Randomized Clinical Trial
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jul 18, 2023; 14(7): 572-581
Published online Jul 18, 2023. doi: 10.5312/wjo.v14.i7.572
Instrumented assisted soft tissue mobilization vs extracorporeal shock wave therapy in treatment of myofascial pain syndrome
Nourhan Elsayed Shamseldeen, Mohammed Moustafa Aldosouki Hegazy, Nadia Abdalazeem Fayaz, Nesreen Fawzy Mahmoud
Nourhan Elsayed Shamseldeen, Mohammed Moustafa Aldosouki Hegazy, Nadia Abdalazeem Fayaz, Nesreen Fawzy Mahmoud, Department of Physical Therapy for Musculoskeletal Disorders & Its Surgery, Faculty of Physical Therapy, Cairo University, Cairo 14531, Egypt
Author contributions: Shamseldeen NE and Hegazy MMA were responsible for the study conception and design; Shamseldeen NE performed the trial procedure and drafted the manuscript; Hegazy MMA revised the manuscript; Fayaz NA reviewed the design, supervised the process of research, and approved the final version to be published; Mahmoud NF supervised the process of research, helped in writing the discussion, and was responsible for the final revision; All authors approved the final manuscript.
Institutional review board statement: This study was approved by the Research Ethics Committee of the Faculty of Physical Therapy (P.T.REC/012/003180).
Clinical trial registration statement: This study is registered at Department of Physical Therapy for Musculoskeletal Disorders & Its Surgery, Faculty of Physical Therapy, Cairo University.
Informed consent statement: All study participants provided an informed consent statement before enrollment.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nesreen Fawzy Mahmoud, MSc, PhD, Lecturer, Physiotherapist, Senior Research Fellow, Department of Physical Therapy for Musculoskeletal Disorders & Its Surgery, Faculty of Physical Therapy, Cairo University, Dokki, Giza, Cairo 14531, Egypt. dr_nesreenfawzy@cu.edu.eg
Received: January 9, 2023
Peer-review started: January 9, 2023
First decision: April 26, 2023
Revised: May 10, 2023
Accepted: May 31, 2023
Article in press: May 31, 2023
Published online: July 18, 2023
Abstract
BACKGROUND

Active myofascial trigger points (TrPs) often occur in the upper region of the upper trapezius (UT) muscle. These TrPs can be a significant source of neck, shoulder, and upper back pain and headaches. These TrPs and their related pain and disability can adversely affect an individual’s everyday routine functioning, work-related productivity, and general quality of life.

AIM

To investigate the effects of instrument assisted soft tissue mobilization (IASTM) vs extracorporeal shock wave therapy (ESWT) on the TrPs of the UT muscle.

METHODS

A randomized, single-blind, comparative clinical study was conducted at the Medical Center of the Egyptian Railway Station in Cairo. Forty patients (28 females and 12 males), aged between 20-years-old and 40-years-old, with active myofascial TrPs in the UT muscle were randomly assigned to two equal groups (A and B). Group A received IASTM, while group B received ESWT. Each group was treated twice weekly for 2 weeks. Both groups received muscle energy technique for the UT muscle. Patients were evaluated twice (pre- and post-treatment) for pain intensity using the visual analogue scale and for pain pressure threshold (PPT) using a pressure algometer.

RESULTS

Comparing the pre- and post-treatment mean values for all variables for group A, there were significant differences in pain intensity for TrP1 and TrP2 (P = 0.0001) and PPT for TrP1 (P = 0.0002) and TrP2 (P = 0.0001). Also, for group B, there were significant differences between the pre- and post-treatment pain intensity for TrP1 and TrP2 and PPT for TrP1 and TrP2 (P = 0.0001). There were no significant differences between the two groups in the post-treatment mean values of pain intensity for TrP1 (P = 0.9) and TrP2 (P = 0.76) and PPT for TrP1 (P = 0.09) and for TrP2 (P = 0.91).

CONCLUSION

IASTM and ESWT are effective methods for improving pain and PPT in patients with UT muscle TrPs. There is no significant difference between either treatment method.

Keywords: Myofascial trigger points, Upper trapezius muscle, Instrument-assisted soft tissue mobilization, Extracorporeal shock wave therapy, Myofascial pain syndrome

Core Tip: This is the first study to compare the effects of instrument-assisted soft tissue mobilization (IASTM) vs extracorporeal shock wave therapy (ESWT) on trigger points of the upper trapezius muscle in myofascial pain syndrome. The results of the current study revealed no statistically significant differences between the effect of IASTM and ESWT on pain intensity and pain pressure threshold of upper trapezius muscle trigger points. However, both IASTM and ESWT improved pain measures in both groups of patients suffering from myofascial pain syndrome. Based on these results, treatment methods can be selected based on availability, cost, therapist experience, and patient preference.