Dry Needling and Maitland Joint Mobilization Techniques in Patients With Myofacial Chronic Neck Pain

Study Overview
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Brief Summary
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The purpose of my research is to compare the effects of dry needling and Maitland mobilization in chronic myofacial neck pain

Detailed Description
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To distinguish which technique is most effective in pain reduction and range gain because in chronic cases there is involvement of fascia, muscles and joints due to prolonged stress on any of the component affecting the other. Hence, the study will help to design a treatment plan with more accurate intervention. After sample collection according to selection criteria treatment sessions will be given to both groups for 6 weeks. Data will be collected at baseline, then after 2 weeks, 4 weeks and at 8th week. Tools for data collection are Visual analogue scale, Neck Disability Index and Goniometer. For statistical analysis SPSS 22 will be used. Intra group difference will be calculated by repeated measurement ANOVA / Friedman test and inter group analysis will be done by Independent sample t test. Descriptive data will be expressed in terms of frequency and proportions.

Official Title
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Comparison Between Dry Needling and Maitland Joint Mobilization Techniques in Patients With Myofacial Chronic Neck Pain

Conditions
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Myofacial Pain, Neck Pain

Intervention / Treatment
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* Other: Dry Needling
* Other: Maitland Mobilization


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Bilateral pain involving the upper trapezius and elevator muscle of the scapula; Duration of pain of at least 3 months; A pain intensity corresponding to at least 20 mm on a 100 mm visual analogue scale (VAS) Neck pain with symptoms provoked by either neck postures or neck movement; Pain localized at least in the cervical and occipital regions but not in the orofacial region; Neck disability index (NDI) greater than or equal to 15 points; Restricted cervical range of movements (flexion, extension, rotation, and sidebending); (i) Presence of bilateral MTrPs in upper trapezius and levator scapulae muscles Exclusion Criteria: Any signs, symptoms, or history of the following diseases: Orofacial pain and temporo-mandibular disorders A history of traumatic injuries (e.g., contusion, fracture, and whiplash injury); Systemic diseases such as fibromyalgia, systemic erythematous lupus, and arthritis; (d) Neurologic disorders (e.g., trigeminal neuralgia or occipital neuralgia); Concomitant medical diagnosis of any primary headache (tension type or migraine); Unilateral neck pain; Cervical spine surgery; Clinical diagnosis of cervical radiculopathy or myelopathy; Needle phobia; History of previous physical therapy intervention for the cervical region in last 6 months.

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 45 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
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dry Needling-Group<br>Tens, Stretching, Strengthening(girdle), Neck Isometrics, DN | Other: Dry Needling<br>* TENS 10 minutes, Stretching, Strengthening(girdle),Neck Isometrics, DN<br>|
| Active Comparator: Maitland-Group<br>Tens Stretching, Strengthening(girdle), Neck Isometrics, Maitland joint mobilization | Other: Maitland Mobilization<br>* TENS 10 minutes, Stretching, Strengthening(girdle),Neck Isometrics, Maitland joint mobilization<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Disability | Scoring: For each section the total possible score is 5: if the first statement is marked the section score = 0, if the last statement is marked it = 5. If all ten sections are completed the score is calculated as follows: Example:16 (total scored) 50 (total possible score) x 100 = 32% If one section is missed or not applicable the score is calculated: 16 (total scored) 45 (total possible score) x 100 = 35.5% Minimum Detectable Change (90% confidence): 5 points or 10 %points | 4 months | 
| Numeric Pain Rating Scale NPRS | The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an eleven-point numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain). | 4 months | 
| Range of Motion | Standard Goniometer will be used.Higher score shows improvement. | 4 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Neck Pain, Myofacial Pain