Effects of Post Isometric Relaxation With Scapular Stabilization Exercises

Study Overview
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Brief Summary
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The levator scapulae is an important postural muscle that tends to shorten or become tight because of overactivity and bad posture, leading to neck and shoulder pain. Levator scapulae syndrome is usually caused by the poor shoulders posture as rounded shoulders as sitting at a computer hunched. It is exacerbated by sustained neck postures, neck movements or levator scapulae muscle palpation. The aim of study will be to determine the effects of post isometric relaxation with scapular stabilization exercises on pain, disability and range of motion in patients with levator scapulae syndrome.

Detailed Description
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A Randomized Controlled Trial will be conducted at Tehsil Headquarter Hospital Sharqpur Shareef, Sheikhupura through consecutive sampling technique on 30 patients with levator scapulae syndrome which will be allocated using simple random sampling through sealed opaque enveloped into Group A and Group B. Group A will be treated with post isometric relaxation, scapular stabilization exercises along with baseline treatment. Group B will be treated with post isometric relaxation along with baseline treatment. Baseline treatment includes hot pack, TENS, upper trapezius stretch, levator scapular stretch and pectoralis major stretch. Both groups will come thrice per week for a total of 4 weeks. Outcome measures are NPRS, universal goniometer and NDI. Data will be analysed during SPSS software version 25. After assessing normality of data by Shapiro-Wilk test, it will be decided either parametric or non-parametric test will be used within a group or between two groups. Keywords: Disability, Levator Scapulae, Range of Motion, Pain

Official Title
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Effects of Post Isometric Relaxation With Scapular Stabilization Exercises on Pain, Range of Motion and Disability With Levator Scapulae Syndrome

Conditions
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Upper Cross Syndrome

Intervention / Treatment
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* Other: Post-isometric relaxation and Conventional treatment
* Other: Conventional Physical Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Both Males and females Age range of 18-40 years Neck and medial border scapular pain for at least 3months Examination - Increased muscle tone and tenderness at neck Reduced Side flexion and Rotation of neck Positive Levator Scapular length Test Exclusion Criteria: Neuropathies Vertebral fractures Pregnancy Previous cognitive and functional disorders Traumatic neck injury Fibromyalgia cancer

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

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: Group A: post isometric relaxation and ConVentional treatment.<br>Post Isometric Relaxation: The term refers to the effect of subsequent relaxation experienced by a muscle or group of muscles, after brief periods during which an isometric contraction has been performed. Post isometric relaxation technique was applied to levator scapulae for 5 repetition using 20% of maximal isometric contraction for 7-10 sec. with complete relaxation of all element, the stretch is maintained for 30 sec. | Other: Post-isometric relaxation and Conventional treatment<br>* The term refers to the effect of subsequent relaxation experienced by a muscle or group of muscles, after brief periods during which an isometric contraction has been performed. Post isometric relaxation technique was applied to levator scapulae for 5 repetition using 20% of maximal isometric contraction for 7-10 sec. with complete relaxation of all element, the stretch is maintained for 30 sec. + hot pack and TENS at neck area for 10 mint upper trapezius, levator scapulae and pectoralis stretching 3 times with 30 second hold. static stretching exercises two sessions per week for 3 weeks were given to each patient<br>Other: Conventional Physical Therapy<br>* Conventional Physical Therapy; hot pack and TENS at neck area for 10 mint upper trapezius, levator scapulae and pectoralis stretching 3 times with 30-second hold. static stretching exercises, two sessions per week for 3 weeks were given to each patient<br>|
| Active Comparator: Group B: Conventional treatment<br>hot pack and TENS at neck area for 10 mint upper trapezius, levator scapulae and pectoralis stretching 3 times with 30-second hold. static stretching exercises, two sessions per week for 3 weeks were given to each patient | Other: Conventional Physical Therapy<br>* Conventional Physical Therapy; hot pack and TENS at neck area for 10 mint upper trapezius, levator scapulae and pectoralis stretching 3 times with 30-second hold. static stretching exercises, two sessions per week for 3 weeks were given to each patient<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Universal Goniometer (UG) | Universal Goniometer (UG) used to measure ROM of cervical Spine A goniometer is an instrument that measures the available range of motion at a joint. Physical therapists commonly use a goniometer to measure the range of motion. The therapist can use a goniometer to assess the range of motion at the initial assessment. In this study range of motion of the neck will be measured. The cervical spine's range of motion is approximately 80° to 90° of flexion, 70° of extension, 20° to 45° of lateral flexion, and up to 90° of rotation to both sides. | upto 4 weeks | 
| Numeric pain rate scale (NPRS) | The numeric pain rate scale (NPRS) measures the pain at the neck region in patients with mechanical neck pain. The patient's level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates no pain, and 10 indicates worst pain. NPRS is categorized into mild, moderate and severe pain. Mild pain value 1 to 3 Moderate pain value 4 to 7 Severe pain value 8 to 10 | upto 4 weeks | 
| Neck Disability index (NDI) | Neck Disability index (NDI) measures the disability of the neck region in patients with mechanical pain. NDI questionnaire will be used to assess disability. It comprises 10 items; 7 related to daily living activities, 2 related to pain and 1 to concentration. Each item is scored from 0 to 5. The total score is a percentage, with higher scores related to more significant disability. 0 to 4 = no disability 5 to 14 = mild 15 to 24 = moderate 25 to 34 = severe Above 34 = complete | upto 4 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Neck muscles, Neck Pain, levator scapulae, Range of Motion