Effect of Post Isometric Relaxation Versus Myofascial Release Therapy in the Management of Non Specific Neck Pain
Condition: Neck Pain
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      Non-specific neck pain (NS-NP) is the most prevailing musculoskeletal disorder (MSK) which
      has large socio-economic burden worldwide. It is associated with poor posture and neck strain
      which may lead to pain and restricted mobility. Post isometric relaxation a form of Muscle
      energy technique, that works on the principles of restoring biomechanics, reducing the
      movement restriction and pain. Myofascial release therapy will improve muscle immobility and
      pain by improving blood circulation lymphatic drainage and relaxing the contracted muscles.
      The aim of this study is to determine the effect of Post-isometric relaxation Versus
      Myofascial release therapy on pain, range of motion, disability and quality of life in the
      management of non-specific neck pain.
    

Detailed description: 
      A randomized control trial will be conducted at IPMR (Institute of Physical Medicine and
      Rehabilitation) on 60 patients with non-specific neck pain with age group between 25-40
      years. Initial screening of the patients will be carried out by referring physiatrist.
      Patients who fulfils inclusion criteria will be randomly allocated to either group by
      computer generated random sampling after taking written informed consent. All the patients
      will be evaluated using Visual analogue scale for pain, Neck disability index for functional
      status and disability, Universal goniometer for cervical range of motion and WHO BREF for
      quality of life on 1st and 6th sessions. Group 1 will receive Post isometric relaxation for
      Upper trapezius and levator scapulae along with Cryotherapy and strengthening exercises .
      Group 2 will receive myofascial release therapy for Upper Trapezius and Levator scapulae
      muscles along with cryotherapy and strengthening exercises. Data will be analyzed using the
      SPSS version 21. Baseline reading will be taken for further comparison at the end of
      treatment. Baseline variables are Pain, ROM, Functional disability and Qol. For within group
      analysis, paired sample t test will be used. For intergroup independent sample t test will be
      used. P value less than 0.05 will be set as threshold to detect statistical significance.
    

Intervention name(s): 1.Post Isometric Relaxation; 1.Myofascial Release therapy
Intervention type(s): Other; Other
Intervention description(s): For Upper Trapezius In supine position Neck flexion, contra-lateral full side bending followed by slight ipsilateral rotation will be provided towards the side being treated. while asking the patient to shrug the stabilized shoulder and contraction will be maintained for 7- 10s. Repeating it 3-5 times.
For Levator Scapulae Step One In supine position while lifting the patients neck in full flexion, lateral flexion and rotation with 7-10s isometric contraction away from side to be treated will be provided.
Step Two The patient will be instructed to take head backwards to the table while at the same time asking the patient to slightly shrug the shoulder and resistance will be provided. Repeating it 3-5 times.
2.Neck isometric strengthening exercises Intensity 5 reps Frequency at 1st week one set and second week will progress to 2 sets
3.Cryotherapy will be placed on cervical region for 10 min after the treatment.; For Upper Trapezius In sitting position Myofascial Release of Trapezius will be performed unilaterally with soft fist or elbow sinking and then taking up the line of tension from mid belly of Trapezius, to the acromion process, while the patient drops the head forward and will slowly rotate the head from side to side. While providing the resistance to contralateral side of rotation. Repeating for 2-3 times.
For Levator Scapulae In sitting position applying same unilateral muscle release as Trapezius, but the line of tension will be to the inferior border of Scapulae slightly laterally and will ask the patient to drop the head forward to increase resistance on Levator muscle. Repeating it 2-3 times
2.Neck isometric strengthening exercises Intensity 5 reps Frequency at 1st week one set and second week will progress to 2 sets
3.Cryotherapy will be placed on cervical region for 10 min after the treatment.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Non specific neck pain; Post isometric relaxation; Muscle energy techniques; Myofascial Release therapy