Comparison of Dry Needling and Dry Cupping in Positional Fault of Pelvis

Study Overview
=================
Brief Summary
-----------------
This project was a Randomized clinical trial conducted to Compare the effects of dry needling and dry cupping in Positional fault of pelvis due to Myofascial trigger points in Quadratus Lumborum so that we can have best treatment option for patients with myofascial trigger points.

Detailed Description
-----------------
Non Probability Convenient sampling was done. Patients following eligibility criteria from Physiotherapy department of Islam Central hospital, Sialkot were considered. Sample size was calculated with Epitool calculator. 26 Participants were randomly allocated in two groups equally via convenient sampling method. Baseline assessment was done initially. Group A was given Dry needling technique and Group B was given Dry Cupping along with conventional physiotherapy treatment (hot pack and stretching). Duration of research was almost 6 months. Participants were treated 6 times over a 3 week period with 2 treatment sessions per week per patient. Pre and Post treatment readings were taken in 1st and 6th session over a 3 week period respectively. A follow up reading was also taken after 1 month for checking prolonged post treatment effects. Assessment was done via Pressure pain threshold Scale, Pelvic goniometer and Measuring tape for assessing functional positional fault of pelvis and muscle length of Quadratus Lumborum. All participants were provided written informed consent prior to commencement of the procedures. They were free to quit the treatment at any stage of research. Data was analyzed by using SPSS version 23.

Official Title
-----------------
Comparison of Dry Needling and Dry Cupping in Positional Fault of Pelvis Due to Myofascial Trigger Points in Quadratus Lumborum

Conditions
-----------------
Myofascial Trigger Point Pain, Quadratus Lumborum Syndrome, Positional Fault of Pelvis, Myofascial Trigger Point in Quadratus Lumborum

Intervention / Treatment
-----------------
* Other: Dry needling
* Other: Dry cupping


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: On palpation the presence of at least 1 active trigger point in quadratus lumborum. So the patient presents with low back pain. Patients presents with positional fault of pelvis (lateral tilt)(4). Patients having chronic Low Back Pain for at least more than 6 months(3). Patients agree to get treatment sessions for the research work. Exclusion Criteria: Participants should not have taken any medications like analgesics, anti-coagulants, Non-steroidal anti-inflammatory drugs or muscle relaxants during this study or even 3 days before this study. Participants should not have received any other treatment for the pain management, because it will affect the results of the study. Patients with bleeding disorders, local or systemic infection, acute muscle trauma. Patients with comorbid conditions. Patients with severe physical disability and true leg length discrepancy(1). Pregnant females

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dry needling<br>Dry needling, hot pack, stretching exercises. | Other: Dry needling<br>* Experimental group 1 got this intervention containing Dry needling for 10 mins, followed by conventional physiotherapy treatment (hot pack and stretching) for 15 mins. Participants were treated 6 times over a 3 week period with 2 treatment sessions per week per patient. Pre and Post treatment readings were taken in 1st and 6th session over a 3 week period respectively. A follow up reading was also taken after 1 month for checking prolonged post treatment effects. Assessment was done via Pressure pain threshold Scale, Pelvic goniometer and Measuring tape for assessing functional positional fault of pelvis and muscle length of Quadratus lumborum<br>|
| Experimental: Dry Cupping<br>Dry cupping, hot pack, stretching exercises. | Other: Dry cupping<br>* Experimental group 2 got this intervention containing Dry cupping for 10 mins, followed by conventional physiotherapy treatment (hot pack and stretching) for 15 mins. Participants were treated 6 times over a 3 week period with 2 treatment sessions per week per patient. Pre and Post treatment readings were taken in 1st and 6th session over a 3 week period respectively. A follow up reading was also taken after 1 month for checking prolonged post treatment effects. Assessment was done via Pressure pain threshold Scale, Pelvic goniometer and Measuring tape for assessing functional positional fault of pelvis and muscle length of Quadratus Lumborum<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Pain by 'Pressure Pain Algometer' | Change in Pain from baseline was checked at 6th session by Pressure Pain Algometer. A follow up reading was also taken after 1 month for checking prolonged post treatment effects. | Baseline, 6th session(at 3rd week), follow up session after 1 month | 
| Change in Range of Motion of lumbar spine side flexion by 'Goniometer' | Change in ROM from baseline was measured at 6th session. A follow up reading was taken after 1 month for checking prolonged post treatment effects. A goniometer is a device that measures an angle or permits rotation of an object to a definite position | Baseline, 6th session(at 3rd week), follow up session after 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in pain by 'Numeric Pain Rating Scale' | Change in pain from baseline was measured at 6th session. A follow up reading was taken after 1 month for checking prolonged post treatment effects. The Numerical Pain Rating Scale (NPRS) is an 11 point pain scale that is completed by a patient himself, under the supervision of researcher. | Baseline, 6th session(at 3rd week), follow up session after 1 month | 
| Change in Range of Motion of lumbar side flexion by Measuring tape | Change in ROM from baseline was measured at 6th session. A follow up reading was taken after 1 month for checking prolonged post treatment effects. The method for using a tape measure to examine lateral flexion of the spine has been introduced in the literature. | Baseline, 6th session(at 3rd week), follow up session after 1 month | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Dry needling, Dry cupping, Quadratus lumborum