Effect of Muscle Energy Technique Versus Strain-counterstrain on Upper Trapezius Trigger Points

Study Overview
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Brief Summary
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Aim of the study To determine the comparative effects of muscle energy technique and strain counter strain in upper trapezius trigger point.

Detailed Description
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A Randomized Controlled trial will be conducted after approval of synopsis. To enroll patients Purposive sampling technique will be used. Patients will be selected according to the pre-defined inclusion and exclusion criteria. The enrolled patients will be allocated into two groups, group A and group B. On Group A muscle energy technique will be applied for 30 seconds and repeat 3 to 5 times per on treatment session and Group B will be treated with strain counter strain for 20-30 seconds and repeat this process for up to five times. Assessment will be done at baseline, 2nd week, 4th week and 6th week of treatment. Follow up will be assessed 15 days after completion of treatment protocol. The patients' outcome will be measured by Visual Analog Scale for pain intensity and Neck Disability Index . Informed consent will be taken from each patient. Statistical Package of Social Sciences software, version 20 will be used for the analysis of data.

Official Title
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Effect of Muscle Energy Technique Versus Strain-Counterstrain on Upper Trapezius Myofascial Active Trigger Points. A Randomized Control Trial

Conditions
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Trigger Point Pain, Myofascial

Intervention / Treatment
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* Other: Strain-counterstrain
* Other: Muscle Energy Technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants who are 18 to 34 years old In upper trapezius From 2 weeks Had mechanical neck pain and was diagnosed with active myofacial Trigger points Subjects have to exhibit a tendor point in the upper trapezius muscle either on the left or right side Local pain is greater than 3/10 on Visual Analog scale Exclusion Criteria: Patient with cervical radiculopathy Patients with Fibromyalgia syndrome Patients who had cervical spine surgery Patient with myelopathy Patients who had myofacial pain therapy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 34 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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Muscle Energy Technique<br>Muscle energy Technique will be applied on the subjects, when they will be lying supine and on the effect side therapist will stabilize shoulder by one hand, while the ear / mastoid area of the affected side will be hold by opposite hand. The head and neck will be bend to contralateral side, then bends on the same side. Subject will raise his shoulder with the shoulder fixed to the ear with less effort than the maximum. Isometric contraction will be maintain for 7-10 seconds. This position will be held for 30 seconds and repeat three to five times per on treatment session | Other: Muscle Energy Technique<br>* Muscle Energy Technique is a common way to achieve muscle tension release (stop) before stretching other's adductor muscles<br>|
| Experimental: Strain-counterstrain<br>Strain And Counter Strain will be applied on subject in normal position and will be produced by placing the muscle in a short / relaxed position, the point where the pain will reduce of at least 70% will be produce will easily define. The patient will be in a supine position while the doctor will place the labial arm in flexion, abduction and external rotation to reduce the reported Trp pain. Once the position is easy to find, the pressure will be apply to the Trp and will be hold for 20-30 seconds and repeat this process for up to five times | Other: Strain-counterstrain<br>* Strain-counterstrain is also used for manual Trigger Point processing. This involves identifying active TRP and then applying pressure until a ridiculous reaction occurs. The area is then positioned to reduce tension in the injured muscle and later reduce tripod pain. When the pain subsides, the tissues that are most stressed feel relaxed and there is a local decrease in the ground<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analogue Scale | A Visual Analogue Scale is a measurement instrument that tries to measure a characteristic or attitude that is believed to range across a continuum of values and cannot easily be directly measured. It is often used in epidemiologic and clinical research to measure the intensity or frequency of various symptoms. | 12th Week | 
| Neck Disability Index | The Neck Disability Index is a 10-item questionnaire that measures a patient's self-reported neck pain related disability. A higher Neck Disability Index score means the greater a patient's perceived disability due to neck pain | 12th Week | 
| Goniometer | Goniometer has been the most widely used tool for measuring joint range of motion. To ensure reliable measurement, standardized, specific positions and landmarks are used to measure Cervical lateral flexion range of motion. | 12th Week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Muscle Energy Technique, Myofascial, Trigger Point, Upper Trapezius, Strain-counterstrain