Short and Medium-term Effects of Manual Therapy on Latent Myofascial Pain
NCT ID: NCT01709357
Last Updated: 2012-10-18
Study Results
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Basic Information
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COMPLETED
NA
117 participants
INTERVENTIONAL
2011-09-30
2012-03-31
Brief Summary
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Detailed Description
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There is few data regarding myofascial trigger point physiopathology. Furthermore, a diversity of therapeutic interventions consisting of trigger point inactivation and interruption of the vicious cycle is suggested in literature. Nevertheless, the effectiveness of these different interventions in trigger points and the duration of the effects are not yet fully clarified.
Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
DOUBLE
Study Groups
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Muscle energy technique
In each volunteer, the therapist identified the latent trigger point on the upper trapezius. A questionnaire about general information was performed. And the maximum homolateral side flexion of the trigger point was measured.
On the following week, the blind assessor performed the pre-intervention measurements of pressure pain threshold, pressure pain perception and cervical range of motions.
Next, the therapist performed the muscle energy technique of the upper trapezius muscle.
Then, all measurements, before described, were repeated, by the assessor, after 10 minutes, 24 hours and one week.
Muscle energy technique
The therapist, with one hand on the occipital bone and the other on the shoulder, performed passive side flexion, contralateral to the muscle, taking the subject's head until the end-feel. Then, subjects performed an isometric contraction of 25% of their maximum force, for 5 seconds, while the therapist offered manual resistance. Afterwards the subject was let to relax in this position for additional 5 seconds. Side flexion was now increased until a new end-feel point was reached. This sequence was repeated 3 times. At the end, the therapist passively guided the cervical segment to the neutral position.
Ischemic compression technique
In each volunteer, the therapist identified the latent trigger point on the upper trapezius. A questionnaire about general information was performed. And the maximum homolateral side flexion of the trigger point was measured.
On the following week, the blind assessor performed the pre-intervention measurements of pressure pain threshold, pressure pain perception and cervical range of motions.
Next, the therapist performed ischemic compression technique on the latent trigger point.
Then, all measurements, before described, were repeated, by the assessor, after 10 minutes, 24 hours and one week.
Ischemic compression technique
The therapist, with a pincer contact, applied gradual pressure on the latent trigger point of the upper trapezius muscle. Subjects had been previously asked to say when pain was "moderate but bearable", a pain value of 7 in a 1 to 1o scale of pain (in which 1 corresponds to "no pain" and 10 do "unbearable pain"). At this point, pressure was maintained until pain levels were reduced to level 3. The therapist increased once more the pressure until the level of pain was 7 again. This procedure was repeated during 90 seconds.
Passive stretching technique
In each volunteer, the therapist identified the latent trigger point on the upper trapezius. A questionnaire about general information was performed. And the maximum homolateral side flexion of the trigger point was measured.
On the following week, the blind assessor performed the pre-intervention measurements of pressure pain threshold, pressure pain perception and cervical range of motions.
Next, the therapist performed the passive stretching of the upper trapezius muscle.
Then, all measurements, before described, were repeated, by the assessor, after 10 minutes, 24 hours and one week.
Passive stretching technique
The therapist, with one hand on the occipital bone and the other on the shoulder, performed a contralateral side flexion of the muscle passively until the maximum obtainable amplitude was reached, while subjects were asked to breathe steadily. During the breathing phase the therapist increased the side flexion until the end of the obtainable amplitude, this position was maintained. This procedure was repeated during 30 seconds. Finally the therapist passively guided the cervical segment to the neutral position.
Sham technique
In each volunteer, the therapist identified the latent trigger point on the upper trapezius. A questionnaire about general information was performed. And the maximum homolateral side flexion of the trigger point was measured.
On the following week, the blind assessor performed the pre-intervention measurements of pressure pain threshold, pressure pain perception and cervical range of motions.
Next, for the sham technique, the therapist only contacted with his hands the head and the shoulder of the subject, without executing any movement, for 30 seconds.
Then, all measurements, before described, were repeated, by the assessor, after 10 minutes, 24 hours and one week.
Sham technique
The therapist was seated at the head of the treatment table, and with one hand on the occipital bone and the other on the shoulder, without executing any movement, for 30 seconds.
