Instrument Assisted Soft Tissue Mobilization Versus Trigger Points Release on Upper Trapezius Trigger Points
Condition: Trigger Points
Study type: Interventional

Summary: 
      Study will be randomized clinical trial. Data will be collected from non probability
      consecutive sampling technique. Total 30 participants from Ganga Ram Hospital and Care
      medical centre will be selected and randomly allocated to two different groups i.e Group A
      and Group B. . Group A will be treated by trigger point release. Group B will be treated by
      Instrument assisted soft tissue release. NPRS, GONIOMETRY, NDI will be used as outcome
      measuring tool before and after treatment. Data will be analyzed by using Statistical package
      for social sciences 25.
    

Detailed description: 
      Trigger point is defined as a hyperirritable palpable nodule contained in the skeletal muscle
      fibers. The palpable nodule, also named taut band, is described as a limited number of fibers
      with an increased stiffness. Trp causes the muscles to week and stiff, leading to reduction
      in range of movement. MTrP can produce local and referred pain, either on manual compression
      or spontaneously.

      Instrument-assisted soft tissue mobilization (IASTM) is the use of hard tools to manipulate
      soft tissue and was derived from the Cyriax1 cross-friction massage. It has recently emerged
      as a popular alternative to traditional manual therapy techniques. Modern-day IASTM
      instruments vary in material (e.g. stainless steel, plastic) and design and are used to
      improve a variety of musculoskeletal conditions and associated outcomes.

      Manual technique that uses direct vertical pressure to the TP, is a well-established
      treatment method used to resolve the TP-related pain syndrome. This directed pressure is
      managed according to the therapist's perception of the tissue resistance of the treated soft
      tissue or according to the pain perceived by the patient based on a pain scale. Manual
      therapy is a commonly used treatment for MPS as it has been considered one of the most
      effective techniques for the inactivation of MTrPs.
    

Intervention name(s): Soft tissue release technique; Comparator: Instrument assisted soft tissue mobilization
Intervention type(s): Other; Other
Intervention description(s): Patient sat on a chair. The therapist stood behind the participant and held one hand over head as the support, with the thumb of the other hand scan to detect the painful area of the latent TP of the upper trapezius muscle along the fibers. Then, pressure was applied by the thumb and the participant was asked to simultaneously actively change the muscle from shorted position to elongated state (ipsilateral side flexion of the cervical to the opposite side). This technique was repeated 3-5 times per session, and each repetition was maintained for 40-60 s till release is felt, with a 15-second rest interval. Three times passive stretching of the upper trapezius muscle was also performed for 45 s for each side.; Patient lied prone; the treatment was applied for approximately 20-seconds in a direction parallel to the muscle fibers with the instrument at a 45º angle. Followed immediately by treating the muscles in a direction perpendicular to the muscle fibers with the instrument at a 45º angle for an additional 20-second, resulting in a total treatment time of approximately 40 s. This technique was applied 3-5 times per session with 20 s rest between each time. Three times passive stretching of the upper trapezius muscle was also performed for 45 s for each side.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: Upper trapezius pain