately for 10 minutes. Dry needling was performed subscapularis, latissimus dorsi, supraspinatus, deltoid, teres minor.

Other: Dry needling

Interventions

Dry needling OTHER

AROM 10 repetitions ×2 set×30 sec ,6days\\week, Shoulder strengthening exercises: Isometric pain free (elastic Thera-band) 10 repetitions ×2 set×30 sec ,6days\\week, Maitland mobilization grade 3 and 4 10 repetitions ×2 set×30 sec ,6days\\week Total of 6 session were given each consisting of 30min

Also known as: conventional treatment

Dry Needling

intramusuar electrical stimulation OTHER

Myofascial trigger point would be targeted by direct intramuscular electrical stimulation by using direct electrode placement method, where anode pole and the cathode pole of the stimulator connected to the needles of the MTrPs of the shoulder girdle muscles .AROM 10 repetitions ×2 set×30 sec ,6days\\week, Shoulder strengthening exercises: Isometric pain free (elastic Thera-band) 10 repetitions ×2 set×30 sec ,6days\\week, Maitland mobilization grade 3 and 4 10 repetitions ×2 set×30 sec ,6days\\week Total of 6 session were given each consisting of 30 min

Also known as: conventional treatment

Intramuscular Electrical stimulation

Eligibility Criteria

• Age: 40 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age 40 to 60 year of both genders
• Diagnosed patients of stage 3 Adhesive capsulitis with type I and II diabetes
• Involvement of at least 3 shoulder girdle muscles in Active MTrPs (subscapularis, latissimus dorsi, deltoid (anterior, middle, posterior)
• Active MTrPs in shoulder girdle muscles (subscapularis, supraspinatus, deltoid (anterior, middle, posterior), teres minor, latissimus dorsi)
• Reproduction of the patient's symptoms at active trigger point, Taut band, Hypersensitive spot, Referred pain pattern, local twitch response
• Minimum 60 degrees of active/passive shoulder abduction range of movement.

You may not qualify if:

• Systemic inflammatory joint disease of shoulder joint (RA, OA polymyalgia rheumatic)
• Cerebral Vascular Accident
• Fibromyalgia, neurological deficits of upper limb (Nerve root entrapment, Cervical radiculopathy, Thoracic outlet syndrome)
• History of Fracture, Dislocation, Acute soft tissue injury, Acute bursitis
• Avascular necrosis of humeral head or visceral referred pain to shoulder
• Pregnancy, Hypothyroidism, skin infection
• Patients who are using Antiplatelet Therapy with in past 3 days of study
• Extreme fear of needles

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Railway general hopsital

Rawalpindi, Punjab Province, 46000, Pakistan

Location

MeSH Terms

Conditions

Shoulder Pain

Interventions

Dry Needling

Condition Hierarchy (Ancestors)

Arthralgia; Joint Diseases; Musculoskeletal Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Complementary Therapies; Therapeutics; Physical Therapy Modalities

Study Officials

• Aneela zia, MS-OMPT

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: randomized
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 4, 2024
• First Posted: March 12, 2024
• Study Start: January 21, 2024
• Primary Completion: July 30, 2024
• Study Completion: July 30, 2024
• Last Updated: January 30, 2025

Record last verified: 2025-01

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)