Stripping Massage Technique and Post-isometric Relaxation

Official title

Combined Effects of Stripping Massage Technique and Post Isometric Relaxation on Pain, ROM and Functional Movement in Patients With Trapezius Myalgia

Overview

This randomized clinical trial investigates the synergistic effects of stripping massage and Post-Isometric Relaxation (PIR) on pain alleviation, ROM and functional movement improvement in individuals with Trapezius myalgia. A purposive sampling approach will select participants aged 18 and 50 years. A total of 44 patients will be taken, who will be randomly divided into two equal groups, each containing 22 patients. Group A will receive standard baseline management, supplemented with heating pad, active stretching, isometrics and ischemic compression, while Group B will receive the combined management (stripping massage + PIR) .

Detailed description

The study will assess pain intensity using NPRS, ROM using goniometer and neck disability or functional movement of neck using Neck Disability Index (NDI) at baseline and four weeks follow-up. Ethical approval and informed consent will ensure the study's integrity. The primary outcomes will focus on pain reduction and improved neck function, with secondary outcomes including trigger point severity and range of motion. Data analysis will utilize SPSS version 25. This study aims to provide valuable insights into the combined efficacy of stripping massage and PIR, ultimately informing evidence-based practice and enhancing patient outcomes in patients with trapezius myalgia.

Interventions

• Other Stripping Massage Technique:
  * The back of the neck and shoulder were uncovered. * Controlled and steady pressure was administered using the thumb along the entirety of the tense trapezius muscle, moving from origin to insertion and perpendicular to the muscle fibers, for approximately 3 minutes, twice weekly over a period of 4 weeks. * The pressure was progressively raised with each subsequent stroke, based on tolerance level.
• Other Post-Isometric Relaxation (PIR)
  * During the PIR intervention, the patients rested in a supine position with their necks tilted to the side, away from the affected side, placing the upper trapezius muscle fibers in a stretched position. * A moderate isometric contraction, around 75% of the patient's maximum effort, was performed by the upper trapezius and maintained for 5 seconds, followed by a 3-second relaxation phase. * The therapist then gently mobilized the cervical spine to a new range of motion barrier. * This sequence

Primary outcome measures

• NPRS [Time frame: 4 weeks]
• Universal Goniometer [Time frame: 4 weeks]
• NDI [Time frame: 4 Weeks]

Eligibility criteria

Inclusion criteria

• Presenting with neck pain and stiffness
• Experiencing tightness in the upper trapezius muscle
• Having pain at rest, local twitch response or jump sign in upper trapezius
• Patients having functional limitations while performing certain activities of everyday living.

Exclusion criteria

• Patients with an NPRS score of 3 or less.
• Presence of structural abnormalities like torticollis or scoliosis.
• Presence of skin disease on the back.
• Having undergone upper limb surgery within the past year .
• Participation in another clinical trial.
• Severe psychiatric conditions that would impair participation or compliance

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Pakistan · 1 center

• The Perfect Physiotherapy Clinic — Muzaffargarh

Publications

• Aras D, Al-Ihsan IM, Sutono E. The effectivity of trigger point dry needling in improving pain on people with upper trapezius myalgia. Enfermería Clínica. 2020;30:87-91.
• Joshi A, Jawade S, Chitale N. Effectiveness of Myofascial Release (MFR) vs. High-Frequency Transcutaneous Electrical Nerve Stimulation (TENS) for Pain Relief and Functional Improvement in College Students With Trapezius Myalgia. Cureus. 2022 Oct 4;14(10):e29898. doi: 10.7759/cureus.29898. eCollection 2022 Oct. PMID 36348914
• Supornpun N, Rummaneethorn P, Nararatwanchai T, Saiwichai T, Chaichalotornkul S. Incobotulinum Toxin A with a One-year Long-lasting Effect for Trapezius Contouring and Superior Efficacy for the Treatment of Trapezius Myalgia. J Cutan Aesthet Surg. 2022 Apr-Jun;15(2):168-174. doi: 10.4103/JCAS.JCAS_68_21. PMID 35965898
• SAMIR SM, AMANY M, ABDELRAHMAN AC, SALWA FA. Effect of Passive Stretching Exercises Versus Post Isometric Relaxation Technique on Pain Intensity in Quadratus Lumborum Trigger Points on Lower Back Myofascial Pain Syndrome. The Medical Journal of Cairo University. 2024;91(12):1519-23.
• Elagamawy MI, Elsayed WH, Zahran MR. Effect of Muscle Energy Technique versus Instrument-assisted Soft Tissue Mobilization in Upper Trapezius Myofascial Trigger Points. Egyptian Journal of Physical Therapy. 2023;16(1):7-16.
• Albaker AB. Ischemic pressure vs. post-isometric relaxation for treatment of rhomboid latent myofascial trigger point: a systemic review. Eur Rev Med Pharmacol Sci. 2023 Jun;27(11):5031-5038. doi: 10.26355/eurrev_202306_32620. PMID 37318477
• El-Hafez HM, Hamdy HA, Takla MK, Ahmed SEB, Genedy AF, Abd El-Azeim ASS. Instrument-assisted soft tissue mobilisation versus stripping massage for upper trapezius myofascial trigger points. J Taibah Univ Med Sci. 2020 Mar 6;15(2):87-93. doi: 10.1016/j.jtumed.2020.01.006. eCollection 2020 Apr. PMID 32368203
• Junaid M, Yaqoob I, Shakil Ur Rehman S, Ghous M. Effects of post-isometric relaxation, myofascial trigger point release and routine physical therapy in management of acute mechanical neck pain: a randomized controlled trial. J Pak Med Assoc. 2020 Oct;70(10):1688-1692. doi: 10.5455/JPMA.15939. PMID 33159734

Identifiers

NCT: NCT07063355 · REC/RCR & AHS/24/0171

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