Comparison of Integrated Neuromuscular Inhibition Technique (INIT) and Active Release Technique (ART) in Patients With Upper Trapezius Trigger Points

NCT07395154 | Not Yet Recruiting DMC

• 1 other identifier: UBAS/ERB/FoRS/25/023
• Study Type: interventional
• Target: 64
• Locations: 0 countries
• Sites: N/A

Brief Summary

The goal of this clinical trial is to determine whether two manual therapy techniques-Integrated Neuromuscular Inhibition Technique (INIT) and Active Release Technique (ART)-can reduce pain, improve neck range of motion, and decrease functional disability in adults with upper trapezius myofascial trigger points. The main questions it aims to answer are: Does INIT reduce pain, improve ROM, and reduce functional disability more effectively than ART? Does ART provide similar or different treatment benefits compared to INIT? Researchers will compare INIT with ART to see which technique produces greater improvements in pain, ROM, and functional disability. Participants will: Receive treatment sessions of either INIT or ART. Undergo assessment of pain, cervical range of motion, and functional disability before and after the intervention.

Conditions

Myofascial Pain Syndrome

Keywords

Integrated Neuromuscular Inhibition Technique; Active Release Technique; Muscle Energy Technique; Ischemic Compression

Outcome Measures

Primary Outcomes (3)

• Goniometer (Range of Motion)

  The Universal Goniometer (UG) will be used to assess Active Cervical Range of Motion (ACROM) in multiple planes. This reliable tool allows physical therapists to measure joint angles accurately, both with and without assistance. In this study, it will be employed to evaluate cervical spine movement as an objective outcome measure of participants' range of motion.

  Assessment at baseline, after 3rd and 6th weeks.

• Numeric Pain Rating Scale (NPRS)

  The NPRS questionnaire is composed of an 11-point scale from 0 to 10. The patient chooses the most compatible value for the force of pain they have experienced in the last 24 h, with "0" meaning no pain and "10" meaning intense pain. The patient has to mark the score on the questionnaire according to the pain intensity he/she is experiencing.

  Assessment at baseline, after 3rd and 6th weeks.

• Neck Disability Index (NDI)

  The Neck Disability Index (NDI) is a ten-item questionnaire that assesses disability associated with neck pain and whiplash. There are four items that relate to subjective symptomatology (pain intensity, headache, concentration, and sleeping) and six items that relate to activities of daily living (lifting, work, driving, recreation, personal care, and reading). The questionnaire requires only 5-10 minutes to complete and score, and requires no special training to administer.

  Assessment at baseline, after 3rd and 6th weeks.

Study Arms (2)

Group A

EXPERIMENTAL

Integrated Neuromuscular Inhibition Technique

Other: Group A

Group B

EXPERIMENTAL

Active Release Technique

Other: Group B

Interventions

Group A OTHER

Participants will receive treatment three times per week for 6 weeks. Each session will begin with a moist hot pack for 10 minutes followed by TENS for 15 minutes to relax the muscles and reduce pain. After this preparation, participants will receive 15 minutes of Integrated Neuromuscular Inhibition Technique, including ischemic compression, strain-counterstrain, and muscle energy technique, applied to the identified myofascial trigger points.

Also known as: Integrated Neuromuscular Inhibition Technique

Group A

Group B OTHER

Participants will receive treatment three times per week for 6 weeks. Each session will begin with a moist hot pack for 10 minutes and TENS for 15 minutes to prepare the tissues. This will be followed by 15 minutes of Active Release Technique, including repeated active passes, targeted fiber release, and mild stretching, applied to the upper trapezius myofascial trigger points.

Also known as: Active Release Technique

Group B

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Presence of active trigger points in the upper trapezius muscle.
• Forward Head Posture (measured by craniovertebral angle).
• Pain duration less than 3 months.

You may not qualify if:

• History of trauma or surgery involving the cervical spine or shoulder
• Neurological disorders (e.g., cervical radiculopathy)
• Systemic conditions like diabetes or rheumatoid arthritis
• Use of corticosteroids
• Fibromyalgia, Thoracic Outlet Syndrome, Temporomandibular Joint Disorders

Sponsors & Collaborators

• Lahore University of Biological and Applied Sciences: lead

Related Publications (2)

• Sadria G, Hosseini M, Rezasoltani A, Bagheban AA, Davari A, Seifolahi AJJob, et al. A comparison of the effect of the active release and muscle energy techniques on the latent trigger points of the upper trapezius. 2017;21(4):920-5.

  BACKGROUND

• Nayak PP. A Study to Find Out the Efficacy of Init (Integrated Neuromuscular Inhibition Technique) with Therapeutic Ultrasound Vs Init with Placebo Ultrasound in the Treatment of Acute Myofascial Trigger Point in Upper Trapezius: Rajiv Gandhi University of Health Sciences (India); 2013.

  BACKGROUND

Related Links

• Related Info

MeSH Terms

Conditions

Myofascial Pain Syndromes

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases

Central Study Contacts

Mehwish Khalid Khalid, MSPT women health

CONTACT

+923324302282; mehwish.khalid@ubas.edu.pk

Maria Akbar Akbar, MSPT

CONTACT

03038243181; mariaakbar61@gmail.com

Study Design

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

Study Record Dates

• First Submitted: December 1, 2025
• First Posted: February 9, 2026
• Study Start: February 15, 2026
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): June 30, 2026
• Last Updated: February 9, 2026

Record last verified: 2026-02