Effects of MR With TENS Conductive Glove in Adults With Neck Myofascial Syndrome.
Condition: Neck Pain
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      Myofascial neck syndrome has a high incidence in the general population and is characterized
      by the presence of painful trigger points in the neck muscles. Both the application of manual
      techniques such as myofascial release and the application of TENS currents to the painful
      points of the neck muscles have been proven to help reduce pain and improve the range of
      motion of the neck. 80 adults who will present at least one trigger point in the upper
      trapezius muscle will be randomly divided into four groups. In the first group, a combination
      therapy of myofascial release with conductive TENS glove will be applied, in the second group
      the same protocol of myofascial release without conductive glove, in the third group a high
      frequency (conventional) TENS, and the fourth group will get placebo TENS with the device
      closed. All participants will follow a total of six treatments over a period of three weeks
      with a follow-up after one month. The following will be evaluated before and after the
      intervention, as well as in the one-month follow-up: pain with the visual analog scale (VAS
      pain), Pressure Pain Threshold (PPT) in the upper trapezius muscle with a digital algometer,
      range of motion (ROM) of the neck with a goniometer, and functional ability with the "Neck
      Disability Index" (NDI) questionnaire.
    

Detailed description: 
      Background: Myofascial neck syndrome has a high incidence in the general population and is
      characterized by the presence of painful trigger points in the neck muscles. Both the
      application of manual techniques such as myofascial release (MR) and the application of
      transcutaneous electrical nerve stimulation (TENS) currents to the painful points of the neck
      muscles have been proven to help reduce pain and improve the range of motion of the neck.

      Aim: To study the efficacy of the combination of MR and the simultaneous application of TENS
      currents in the painful points of the upper part of the trapezius muscle. The myofascial
      release protocol will be applied with a conductive glove, which will be connected to a TENS
      device so that the physiotherapist's hand can be used simultaneously as a mobile electrode.

      Method: 80 adults who will present at least one trigger point in the upper trapezius muscle
      will be randomly divided into four groups. In the first group, a combination therapy of MR
      with a TENS conductive glove will be applied, in the second group the same protocol of
      myofascial release without conductive glove, in the third group a high frequency
      (conventional) TENS, and the fourth group will get placebo TENS with the device closed. All
      participants will follow a total of six treatments over a period of three weeks with a
      follow-up after one month. The following will be evaluated before and after the intervention,
      as well as in the one-month follow-up: pain with the visual analog scale (VAS pain), Pressure
      Pain Threshold (PPT) in the upper trapezius muscle with a digital algometer, range of motion
      (ROM) of the neck with a goniometer, and functional disability with the "Neck Disability
      Index" (NDI) questionnaire. For the statistical analysis of the results, a two-way ANOVA with
      repeated measurements will be applied.

      Expected results: The combination protocol proposed in this clinical study combines the
      beneficial effects of TENS with the benefits of MR. For this reason, this combination is
      expected to be more effective than their individual application in improving the clinical
      picture of adults with myofascial neck syndrome.
    

Intervention name(s): Myofascial release with TENS conductive glove; Myofascial release without TENS conductive glove; Conventional TENS; Sham TENS
Intervention type(s): Other; Other; Other; Other
Intervention description(s): Before each MR session, light massage and stretching was applied for five minutes as preparation for the manipulations. The massage included the effleurage technique followed by petrissage and kneading on the cervical and thoracic areas (on the upper three parts of the trapezius muscle, in the suboccipital area, and on the paraspinal cervical muscles). Stretching was applied to the following muscles: upper part of the trapezius, levator scapulae, and the sternocleidomastoid muscle.
Upper trapezius myofascial release, unilateral gross stretch, vertical gross stretch, focused stretch, cranial base myofascial release, gross release of the sternocleidomastoid muscle, and release of the suprahyoid and infrahyoid muscles.; Before each MR session, light massage and stretching was applied for five minutes as preparation for the manipulations. The massage included the effleurage technique followed by petrissage and kneading on the cervical and thoracic areas (on the upper three parts of the trapezius muscle, in the suboccipital area, and on the paraspinal cervical muscles). Stretching was applied to the following muscles: upper part of the trapezius, levator scapulae, and the sternocleidomastoid muscle.
Upper trapezius myofascial release, unilateral gross stretch, vertical gross stretch, focused stretch, cranial base myofascial release, gross release of the sternocleidomastoid muscle, and release of the suprahyoid and infrahyoid muscles.; Two 40*50mm silicone electrodes were placed with the negative electrode on the trigger point of the trapezius muscle and the positive one on the acromion. The current frequency was 120Hz and pulse duration 80ms for 30 minutes. This protocol has been proposed by Ebadi et al. (2021); Two 40*50mm silicone electrodes were placed with the negative electrode on the trigger point of the trapezius muscle and the positive one on the acromion. The current frequency was 120Hz and pulse duration 80ms for 30 minutes. This protocol has been proposed by Ebadi et al. (2021)
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: An assessor-blind randomized control trial with a duration of three weeks and a one-month follow up will be performed in 80 adults with neck pain due to the presence of trigger points on the upper part of trapezius muscle. The participants will be allocated into four groups of 20 persons each (three intervention groups and one control group). In the first group, a combination therapy of myofascial release with conductive TENS gloves will be applied, in the second group the same protocol of myofascial release without conductive gloves, in the third group a high frequency (conventional) TENS, and the fourth group will get placebo TENS with the device closed. All participants will follow a total of six treatments over a period of three weeks.
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Neck Pain; Myofascial trigger points; Myofascial release; Transcutaneous electrical nerve stimulation; Physiotherapy