Impact of Visceral Manipulation Versus Integrated Neuromuscular Inhibition Technique in Shoulder Impingement Syndrome

NCT ID: NCT06271720

Last Updated: 2024-02-22

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 75 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-03-31
• Study Completion Date: 2024-05-31

Brief Summary

This study will be conducted To evaluate the effect of Visceral Manipulation versus Integrated Neuromuscular Inhibition Technique on the upper fiber of trapezius on pain intensity, pain threshold, shoulder range of motion, and function in shoulder impingement syndrome

Detailed Description

HYPOTHESES

It will be hypothesized that:

1. There will be no statistically significant effect of Visceral Manipulation on the upper fiber of the trapezius on pain intensity, pain threshold, shoulder range of motion, or function in shoulder impingement syndrome

2. There will be no statistically significant effect of the Integrated Neuromuscular Inhibition Technique on the upper fiber of the trapezius on pain intensity, pain threshold, shoulder range of motion, or function in shoulder impingement syndrome.

3. There will be no statistically significant difference in the effect of visceral manipulation versus the integrated neuromuscular inhibition technique on the upper fiber of the trapezius on pain intensity, pain threshold, shoulder range of motion, and function in shoulder impingement syndrome.

This study will be conducted to answer the following questions:

Is there an effect of Visceral Manipulation versus Integrated Neuromuscular Inhibition Technique on the upper fiber of the trapezius on pain intensity, pain threshold, shoulder range of motion, and function in shoulder impingement syndrome?

Conditions

Shoulder Impingement

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

visceral manipulation

Palpation will be applied and the pressure will directly to the skin, into the direction of restriction just until resistance (tissue barrier) is felt. Once found, the collagenous barrier will be engaged for 90 to 120 seconds for each technique without sliding over the skin or forcing the tissue until the fascia complex starts to yield and a sensation of softening is achieved.

Group Type: ACTIVE_COMPARATOR

visceral manipulation

Intervention Type: OTHER

visceral manipulation: A palpation technique will be applied till the barrier is felt and it will be applied until release is felt.

integrated neuromuscular inhibition: ischemic compression will be applied to trigger point of upper trapezius

integrated neuromuscular inhibition

The practitioner first identifies TrPs to be treated within the upper trapezius muscle. The subjects will be placed in a supine position. Their arm will be positioned in slight shoulder abduction with the elbow bent and their hand resting on their stomach. Using a pincer grasp, the practitioner will move throughout the fibers of the upper trapezius and make note of any active TrPs. Once the TrPs were identified, treatment began. The first technique applied will be ischemic compression. The therapist again utilized a pincer grasp, placing the thumb and index finger over the active TrP. Slow, increasing levels of pressure will be applied until the tissue resistance barrier is identified. The pressure will be maintained until a release of the tissue barrier is felt. At that time, pressure will again be applied until a new barrier is felt. This process will be repeated until tension or tenderness is unable to be identified or 90 seconds have elapsed.

Group Type: ACTIVE_COMPARATOR

integrated neuromuscular inhibition

Intervention Type: OTHER

It involves applying direct sustained digital pressure to the TrP with sufficient force over dedicated time duration, to slow down the blood supply and relieve the tension within the involved muscle. The pressure is gradually applied, maintained and the gradually released

Interventions

visceral manipulation

visceral manipulation: A palpation technique will be applied till the barrier is felt and it will be applied until release is felt.

integrated neuromuscular inhibition: ischemic compression will be applied to trigger point of upper trapezius

Intervention Type: OTHER

integrated neuromuscular inhibition

It involves applying direct sustained digital pressure to the TrP with sufficient force over dedicated time duration, to slow down the blood supply and relieve the tension within the involved muscle. The pressure is gradually applied, maintained and the gradually released

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• -active myofascial trigger points in the upper trapezius muscle, and chronic Pain lasting more than 12 weeks
• BMI between 25 and 30 Kg/m².

Exclusion Criteria

• a previous fracture in the cervical spine or shoulder surgery
• acute inflammatory condition.
• Malignant tumor.
• Multiple osteophytes.
• Cervical posture abnormalities.
• Osteoporosis.

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 40 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Noha Elserty

OTHER

Sponsor Role: lead

Responsible Party

Noha Elserty

Assistant professor

Responsibility Role: SPONSOR_INVESTIGATOR

Other Identifiers

faculty of physical therapy

Identifier Type: -

Identifier Source: org_study_id