Effects of Myofascial Trigger Point Release Versus Neil Asher Technique Oin Patients With Rotator Cuff Syndrome

NCT07645963 | Not Yet Recruiting

• 1 other identifier: REC/RCR&AHS/25/0116 Iqra
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

Rotator cuff syndrome is a common cause of shoulder pain and functional limitation, often associated with myofascial trigger points. Myofascial Trigger Point Release (MFTR) and the Neil Asher Technique (NAT) are manual therapies aimed at reducing pain and improving mobility. This study compares their effects on pain, range of motion, and disability in individuals with rotator cuff syndrome.

Conditions

Rotator Cuff Syndrome

Keywords

pain; functional disability; range of motion

Outcome Measures

Primary Outcomes (3)

• Numeric Pain Rating Scale (NPRS) - Pain Assessment

  The Numeric Pain Rating Scale (NPRS) is a unidimensional, patient-reported outcome measure used to assess pain intensity. Participants are asked to rate their current pain level, or average pain over a specified recall period (e.g., past 24 hours or past week), using an 11-point scale ranging from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst imaginable pain."

  upto 4 weeks

• Universal Goniometer (UG) - Range of Motion (ROM)

  The Universal Goniometer (UG) is a standard clinical instrument used for measuring joint range of motion (ROM) in degrees. It consists of a fulcrum, stationary arm, and movable arm, allowing precise angular measurement of joint movement. For ROM assessment, the participant is positioned according to standardized protocols (supine, prone, or sitting depending on the joint being assessed). Anatomical landmarks are used for alignment to ensure accuracy and reliability. The stationary arm is aligned with the proximal segment of the joint, while the movable arm follows the distal segment.

  upto 4 weeks

• Shoulder Pain and Disability Index (SPADI) - Disability Outcome

  The Shoulder Pain and Disability Index (SPADI) is a validated, self-administered questionnaire designed to measure pain and functional disability in patients with shoulder conditions. It consists of 13 items divided into two subscales: Pain subscale (5 items) - assesses severity of shoulder pain during specific activities Disability subscale (8 items) - assesses difficulty in performing functional tasks such as dressing, reaching, lifting, and carrying objects Each item is scored on a Visual Analog Scale (0-10), where higher scores indicate greater pain and disability. The total SPADI score is calculated as a percentage, with 0% representing no disability and 100% representing maximum disability.

  upto 4 weeks

Study Arms (2)

Myofascial Trigger Point Release (MFTR)+ conservative physiotherapy Group)

EXPERIMENTAL

This group will be given Myofascial Trigger Point Release (MFTR) with basic physiotherapy care.

Other: Myofascial Trigger Point Release (MFTR)+ conservative physiotherapy Group

Neil Asher Technique (NAT) + conservative physiotherapy Group

ACTIVE COMPARATOR

This group will be given Neil Asher Technique (NAT) along with basic physiotherapy care.

Other: Neil Asher Technique (NAT) + conservative physiotherapy Group

Interventions

Neil Asher Technique (NAT) + conservative physiotherapy Group OTHER

The NAT is a non-invasive trigger point therapy that applies a specific sequence of ischemic compressions to deactivate active trigger points, stimulate reflex responses, and promote muscular balance. Apply several deep strokes over the fibrous band and then each trigger point is treated with sustained manual pressure for 20-30 seconds, repeated 2-3 times per session. Hot Pack Application: A moist hot pack will be applied over the affected shoulder for 5 minutes using a protective towel. Shoulder Stretching Routine: Includes flexion/extension, abduction/adduction, and internal/external rotation (each stretch held for 20-30 seconds and repeated 3-5 times).

Neil Asher Technique (NAT) + conservative physiotherapy Group

Myofascial Trigger Point Release (MFTR)+ conservative physiotherapy Group OTHER

lateral border of the scapula, just below the infraspinatus. • Compression is followed by horizontal abduction and external rotation to stretch the muscle. Ischemic Compression: Each active trigger point is treated with 2 sets of deep pressure, applied using the therapist's fingers, thumb, or elbow. Duration: Each compression lasts 20-30 seconds, gradually increasing pressure to the patient's tolerance. Post-Compression Stretching: Gentle passive stretching of the treated muscle follows immediately after each compression set to restore muscle length. Each session will last 35 minutes (5 minutes hot pack, 10 minutes stretching, 20 minutes Myofascial Trigger Point Release)

Myofascial Trigger Point Release (MFTR)+ conservative physiotherapy Group)

Eligibility Criteria

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

You may qualify if:

• Age 40-60 years
• Positive Neer's and Hawkins Kennedy test (27)
• Grade 1 or 2 rotator cuff syndrome (non-surgical)

