comparative study of intramuscular manual therapy percutanceous electrrical nerve stimulation and tens on myofacial trigger points of trapezius musc

Abstract

newline Background -A myofascial trigger point is defined as a hypersensitivity point in a tight band of skeletal muscle that is painful when contracted, stretched, orstimulated, and which induces pain at a distance from the point .Tight bands are found on either side of contraction knot that are stretched due to pulling effect of the contraction knot in muscle fibers. Methods -College of Physiotherapy, Pimpri (Pune)were selected by convenience sampling method. 90 Patients satisfying inclusion and exclusion criteria were selected for this study.All thepatientswere divided randomlyinto 3groups,30ineachgrouppatients were treated with Intermuscular manual therapy (IMMT), Percutaneous electrical nerve stimulation(PENS) and TENS respectively. A clear explanation of the study was given to them and informed consent was obtained, duly signed, from them who were ready and agreed to participate. The. Each group was given assigned treatment alternate days for 10 mins, 3 sessions for 3 weeks .Vitamin C supplement was recommended prior to the treatment for the patients who were treated with Intramuscular Manual Therapy and PENS. Pre and post interventions were recorded in Ultrasonography(size ofthe trigger pointand width ofthe upper fibresoftrapezius muscle) , NPRS, Goniometer, Pressure Algometer and Neck Disability Indexwhich were analysed statistically. newlineResults No significant differences were seen among the three procedures. However proclivity for percentage of Improvement in Cervical Range of Motion (left Cervical Rotation, Right Cervical Rotation, Right Cervical Lateral Flection and Left Cervical Lateral Flection) irrespective of sides in which the Myofascial Trigger point was nestled, was less than 50%. This is probably because of Kinesio phobia. newlineConclusion The studydemonstratedameliorationofpainanddisabilityinpatients treated with IMMT, PENS and TENS. Ultrasonography images of trigger point size and muscle thickness showed abated in all three groups. Painful experience was interpreted as threatening, it generated catastrophising cognitions that activity might have caused more pain and re/injury. This resulted in restriction of neck movements despite of decrease in pain. newlineKeywords- Trigger point, Percutaneous Intramuscular nerve stimulation, Intramuscular manual therapy, Transcutaneous Electrical Nerve Stimulation, Ultrasonography, Kinesiophobia newline