Clinical trial NCT04179214: Thoracic Spine Manipulation on Pressure Pain Sensitivity of Active Myofascial Trigger Points in Rhomboid Muscle
Official title: Effects of Thoracic Spine Manipulation on Pressure Pain Sensitivity of Active Myofascial Trigger Points in Rhomboid Muscle
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Trigger Points
Keywords: Trigger Area
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2019-11-27
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Maximum age (years): 30
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Both experimental and control groups will be treated simultaneously with one treatment option common to both groups
Primary purpose: TREATMENT

Brief summary: This study intends to determine the effects of thoracic manipulation on pressure pain sensitivity in patients with rhomboid active trigger points.

Detailed description: This is a single blinded controlled trial and will be conducted at physiotherapy clinic of women institute of rehabilitation sciences Abbottabad. The "screw" manipulation is a fairly aggressive manipulative technique in which the transverse processes are forced into a posterior to anterior direction Individual will be screened out according to inclusion criteria. Individuals will be allocated randomly into two groups, 30 in thoracic manipulation group and 30 in conventional physiotherapy protocol group by sealed envelope method. Both groups will receive conventional physiotherapy protocol (manual pressure release technique and muscle imbalances exercises) for rhomboid trigger points in common and the experimental group will receive thoracic manipulation in addition to conventional protocol.

Assessment will be done on baseline and after 3 weeks. Data will be analyzed on SPSS version 21.

Eligibility criteria: Inclusion Criteria:

* Age between 18 to 30 years
* Participants presented with interscapular pain
* Forward head posture with active trigger points in rhomboid muscle
* Segmental hypomobility in upper thoracic identified with positive springing test

Exclusion Criteria:

* Participants who demonstrated contraindication to manipulation
* Open wounds or Trauma to the area which occurred less than two months prior treatment
* Any neurological compromise
* Mid scapular pain due to degenerative process or osteoporosis

Primary outcomes:
measure: Numeric pain rating scale (NPRS)
timeFrame: Baseline
measure: Numeric pain rating scale (NPRS)
timeFrame: post 3 weeks
measure: Pain pressure threshold
timeFrame: baseline
measure: Pain pressure threshold
timeFrame: post 3 weeks
measure: Thoracic ROM
timeFrame: Baseline
measure: Thoracic ROM
timeFrame: post 3 weeks
Secondary outcomes:
measure: Neck Disability Index (NDI)
timeFrame: Baseline
measure: Neck Disability Index (NDI)
timeFrame: post 3 weeks
Other outcomes:
Locations:
city: Abbottabad
country: Pakistan
facility: Women Institute of Rehabilitation Sciences
state: KPK
Study officials:
affiliation: Riphah International University
name: Huma Riaz, PHD*
role: PRINCIPAL_INVESTIGATOR
References:
citation: Schiller L. Effectiveness of spinal manipulative therapy in the treatment of mechanical thoracic spine pain: a pilot randomized clinical trial. J Manipulative Physiol Ther. 2001 Jul-Aug;24(6):394-401. doi: 10.1067/mmt.2001.116420.
citation: Ruiz-Saez M, Fernandez-de-las-Penas C, Blanco CR, Martinez-Segura R, Garcia-Leon R. Changes in pressure pain sensitivity in latent myofascial trigger points in the upper trapezius muscle after a cervical spine manipulation in pain-free subjects. J Manipulative Physiol Ther. 2007 Oct;30(8):578-83. doi: 10.1016/j.jmpt.2007.07.014.
citation: Dunning JR, Cleland JA, Waldrop MA, Arnot CF, Young IA, Turner M, Sigurdsson G. Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: a multicenter randomized clinical trial. J Orthop Sports Phys Ther. 2012 Jan;42(1):5-18. doi: 10.2519/jospt.2012.3894. Epub 2011 Sep 30.
citation: Nilsson N, Christensen HW, Hartvigsen J. The effect of spinal manipulation in the treatment of cervicogenic headache. J Manipulative Physiol Ther. 1997 Jun;20(5):326-30.
citation: Cleland JA, Glynn P, Whitman JM, Eberhart SL, MacDonald C, Childs JD. Short-term effects of thrust versus nonthrust mobilization/manipulation directed at the thoracic spine in patients with neck pain: a randomized clinical trial. Phys Ther. 2007 Apr;87(4):431-40. doi: 10.2522/ptj.20060217. Epub 2007 Mar 6.
citation: Haleema B, Riaz H. Effects of thoracic spine manipulation on pressure pain sensitivity of rhomboid muscle active trigger points: A randomized controlled trial. J Pak Med Assoc. 2021 Jul;71(7):1720-1724. doi: 10.47391/JPMA.02-256.