Myofascial Trigger Points of the Levator Scapulae Muscle

Study Overview
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Brief Summary
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Chronic neck pain (CNP) is considered one of the most common musculoskeletal disorders worldwide and myofascial pain syndrome (MPS) is the most prevalent musculoskeletal disorder in the majority of the population. However, normal tissue contractility changes and the different types of myofascial trigger points (MTrPs) measured by tensiomography have not yet been studied. For this reason, the aim of our study is to determine the differences in pressure pain threshold (PPT), tensiomyography and sonoelastography between the palpation zone of control points with respect to active and latent MTrPs in the levator scapulae muscles of subjects with CNP. A single-blind descriptive cross-sectional study is conducted with a convenience sample of 60 points (20 active, 20 latent and 20 control points) on both sides of the subject in the levator scapulae muscles of individuals diagnosed with CNP. The order of outcome measurements for each point was PPT, manual tension index sonoelastography and tensiomyography separated by 15 minutes. Objective contractile parameters were: contraction time (Tc), mean relaxation time (Tr), maximum radial displacement (Dm), holding time (Ts) and delay time (Td).

Official Title
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Sonoelastography, Tensiomyography and Mechanosensitivity Between Latent, Active and Control Trigger Points in Myofascial Trigger Points of the Levator Scapulae Muscle.

Conditions
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Myofascial Pain Syndrome

Intervention / Treatment
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* Diagnostic Test: Sonoelastography, tensiomyography and mechanosensitivity


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Bilateral presence of at least one active trigger point. One control point and one latent trigger point in the levator scapulae muscles. Subjects aged between 18 and 65 years. Subjects diagnosed with chronic neck pain for more than 6 weeks. Signed informed consent to be able to participate in the study. Exclusion Criteria: Previous treatment for chronic neck pain (within one year) or medical history with a diagnosis of neuropathy. Rheumatoid arthritis. Myopathy. Cognitive impairment or mental disability. Skin disorders. Pregnancy. Activity level of a high-level athlete. Medical conditions (fractures, structural deformities and neoplasms). Surgical interventions in the cervical-dorsal region or upper extremities.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 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: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Ischemic Compression group<br>IC group with conservative technique in trigger points in levator scapulae muscle | Diagnostic Test: Sonoelastography, tensiomyography and mechanosensitivity<br>* To observe the differences between the different trigger points of the levator scapulae muscle by means of different diagnostic options.<br>|
| Active Comparator: Dry needling group<br>Dry needling group with invasive technique in trigger points in levator scapulae muscle | Diagnostic Test: Sonoelastography, tensiomyography and mechanosensitivity<br>* To observe the differences between the different trigger points of the levator scapulae muscle by means of different diagnostic options.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| manual tension index sonoelastography | Measurement of manual ultrasound transducer tension on the trigger point of the levator scapulae | 1 week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| tensiomyography | Ultrasound transducer tensiomyography measurement of the levator scapulae trigger point | 1 week | 
| minimum intensity of a stimulus that elicits the sensation of pain (pressure pain threshold). | patient-tolerable pain at the trigger point of the levator scapulae muscle measured by algometer. | 1 week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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physiotherapies techniques, sonoelastography;, muscle tension, neck pain