Instrument-assisted Soft Tissue Mobilization and Phonophoresis on Trigger Points of Tension Headache
Condition: Headache; Tension-Type Headache
MeSH terms: Tension-Type Headache; Headache
Study type: Interventional

Summary: 
      General purpose:

      It was investigate the effect of IASTM and phonophoresis on Tension Type headache.

      Specific Purpose:

        1. It was investigate the effect of IASTM on headache frequency, PPT, pain intensity, and
           functional disability on trigger points of tension type headache.

        2. It was investigate the effect of Lidocaine phonophoresis on headache frequency, PPT,
           pain intensity and functional disability on trigger points of tension type headache.

        3. It was investigate the effect of IASTM and Lidocaine phonophoresis on headache
           frequency, PPT, pain intensity, and functional disability on trigger points of tension
           type headache.
    

Detailed description: 
      Phonophoresis is the use of therapeutic ultrasound to increase percutaneous drug absorption
      Percutaneous administration offers many benefits such as steady plasma levels, lack of
      degradation by the gastrointestinal system, and lack of liver effects (first-pass drug
      metabolism) on drug molecules. Transdermal drug delivery offers a unique opportunity for
      non-invasive and controlled drug delivery, in contrast to needle-based and oral drug
      administration. Phonophoresis is a therapeutic method that may be helpful for the treatment
      of MTP.

      There are potentially adverse treatment responses to ISTM that may occur. The patient may
      experience discomfort during the administration of the treatment, and petechiae (i.e.,
      bruising) may become apparent during or after the treatment Although discomfort may be
      experienced, patients who have realized a decrease in symptoms have returned repeatedly for
      additional ISTM sessions other therapeutic modalities should be administered for pain
      management.

      Clinical and scientiﬁc evidence supports that proper management of patients with headache
      should be multimodal including appropriate use of pharmacological and
      non-pharmacological.IASTM used to facilitate normal alignment of soft tissue and increase
      fibroblast recruitment and regeneration of damaged tissue. Phonophoresis is frequently used
      to treat pain associated with muscular disorders, enhancing skin absorption of the topical
      medication's molecules. Study report that lidocaine decreases sensory input from
      mrofascialTrps and release local Tenderness by lowering the degree of the reflex mechanism
      responsible for referred pain.
    

Intervention name(s): Conventional physical therapy program; IASTM by M2t blade; Phonophoresis
Intervention type(s): Other; Other; Device
Intervention description(s): Infrared, Exercises, Stretching exercise of Suboccepital muscle; A lubricant (Vaseline) will be applied to the skin around the neck area prior to treatment and the M2t blade will be cleaned with an alcohol pad. First, the M2T blade will used to ﬁnd the exact areas of restriction in affected muscles. Then the M2T blade will use at an angle of 45 to apply slow strokes along the muscle. Changes in soft tissue consistency will detected by the clinician through vibrations of the instrument when it slides on areas of irregular fibrosis of the underneath connective tissue. Once an adhesion is discovered, strokes are repeated for 5 min.; It will be consisted of 1 MHz pulsed mode with an intensity set at 1.5 W/cm2 and. A 5 cm2 crystal head with an effective radiating area of 4.0 cm2 ±1.0 wills utilized for 5 Min for each trigger point of neck. lidocine gelwill applied instead of coupling US gel used for transmission.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment