Immediate Effects of Cervical Spine Manipulation versus Conventional Physical Therapy on Upper Trapezius Active Trigger Points

Marium Khalid; Waqas Shaukat; Esha Khan; Sidra Malik; Rameen Ikram; Zunaira Anwar

doi:10.55735/5cmawa49

Authors

Marium Khalid Department of Physical Therapy, Ibadat International University, Islamabad, Pakistan
Waqas Shaukat Chakwal Physiotherapy and Rehab Center, Chakwal, Pakistan
Esha Khan Department of Rehabilitation Sciences, Shifa Tameer e Millat University, Islamabad, Pakistan
Sidra Malik Department of Physical Therapy, Ibadat International University, Islamabad, Pakistan
Rameen Ikram University Institute of Physical Therapy, University of Lahore, Islamabad, Pakistan
Zunaira Anwar Alhamd Islamic University, Islamabad, Pakistan

DOI:

https://doi.org/10.55735/5cmawa49

Keywords:

Cervical manipulation , Myofascial trigger points , Neck pain , Upper trapezius

Abstract

Background: Myofascial trigger points in the muscles are also a prime source of neck pain. The trapezius muscle is the most affected muscle by the myofascial trigger points. Several treatment techniques are used for the treatment of trigger points, such as mobilisation, manipulation, and sustained pressure release. Objective: To evaluate the immediate effects of cervical spine manipulation on pressure pain sensitivity at the upper trapezius trigger point and cervical range of motion. Methodology: A randomised controlled trial involving 66 participants was conducted from August and December 2019 at the Physiotherapy Outpatient Department of Railway Rehabilitation Centre, Railway General Hospital, and Max Rehab & Decompression Centre, Maxhealth Hospital, G8 Islamabad. Participants were randomly allocated to either the control or experimental group using the sealed envelope method. The control group received manual pressure release followed by muscle stretching, while the experimental group underwent cervical spine manipulation using the Kaltenborn chin-hold technique, followed by stretching. A structured questionnaire was used to assess pre- and post-intervention responses. Outcomes were evaluated using algometry and an inclinometer before and immediately after the respective interventions. Data were analysed using IBM SPSS version 22. For qualitative variables, mean, standard deviation, and mean ranks were calculated. The test applied to parametric end values between groups was an independent t-test. The Mann-Whitney test was applied to non-parametric variables. Results: Pre and post-intervention data were captured using a structured questionnaire. The total mean age of patients was 37.17±5.72 for the group. The mean age value was 33.3±6.9 for group B. out of 59 patients, 14 were males and 45 were females. About 25 females and 4 males were found in group A, while 9 males and 25 females were found in group B. The experimental group showed a significant improvement in cervical range of motion, whereas the control group demonstrated a notable increase in pressure pain threshold levels. Conclusion: The ranges of motion, specifically rotation and side bending, were increased in the experimental group, and pain pressure threshold levels were increased in the control group.

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