Effect of Integrated Neuromuscular Inhibition Technique on Hand Grip Strength in Upper Trapezius Myofascial Trigger Points

NCT07591259 | Not Yet Recruiting

• 1 other identifier: P.T.REC/012/006407
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to investigate the effects of the integrated neuromuscular inhibition technique on patients with upper trapezius myofascial trigger points by evaluating its impact on neck pain intensity, pressure pain threshold, hand grip strength, pinch grip strength, wrist joint range of motion, and upper extremity function.

Conditions

Myofascial Trigger Point Pain

Outcome Measures

Primary Outcomes (3)

• Hand Grip Strength assessment

  Hand grip strength will be assessed using a Baseline Digital Hand Dynamometer following the standardized guidelines of the American Society of Hand Therapists (ASHT). Participants will be seated comfortably with back support, shoulders abducted, elbows flexed to 90°, and forearms and wrists maintained in a neutral position. The contralateral hand will rest on the thigh during testing. Participants will be instructed to grip the dynamometer maximally for approximately 3 seconds after one practice trial for each hand. Grip strength values will be recorded in kilograms using the same device throughout the study.

  4 weeks

• Pinch Grip Strength assessment

  Pinch grip strength will be assessed using a Baseline Digital Pinch Dynamometer according to the standardized posture recommended by the American Society of Hand Therapists (ASHT). Participants will be seated comfortably with the back straight and feet fully supported on the floor. The shoulders will remain stable without rotation, the elbow will be flexed to 90°, and the forearm will be maintained in a neutral position. The wrist will be positioned between 0-30° of extension and 15° of ulnar deviation, with the arm unsupported by the chair handle during testing.

  4 weeks

• Wrist Range of Motion assessment

  It will be assessed by using Digital Goniometer. A goniometer was placed at the ulnar styloid next to the little finger and set the initial state as the zero-degree position for wrist flexion and extension measurements. The radial deviation and ulnar deviation were measured by placing the goniometer at the center of the hand and in the middle of the middle finger.

  4 weeks

Secondary Outcomes (3)

• Pain Intensity Level assessment

  4 weeks

• Pressure Pain Threshold assessment

  4 weeks

• Upper Extremity Function assessment

  4 weeks

Study Arms (2)

Integrated Neuromuscular Inhibition Technique + Conventional Physical Therapy

EXPERIMENTAL

It will consist of 30 participants who will receive the integrated neuromuscular inhibition technique, including muscle energy techniques (MET), ischemic compression (IC), and strain-counterstrain (SCS), in addition to conventional physical therapy consisting of deep friction massage, passive stretching, and isometric strengthening exercises for the neck muscles. All participants will receive 12 treatment sessions, conducted three times weekly over a period of four weeks.

Other: Integrated Neuromuscular Inhibition Technique; Other: Conventional Physical Therapy

Conventional Physical Therapy

ACTIVE COMPARATOR

It will consist of 30 participants who will receive conventional physical therapy only, including deep friction massage, passive stretching, and isometric strengthening exercises for the neck muscles. All participants will receive 12 treatment sessions, conducted three times weekly over a period of four weeks.

Other: Conventional Physical Therapy

Interventions

Integrated Neuromuscular Inhibition Technique OTHER

Participants in the experimental group will receive the integrated neuromuscular inhibition technique three times per week for four consecutive weeks. The integrated neuromuscular inhibition technique protocol will include ischemic compression, strain-counterstrain (SCS), and muscle energy technique (MET).

Integrated Neuromuscular Inhibition Technique + Conventional Physical Therapy

Conventional Physical Therapy OTHER

Participants in the two groups will receive conventional physical therapy three times per week for four consecutive weeks. It consists of deep transverse friction massage (DTFM), passive stretching, and isometric strengthening exercises for the neck muscles.

Conventional Physical Therapy; Integrated Neuromuscular Inhibition Technique + Conventional Physical Therapy

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Subjects will be selected from out patient clinic of Delta University hospital, Dakahlia, Egypt.
• Subjects aged between 18 and 55 years.
• Their body mass index (BMI) were ranged from 18-30 kg/m2.
• Subjects diagnosed as myofascial pain syndrome with a unilateral upper trapezius myofascial trigger point on the dominant side by a physician.
• Subjects must have characteristics of trigger points: hardened, thickened taut bands in MPS patients. Contraction knots within taut muscle bands are pathognomonic features of MTrPs. Common features of the trigger point include the tender bands of muscles, taut band which could produce pain while pressing it directly or sometimes spontaneous, with this there was weak muscles, sensory motor dysfunctions, changes in motor control function and disruption of normal patterns of motor recruitments are seen.
• Subjects from both genders.
• The severity of pain on the visual analogue scale should be higher than two out of ten.
• Patients will receive all standard medical treatment.

You may not qualify if:

• A history of any major neurological or musculoskeletal disorders, cardiovascular or respiratory diseases.
• Neck pain due to cervical spine pathology.
• Any history of cervical trauma, fractures or dislocations, carcinoma.
• Uncooperative behavior, and unwillingness to participate.
• Wrist problems (stiffness, fracture, operation or carpal tunnel syndrome).

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

out patient clinic of Delta University hospital

Gamasa, Egypt

Location

MeSH Terms

Conditions

Myofascial Pain Syndromes

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases

Study Officials

• Rania Reda Mohamed, PhD

  Ass. Prof, Cairo university

  STUDY CHAIR

• Hoda Ibrahim Abbas, PhD

  Lecturer, Cairo university

  STUDY DIRECTOR

• Amr Abdalla Azzam, PhD

  Consultant, National Institute of Neuromotor System

  STUDY DIRECTOR

Central Study Contacts

Nouran Ali El-Metwally Ali El-Agamy, B.Sc

CONTACT

+20 10 19835158; nouranelagamy01@gmail.com

Rania Reda Mohamed, PhD

CONTACT

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: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: May 9, 2026
• First Posted: May 15, 2026
• Study Start: May 15, 2026
• Primary Completion (Estimated): September 15, 2026
• Study Completion (Estimated): September 22, 2026
• Last Updated: May 15, 2026

Record last verified: 2026-05

Locations

EG (1)