Effects of Dry Needling in Patients With Upper Cross Syndrome

Study Overview
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Brief Summary
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The study will be done to evaluate the effectiveness of dry needling of muscles involved in Upper Cross Syndrome. Muscles involved in upper cross syndrome are tight upper trap, Levator Scapulae, Sternocledomastoid , Pectorals major and minor and rhomboids. Physical assessment of trigger points will locate the target area for dry needling. After pre treatment measurements, dry needling will be performed to treatment group and stretching, hot pack and tens will be apply in control group. Study design will be randomized controlled trial and sample size will be 34 participants. Data will be collected from Riphah Rehabilitation Center. Patients of 20-50 years old with UCS diagnosed through observation and physical examination will be included. Patients with systemic soft tissue and bony diseases will be excluded. Intervention duration will be two session of DNT with two weeks routine management. Basic tools will be Visual analog scale (VAS), Neck Disability Index (NDI) and Goniometry

Detailed Description
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Dry needling is relatively new method for the management of musculoskeletal pain.Different methods of dry needling, its effectiveness, and physiologic and adverse effects are discussed. Dry needling is a treatment modality that is minimally invasive, cheap, easy to learn with appropriate training, and carries a low risk. The deep method of dry needling has been shown to be more effective than the superficial one for the treatment of pain associated with myofascial trigger points. However, over areas with potential risk of significant adverse events, such as lungs and large blood vessels, we suggest using the superficial technique, which has also been shown to be effective. Questionnaire for assessing the improvement in quality of life is by NDI and ranges like neck flexion/extension, side bending and rotation will be measured by standard goniometry. Neck disability index will use to check the patient's ability to perform his ADL before and after the treatment/control. Data will be collected from Riphah rehab center. Assessed patients of UCS of age 20 to 50 will be the targeted population of this study. Patients with systematic and bony disease excluded from the study. Population having stiff upper back, tight trap and stiff upper thoracic spine have UCS. Ethical guidelines will be followed for both treatment and control group. SPSS version 21 will be use for data analysis with sample size of 34 participants, 17 participants each group that will randomly allocated in treatment/control group.

Official Title
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Effects of Dry Needling on Pain, Range of Motion and Function in Patient With Upper Cross Syndrome

Conditions
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Neck Syndrome

Intervention / Treatment
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* Other: Dry Needling
* Other: Hot pack , TENS , Stretching


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Stiffness and gradual pain in neck and shoulder Pain due to Postural Dysfunction Trauma or insidious onset Exclusion Criteria: Any systemic soft tissue and bony disease. Patient with spinal tuberculosis, spinal fractures, pregnancy, cancer. Any recent surgery. Patient with any cervical or thoracic problem. Patients with any other serious pathology/red flags

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 50 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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group A<br>Dry Needling | Other: Dry Needling<br>* Dry needling on Upper trapezius, Levator Scapulae, Sternocledomastoid , Pectorals major and minor and rhomboids for 10 min<br>|
| Active Comparator: Group B<br>Hot pack , TENS , Stretching | Other: Hot pack , TENS , Stretching<br>* Treatments are Hot Pack for 15 minutes TENS for 10 minutes Stretching The third treatment which is Stretching will be given one time on each muscle (tight upper trap, Levator Scapulae, Sternocledomastoid , Pectorals major and minor and rhomboids) of upper spine<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 (VAS) 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 | 2nd Week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neck Disability Index Questionnaire | Neck disability index is a self report questionnaire use to determine how neck pain effects the patients daily life and to assess the self rated disability of patients with neck pain. Area of assessment are activities of daily life, attention ,work memory ,functional mobility ,pain ,occupational performance ,quality of life and sleep. Totally based on patient reported outcome | 2nd Week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dry needling, upper cross syndrome, VAS, NDI, goniometry