Interferential Current And Trapezius Myofascial Trigger Points
Condition: Upper Trapezius Trigger Points
Study type: Interventional

Summary: 
      To investigate the effect of different carrier frequencies of interferential current on
      pressure pain threshold, neck disability, cervical range of motion and upper trapezius muscle
      activity when applied on upper trapezius chronic myofascial trigger points: Randomized
      Controlled Trial
    

Detailed description: 
      Interferential current (IFC) is a medium frequency current derived from the interference of
      two symmetrical, but asynchronous alternating currents ranged from 1 to 10 KHz. The two main
      currents resulting in a single interference current with properties uniquely different from
      the two original currents.The lesser current of the two original currents is termed the
      carrier frequency and the interference current is called the beat frequency. A specific beat
      frequency can be obtained from several possible interference currents as long as the
      difference between the original currents is the same. For electro pain modulation, IFC is
      commonly used form of electrotherapy. It has the advantage of reducing the skin impedance,
      deeper penetration into tissues and is perceived as more comfortable.

      Myofascial pain syndrome (MPS) is a common form of chronic musculoskeletal pain that widely
      spread and contributing to a significant financial burden and job- related disability. It
      represents the most common disorder in patients with nonspecific chronic neck pain.The main
      characteristics of MPS include the presence of myofascial trigger points (MTrPs) which are
      defined as hyperirritable nodule in a taut band of skeletal muscle fibers which is palpable
      and tender during physical examination. Trigger points (TrPs) are usually seen in the upper
      fiber of trapezius. TrPs can be clinically classified as either active or latent. Active TrPs
      was defined as: MTrPs that refer pain during activity and during rest without any pressure.
      They prevent full muscle lengthening and induce their weakness. Latent TrPs was defined as:
      MTrPs that is painful only when palpated. Evidence on the effect of IFC on pain modulation is
      not confirmed up till now. This might be attributed to multiple factors such as limited
      number of studies, inappropriate use of the parameters or using single carrier frequency (4
      KHz) in majority of studies and the physiological effects of all our modalities are dose
      dependent. Dose depends on details of parameters including frequency. For IFC, the carrier
      frequency of the current has been suggested as an important parameter to achieve the most
      effective hypoalgesic response. However, there remains no evidence to support the selection
      of one carrier frequency over another. Few studies were conducted to examine the effect of
      different carrier frequencies by comparing their individual effects. Further researches are
      needed to prove which carrier frequency is more effective in treatment. Therefore, this study
      will be conducted to compare the effect of different carrier frequencies of the IFC in the
      management of upper trapezius chronic TrPs.
    

Intervention name(s): Stander treatment; Interferential current with carrier frequency 2 KHz; Interferential current with carrier frequency 4 KHz; Interferential current with carrier frequency 8 KHz; placebo interferential current
Intervention type(s): Other; Device; Device; Device; Device
Intervention description(s): Standard treatment will be (active cervical range of motion exercises, myofascial release to upper trapezius muscle and postural advices at home).; Interferential current treatment parameters will be as following; carrier frequency 2 KHz and beat frequency 15 Hz performed for 45 minutes per session.The intensity will be raised according to the subject's tolerance, remaining in the sensory level.; Interferential current treatment parameters will be as following; carrier frequency 4 KHz and beat frequency 15 Hz performed for 45 minutes per session.The intensity will be raised according to the subject's tolerance, remaining in the sensory level.; Interferential current treatment parameters will be as following; carrier frequency 8 KHz and beat frequency 15 Hz performed for 45 minutes per session.The intensity will be raised according to the subject's tolerance, remaining in the sensory level.; Interferential current intensity will not be raised.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This trial has four groups; three experimental and one group control.
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Interferential current; Carrier frequency; Upper trapezius; Trigger points