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Completed

NCT Number: NCT03946995

Dry Needling Versus Graston Technique in Active Myofascial Trigger Points on Upper Trapezius

This study will compare the effects dry needling and Graston technique in active myofascial trigger points on upper trapezius. Half of the study participants will receive dry needling whereas other half will receive Graston technique.

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Key information

Conditions

Trigger Points Muscular Diseases Musculoskeletal Diseases Myofascial Pain Syndromes

Age range

20 year–40 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Rawal General and Dental Hospital,

Islamabad, 44000, Pakistan

About this study

This is a single blinded randomized controlled trial, will be conducted at Rawal General & Dental Hospital, Islamabad. Both dry needling and Graston Techniques are used to release active Myofascial Trigger points with different mechanism.

Dry needling is technique in which without any medication or injection, dry needles are inserted into hyper irritable points in muscle. Graston technique is done with specially designed tools to locate knots within muscle by running the tools over the skin.

This study is planned with objectives to compare both treatment techniques on active myofascial trigger points in patients with neck pain. Effects of these will be measured on Neck Pain, Range of Motion, functional status and trigger points.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patient with non-specific pain in neck (acute and sub-acute)
  • Age: 20-40 years
  • Patient agrees to use the dry needling or Graston exclusively

Exclusion criteria

  • Patients that were using any medication to reduce the pain and/or have any effect in the skeleton muscle.
  • Patient taking other treatment in the same period of research.
  • Patients having malignancy, tuberculosis, spinal cord injury, neurodegenerative diseases radiculopathies and hematoma.
  • Patients on anticoagulants.
  • Patient with chronic neck pain.

Treatment and study plan

Dry needling group

Other

Hot Pack will be applied on upper trapezius muscles before session for general relaxation for 7-10 minutes. Generalized Stretching and strengthening neck exercises will be performed. Then after wearing gloves and appropriate personal protective measures, a thin filiform needle will be inserted which will penetrate into the skin and stimulate underlying myofascial trigger points.

The treatment will be continued for 2 weeks with 2 sessions per week.

Graston Technique Group

Other

Hot Pack will be applied on upper trapezius muscles before session for general relaxation for 7-10 minutes. Generalized Stretching and strengthening neck exercises will be performed.

Later, lubricant will be applied to the skin, and Graston technique will be applied using instrument over the active myofascial trigger points in upper trapezius.

The treatment will be continued for 2 weeks with 2 sessions per week.

Primary outcomes

  1. Numeric Pain Rating Scale (NPRS)

    Time frame: Baseline

    Numeric Pain Rating Scale (NPRS) is used to assess pain. It scores ranges from 0-10, 0 means No pain and 10 means Severe pain. Patient will be asked to verbally report the pain score.

  2. Numeric Pain Rating Scale (NPRS)

    Time frame: Post 2nd week

    Numeric Pain Rating Scale (NPRS) is used to assess pain. It scores ranges from 0-10, 0 means No pain and 10 means Severe pain. Patient will be asked to verbally report the pain score.

  3. cervical range of motion (CROM)

    Time frame: Baseline

    A cervical range of motion (CROM) inclinometer will be use to assess cervical range of motion in flexion, extension, left right lateral flexion and left-right rotation. Participants will be seated upright and asked to actively move their neck in each direction.

  4. cervical range of motion (CROM)

    Time frame: Post 2nd week

    A cervical range of motion (CROM) inclinometer will be use to assess cervical range of motion in flexion, extension, left right lateral flexion and left-right rotation. Participants will be seated upright and asked to actively move their neck in each direction.

  5. Myofascial Diagnostic Scale (MDS)

    Time frame: Baseline

    It is a scale using the signs of a Myofascial trigger point as indicators to assess the extent to which the patient suffers from Myofascial Pain Syndrome.

    The signs include: referred pain in the zone of reference, local twitch response, palpable taut band, and focal or spot tenderness.

    Spot tenderness or soft tissue tenderness consisted of five grades or indicators: grade 0 - no tenderness = 0, grade 1 - tenderness to palpation without grimace or flinch = 1, grade 2 - tenderness with grimace and/or flinch to palpation = 2, grade 3 - tenderness with withdrawal = 3, grade 4 - withdrawal to non-noxious stimuli = 4.

    The presence of a local twitch response and the presence of a palpable taut band were indicated by a score of 4 on the scale.

    The presence of referred pain was indicated by a score of 5. A total score of 9 or more was indicative of active trigger points.

  6. Myofascial Diagnostic Scale (MDS)

    Time frame: Post 2nd Week

    It is a scale using the signs of a Myofascial trigger point as indicators to assess the extent to which the patient suffers from Myofascial Pain Syndrome.

    The signs include: referred pain in the zone of reference, local twitch response, palpable taut band, and focal or spot tenderness.

    Spot tenderness or soft tissue tenderness consisted of five grades or indicators: grade 0 - no tenderness = 0, grade 1 - tenderness to palpation without grimace or flinch = 1, grade 2 - tenderness with grimace and/or flinch to palpation = 2, grade 3 - tenderness with withdrawal = 3, grade 4 - withdrawal to non-noxious stimuli = 4.

    The presence of a local twitch response and the presence of a palpable taut band were indicated by a score of 4 on the scale.

    The presence of referred pain was indicated by a score of 5. A total score of 9 or more was indicative of active trigger points.

Secondary outcomes

  1. Neck Disability Index (NDI)

    Time frame: Baseline

    Neck Disability Index (NDI) is a questionnaire designed to assess how neck pain has affected patient's ability to manage in everyday life. It has total 10 sections, For each section the total possible score is 5: if the first statement is marked the section score = 0, if the last statement is marked it = 5. If all ten sections are completed the score is calculated and converted into percentages. The maximum Score of Neck Disability Index (NDI) is 50.

  2. Neck Disability Index (NDI)

    Time frame: Post 2nd week

    Neck Disability Index (NDI) is a questionnaire designed to assess how neck pain has affected patient's ability to manage in everyday life. It has total 10 sections, For each section the total possible score is 5: if the first statement is marked the section score = 0, if the last statement is marked it = 5. If all ten sections are completed the score is calculated and converted into percentages. The maximum Score of Neck Disability Index (NDI) is 50.

Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Official study title

Comparison of Dry Needling and Graston Technique in Active Myofascial Trigger Points on Upper Trapezius

Important dates

Study start
2019
Primary completion
2019
Study completion
2019
First posted
May 13, 2019
Registry last updated
Aug 9, 2019

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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