No intervention group
In each volunteer, the therapist identified the latent trigger point on the upper trapezius. A questionnaire about general information was performed. And the maximum homolateral side flexion of the trigger point was measured.
On the following week, the blind assessor performed the pre-intervention measurements of pressure pain threshold, pressure pain perception and cervical range of motions.
Next,the subject was lying for 30 seconds, without intervention.
Then, all measurements, before described, were repeated, by the assessor, after 10 minutes, 24 hours and one week.
No interventions assigned to this group
Interventions
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Muscle energy technique
The therapist, with one hand on the occipital bone and the other on the shoulder, performed passive side flexion, contralateral to the muscle, taking the subject's head until the end-feel. Then, subjects performed an isometric contraction of 25% of their maximum force, for 5 seconds, while the therapist offered manual resistance. Afterwards the subject was let to relax in this position for additional 5 seconds. Side flexion was now increased until a new end-feel point was reached. This sequence was repeated 3 times. At the end, the therapist passively guided the cervical segment to the neutral position.
Passive stretching technique
The therapist, with one hand on the occipital bone and the other on the shoulder, performed a contralateral side flexion of the muscle passively until the maximum obtainable amplitude was reached, while subjects were asked to breathe steadily. During the breathing phase the therapist increased the side flexion until the end of the obtainable amplitude, this position was maintained. This procedure was repeated during 30 seconds. Finally the therapist passively guided the cervical segment to the neutral position.
Ischemic compression technique
The therapist, with a pincer contact, applied gradual pressure on the latent trigger point of the upper trapezius muscle. Subjects had been previously asked to say when pain was "moderate but bearable", a pain value of 7 in a 1 to 1o scale of pain (in which 1 corresponds to "no pain" and 10 do "unbearable pain"). At this point, pressure was maintained until pain levels were reduced to level 3. The therapist increased once more the pressure until the level of pain was 7 again. This procedure was repeated during 90 seconds.
Sham technique
The therapist was seated at the head of the treatment table, and with one hand on the occipital bone and the other on the shoulder, without executing any movement, for 30 seconds.
Eligibility Criteria
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Inclusion Criteria
* with a palpable latent trigger point in the fibbers of the upper trapezius muscle
* with an average time of computer work of at least 2h/day.
Exclusion Criteria
* with bilateral latent triggers in the fibers of the upper trapezius muscle
* have done any pharmacological therapeutic during any of the 7 days before the study or anti-coagulant therapeutics
* have done any treatment at cervical region during the month before the study
* having cardio-respiratory, neurological, neuro-musculoskeletal, oncologic or systemic pathologies
* having cognitive deficits or psychologic/psychiatric disturbances
* be pregnant
* having a clinical history of cervical, high dorsal, shoulder or cranial surgery or trauma during the prior 12 months.
18 Years
ALL
Yes
Sponsors
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Escola Superior de Tecnologia da Saúde do Porto
OTHER
Responsible Party
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Natália Maria Oliveira Campelo
Professor
Principal Investigators
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Natália MO Campelo
Role: PRINCIPAL_INVESTIGATOR
Escola Superior de Tecnologia da Saúde do Porto
Locations
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Escola Superior de Tecnologia da Saúde do Porto
Vila Nova de Gaia, Porto District, Portugal
Countries
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References
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Simons DG. New views of myofascial trigger points: etiology and diagnosis. Arch Phys Med Rehabil. 2008 Jan;89(1):157-9. doi: 10.1016/j.apmr.2007.11.016.
Fernandez-de-Las-Penas C, Simons D, Cuadrado ML, Pareja J. The role of myofascial trigger points in musculoskeletal pain syndromes of the head and neck. Curr Pain Headache Rep. 2007 Oct;11(5):365-72. doi: 10.1007/s11916-007-0219-z.
Simons DG. Review of enigmatic MTrPs as a common cause of enigmatic musculoskeletal pain and dysfunction. J Electromyogr Kinesiol. 2004 Feb;14(1):95-107. doi: 10.1016/j.jelekin.2003.09.018.
Ge HY, Arendt-Nielsen L. Latent myofascial trigger points. Curr Pain Headache Rep. 2011 Oct;15(5):386-92. doi: 10.1007/s11916-011-0210-6.
Other Identifiers
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NC-001
Identifier Type: -
Identifier Source: org_study_id