You may not qualify if:

• Cardiac issues (e.g., myocardial infarction)
• Fibromyalgia
• Pregnancy
• Trauma-related shoulder pain
• History of shoulder surgery
• Numbness, tingling
• Corticosteroid injections

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

University of Lahore Teaching Hospital, Lahore HOD Physio Department

Lahore, Punjab Province, 54000, Pakistan

Location

Related Publications (11)

• Varacallo MA, El Bitar Y, Sina RE, Mair SD. Rotator Cuff Syndrome. 2024 Mar 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK531506/

  PMID: 30285401 BACKGROUND

• Kuhn JE. Prevalence, natural history, and nonoperative treatment of rotator cuff disease. Operative techniques in sports medicine. 2023;31(1):150978.

  BACKGROUND

• Meyers AR, Wurzelbacher SJ, Krieg EF, Ramsey JG, Crombie K, Christianson AL, Luo L, Burt S. Work-Related Risk Factors for Rotator Cuff Syndrome in a Prospective Study of Manufacturing and Healthcare Workers. Hum Factors. 2023 May;65(3):419-434. doi: 10.1177/00187208211022122. Epub 2021 Jun 20.

  PMID: 34148475 BACKGROUND

• Zahra T, Altaf F, Akhtar H, Awan SS, Sher UA, Waris S. Sleep Quality and Nocturnal Pain in Patients of Rotator Cuff Syndrome. Pakistan Journal of Medical & Health Sciences. 2022;16(09):394-.

  BACKGROUND

• Kwan CK, Ko MC, Fu SC, Leong HT, Ling SK, Oh JH, Yung PS. Are muscle weakness and stiffness risk factors of the development of rotator cuff tendinopathy in overhead athletes: a systematic review. Ther Adv Chronic Dis. 2021 Jul 3;12:20406223211026178. doi: 10.1177/20406223211026178. eCollection 2021.

  PMID: 34276924 BACKGROUND

• Sidiropoulos K, Samundeeswari S, Giannatos V, Kotsapas M, Arrigoni P, Montoya F, Brilakis E, Latz D, Koukos C. Partial Cuff Repair in Rotator Cuff Tears: Current Concepts and Clinical Considerations. Indian J Orthop. 2025 Feb 4;59(6):743-755. doi: 10.1007/s43465-025-01338-0. eCollection 2025 Jun.

  PMID: 40511351 BACKGROUND

• Zhao J, Luo M, Pan J, Liang G, Feng W, Zeng L, Yang W, Liu J. Risk factors affecting rotator cuff retear after arthroscopic repair: a meta-analysis and systematic review. J Shoulder Elbow Surg. 2021 Nov;30(11):2660-2670. doi: 10.1016/j.jse.2021.05.010. Epub 2021 Jun 2.

  PMID: 34089878 BACKGROUND

• Giri A, O'Hanlon D, Jain NB. Risk factors for rotator cuff disease: A systematic review and meta-analysis of diabetes, hypertension, and hyperlipidemia. Ann Phys Rehabil Med. 2023 Feb;66(1):101631. doi: 10.1016/j.rehab.2022.101631. Epub 2022 Nov 30.

  PMID: 35257948 BACKGROUND

• Khadour FA, Khadour YA, Alharbi NSK, Alhatem W, Albarroush D, Dao X. Risk factors for rotator cuff tear in Syrian adults: a cross-sectional study. Sci Rep. 2025 Feb 18;15(1):5837. doi: 10.1038/s41598-025-89878-1.

  PMID: 39966503 BACKGROUND

• Javed O, Maldonado KA, Ashmyan R. Anatomy, Shoulder and Upper Limb, Muscles. 2023 Jul 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK482410/

  PMID: 29494017 BACKGROUND

• Cao Z, Li Q, Li Y, Wu J. The association of metabolic syndrome with rotator cuff tendinopathy: a two-sample Mendelian randomization study. Diabetol Metab Syndr. 2023 Oct 24;15(1):211. doi: 10.1186/s13098-023-01189-5.

  PMID: 37875953 BACKGROUND

MeSH Terms

Conditions

Pain

Interventions

N-acetyltalosaminuronic acid

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Iqra Nazir, MSPT*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Samrood Akram, PhD*

CONTACT

03324806143; samrood.akram@riphah.edu.pk

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: June 8, 2026
• First Posted: June 12, 2026
• Study Start (Estimated): June 30, 2026
• Primary Completion (Estimated): September 30, 2026
• Study Completion (Estimated): October 30, 2026
• Last Updated: June 12, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)