Influence of Adding High Power Pain Threshold Ultrasound to Traditional Therapy on Axioappendicular Muscles Amplitude and Fatigue in Mechanical Neck Pain Randomized Clinical Trials

Study Overview
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Brief Summary
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The purpose of this study will investigate the effect of adding high power pain threshold ultrasound to traditional therapy on axioappendicular muscles amplitude and fatigue in neck pain

Detailed Description
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Myofascial pain syndrome is a common musculoskeletal pain disorder affecting almost 95% of people with chronic pain disorders and is a common finding in especially pain management centres.It is characterized by trigger points, defined as hyperirritable spots within taut bands of skeletal muscle fibers. The syndrome is associated with tenderness in the muscle, referred pain, spasm and restriction of motion. Patients with MPS begin with one active MTrP (called the primary MTrP) in the affected muscles due to chronic repetitive minor muscle strain, poor posture, systemic diseases, or neuro-musculoskeletal lesions. When not treated correctly, expansion of the pain region and additional active MTrPs (called secondary or satellite MTrPs) will develop one of the most appropriate treatments for trigger points ultrasound therapy. The high-power pain threshold ultrasound (HPPTUS) technique is one of the ultrasound modifications used to treat trigger points In 2004, Majlesi et al. performed the first clinical study to compare this technique with the traditional ultrasound technique in patients with myofascial trigger points. The results showed that HPPTUS was much more effective than the traditional technique, and pain reduction and improved range of motion (ROM) were significant in a smaller number of sessions.sixty patients with mechanical neck pain will be assigned randomly to two equal group. one group will receive high power pain threshold ultrasound and traditional therapy and the other receive traditional therapy alone for four weeks. .

Official Title
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Influence of Adding High Power Pain Threshold Ultrasound to Traditional Therapy on Axioappendicular Muscles Amplitude and Fatigue in Mechanical Neck Pain Randomized Clinical Trials

Conditions
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Neck Pain

Intervention / Treatment
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* Other: high power pain threshold ultrasound
* Other: traditional therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients with mechanical neck pain from both genders. age between 19 and 38 years patients will be required to have active TrPs in the upper trapezius and levator muscle and neck pain Exclusion Criteria: Patients will be excluded if they have History of whiplash injury, History of cervical spine surgery, Cervical radiculopathy or myelopathy, Having undergone physical therapy within the past 3 months before the study Non- rheumatologic diseases as multiple sclerosis, thyroid dysfunction and chronic infection and Rheumatologic condition as mild systemic lupus erythematosus, poly-articular osteoarthritis, rheumatoid arthritis and advanced cervical spine degenerative diseases.

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 38 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: high power pain threshold ultrasound and traditional therapy
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: high power pain threshold ultrasound<br>the patients will receive high power pain threshold ultrasound and traditional therapy twice a week for four weeks | Other: high power pain threshold ultrasound<br>* After explaining the procedure, and the trigger points will be marked by a physical therapist that . Then, the hand placed next to the prone position with the head in the neutral position, and the hands placed next to the body. The frequency was set to 1 MHz, and the intensity increased from 0.5 to 2 until the patient reported an unpleasant sensation. The probe will be held there for 4 s; then, the intensity was reduced by 50%, and the probe was moved over and around the trigger point. This process is done several times for three minutes.<br>Other: traditional therapy<br>* the patients will receive traditional therapy in the form of postural correction exercise, active range of motion and stretching exercise for cervical muscles<br>|
| Active Comparator: traditional therapy<br>the patients will receive traditional therapy twice a week for four weeks | Other: traditional therapy<br>* the patients will receive traditional therapy in the form of postural correction exercise, active range of motion and stretching exercise for cervical muscles<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain intensity | pain will be measured by visual analogue scale | up to four weeks | 
| pressure pain threshold | commander algometer device will be used to measure pressure pain threshold | up to four weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| neck disability | neck disability index will be used to measure neck disability. | up to four weeks | 
| muscle amplitude and fatigue | electromyography will be used to measure muscle amplitude and fatigue | up to four weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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high power pain threshold ultrasound, mechanical neck pain