Instrument-assisted Soft Tissue Mobilization Versus Integrated on Mechanical Neck Pain

Study Overview
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Brief Summary
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the aim of this study is to investigate the efficacy of instrumented assisted soft tissue mobilization versus integrated neuromuscular inhibition technique on mechanical non-specific neck pain

Detailed Description
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Mechanical neck pain is a prevalent condition in various populations. Neck pain occurrence is affected by several factors, involving environmental, psychological, and social aspects. Neck pain represents the fourth major disorder responsible for a person's year lived with disability and ranked eleventh as disability-adjusted life years of a person. The neck pain incidence ranges from 10.4 to 23.3% in 1-year time, while the range of prevalence was 0.4 to 86.8%. It has a high prevalence among computer users, office workers, and females, especially females aged 35 to 49 years old. Myofascial trigger point (MTrP) might play an important role in the formation of mechanical neck pain and is known as a hyperirritable spot in skeletal muscle that is accompanied with a hypersensitive palpable nodule in a taut band. IASTM and integrated play an important role in the treatment of mechanical neck pain.this trial has three groups; one will receive IASTM+ conventional, the second will receive integrated + conventional and the third will receive conventional treatment for four week

Official Title
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Instrument-assisted Soft Tissue Mobilization Versus Integrated Neuromuscular Inhibition Technique on Mechanical Non-specific Neck Pain

Conditions
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Non-specific Chronic Mechanical Neck Pain

Intervention / Treatment
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* Other: instrument assisted soft tissue mobilization
* Other: integrated neuromuscular inhibition technique
* Other: conventional therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosed as non-specific neck pain with upper trapezius active myofascial trigger points less than 3 months of duration and have these criteria: taut band on palpation, hyper sensible tender spot in the taut band, local twitch response referred pain pattern body mass index from 18 to 25 kg/m2 their ages from 18-35 Exclusion Criteria: if they had trigger point injections within the past 6 months history of neck or upper back surgery, trauma or fracture history of a whiplash injury, skin diseases and lesions, any sensory disturbances, any vascular syndromes, neck and back deformities cervical radiculopathy, and diagnosis of fibromyalgia syndrome, skin diseases

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 35 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: instrument assisted soft tissue mobilization and integrated neuromuscular inhibition technique
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: instrument assisted soft tissue mobilization<br>the patients will receive instrument-assisted soft tissue mobilization+conventional therapy three times per week for four week | Other: instrument assisted soft tissue mobilization<br>* the patients will receive instrument-assisted soft tissue mobilization:The subject was seated in a relaxed sitting position. M2T blade was used to find specific areas of restriction on RT upper trapezius. Then treatment plane 1 - 2 and 3 were used.The lubricant (Vaseline) was applied to the skin around the neck area prior to treatment and the tool was cleaned with an alcohol preparation pad. Then by using M2T blade with angle 45, we were giving long slow strokes without causing any discomfort or pain over muscle starting from its insertion up to its origin approximately for 2 to 3 min repeated two times.<br>Other: conventional therapy<br>* the patients will receive hot back for 10 minutes, active range of motion exercise, chin tuck, stretches<br>|
| Experimental: integrated neuromuscular inhibition technique<br>the patients will receive integrated neuromuscular inhibition technique+ conventional therapy. three times a week for four week | Other: integrated neuromuscular inhibition technique<br>* will receive integrated neuromuscular inhibition technique: from supine lying position.we the patients will perform ischemic compression at trigger points then positional release technique and finally muscle energy technique.<br>Other: conventional therapy<br>* the patients will receive hot back for 10 minutes, active range of motion exercise, chin tuck, stretches<br>|
| Active Comparator: conventional therapy<br>the patients will receive conventional therapy three times a week for four week | Other: conventional therapy<br>* the patients will receive hot back for 10 minutes, active range of motion exercise, chin tuck, stretches<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain intensity | The scale that will be used the VAS ;each subject will instructed to put point on line from no pain to tolerable pain | up to four weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| neck disability | will be measured by Arabic neck disability index | up to four weeks | 
| muscle amplitude in the form of normalized root mean square (RMS) | muscle amplitude will be measured by surface electromyography for upper trapezius | up to four weeks | 
| muscle fatigue in the form of median frequency | muscle fatigue will be measured by surface electromyography for upper trapezius | up to four weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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instrument-assisted soft tissue mobilization, integrated neuromuscular inhibition technique