The Effect of Soft Tissue Mobilization in Myofascial Neck Pain
Condition: Neck Pain
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      A long term habitual posture with abnormal loading of ligaments and muscles, leads to
      development of neck pain. 33 patients including 18 males and 15 females were selected and
      randomly allocated into three groups using sealed opaque envelope containing treatment
      allocation. Group A (n=11) received conventional treatment such as MHP (Moist Heat Pack),
      Static Stretching exercises, Cervical spine non-thrust mobilization, Cervical spine active
      ROM (Range of Motion) exercises and Postural exercises. Group B (n=11) received DNF training
      with conventional treatment. Group C (n=11) received Muscle Energy Technique (MET) in
      additional to conventional treatment. Primary outcome measure functional disabilities and
      secondary measure pain and ROM were recorded at baseline, 7th day and 14th day.One-way ANOVA
      was used for within group analysis. Repeated measure ANOVA followed by post hoc analysis was
      employed for between group comparisons. The results suggest that there was a significant
      improvement in mean change scores of Neck Disability Index (NDI), Visual Analogue Scale (VAS)
      and Range of Motion (ROM) .Both DNF training and MET have additional therapeutic effects over
      a standard care by reducing functional disabilities, pain and in improving ROM in mechanical
      neck pain patients.
    

Detailed description: 
      According to Janda, postural muscles have tendency to get shorten, in both normal and
      pathological conditions. Upper trapezius, levator scalpulae and scalene are most common
      postural muscles. Additionally, longus colli and longus capitis (DNF) have important role in
      postural support and their impaired activation leads to neck pain.

      More recently, muscle based treatments approaches for MNP evolved from a passive treatment
      technique such as myofascial release towards more active treatment technique such as MET and
      DNF training.

      Group A (N=11) received conventional treatment for 5 days per week for 2 weeks such as MHP
      (Moist Heat Pack) for 20 minutes, Static Stretching exercises for upper trapezius, levator
      scapulae and scalene muscle which is held for 10-30 seconds- repeated 3-5 times, Cervical
      spine non-thrust mobilization (Grade 3) was given to each segment from C2-C7 was oscillated
      for 10 repetitions, followed by a 10 seconds rest between segments, Cervical spine active ROM
      (Range of Motion) exercises with 10 repetitions- 2-3 times a day and Postural exercises were
      given as home programme.

      Group B (N=11) received DNF training along with conventional treatment. In this programme,
      emphasis was placed on first attaining the correct craniocervical flexion action, with
      minimal activity of the superficial cervical flexor muscles. The craniocervical flexion
      action involves a specific craniocervical movement (nodding - "yes" movement) of head such
      that it remains in contact with the supporting surface. Once the correct action had been
      achieved, participants were instructed in the use of the sphygmomanometer to guide the
      training of the Craniocervical Flexors muscle contraction at the various incremental levels
      of pressure (22 to 30 mmHg, progressively inner range positions).

      Group C (N=11) received MET in additional to conventional treatment. MET was applied to Upper
      trapezius, Levator scapulae and Scalene Following the 7-10 seconds isometric contraction and
      complete relaxation of all elements, the stretch is maintained for 30 seconds. The effort and
      the counter-pressure should be modest (20% of available strength) and painless. The process
      is repeated 3-5 times.
    

Intervention name(s): Dr. Gene's Health and Wellness; Muscle Energy Technique; Static stretching and Cervical non thrust manipulation
Intervention type(s): Device; Procedure; Procedure
Intervention description(s): The device is used to perfom deep neck flexors muscles traning. These low load craniocervical flexion exercise are even in early stages of rehabilitation when pain or pathology might preclude high load exercises and thus gradually reduces the symptoms.; MET was applied to Upper trapezius, Levator scapulae and Scalene Following the 7-10 seconds isometric contraction and complete relaxation of all elements, the stretch is maintained for 30 seconds. The effort and the counter-pressure should be modest (20% of available strength) and painless. The process is repeated 3-5 times.; conventional treatment for 5 days per week for 2 weeks such as MHP (Moist Heat Pack) for 20 minutes, Static Stretching exercises for upper trapezius, levator scapulae and scalene muscle which is held for 10-30 seconds- repeated 3-5 times, Cervical spine non-thrust mobilization (Grade 3) was given to each segment from C2-C7 was oscillated for 10 repetitions, followed by a 10 seconds rest between segments, Cervical spine active ROM (Range of Motion) exercises with 10 repetitions- 2-3 times a day and Postural exercises were given as home programme.
Other intervention name(s): Sphymomanometer
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: MNP; MET; Soft tissue mobilization; DNF; Static Stretching