To investigate the effect of different carrier frequencies of interferential current on pressure pain threshold, neck disability, cervical range of motion and upper trapezius muscle activity when applied on upper trapezius chronic myofascial trigger points: Randomized Controlled Trial
Interferential current (IFC) is a medium frequency current derived from the interference of two symmetrical, but asynchronous alternating currents ranged from 1 to 10 KHz. The two main currents resulting in a single interference current with properties uniquely different from the two original currents.The lesser current of the two original currents is termed the carrier frequency and the interference current is called the beat frequency. A specific beat frequency can be obtained from several possible interference currents as long as the difference between the original currents is the same. For electro pain modulation, IFC is commonly used form of electrotherapy. It has the advantage of reducing the skin impedance, deeper penetration into tissues and is perceived as more comfortable. Myofascial pain syndrome (MPS) is a common form of chronic musculoskeletal pain that widely spread and contributing to a significant financial burden and job- related disability. It represents the most common disorder in patients with nonspecific chronic neck pain.The main characteristics of MPS include the presence of myofascial trigger points (MTrPs) which are defined as hyperirritable nodule in a taut band of skeletal muscle fibers which is palpable and tender during physical examination. Trigger points (TrPs) are usually seen in the upper fiber of trapezius. TrPs can be clinically classified as either active or latent. Active TrPs was defined as: MTrPs that refer pain during activity and during rest without any pressure. They prevent full muscle lengthening and induce their weakness. Latent TrPs was defined as: MTrPs that is painful only when palpated. Evidence on the effect of IFC on pain modulation is not confirmed up till now. This might be attributed to multiple factors such as limited number of studies, inappropriate use of the parameters or using single carrier frequency (4 KHz) in majority of studies and the physiological effects of all our modalities are dose dependent. Dose depends on details of parameters including frequency. For IFC, the carrier frequency of the current has been suggested as an important parameter to achieve the most effective hypoalgesic response. However, there remains no evidence to support the selection of one carrier frequency over another. Few studies were conducted to examine the effect of different carrier frequencies by comparing their individual effects. Further researches are needed to prove which carrier frequency is more effective in treatment. Therefore, this study will be conducted to compare the effect of different carrier frequencies of the IFC in the management of upper trapezius chronic TrPs.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
68
Standard treatment will be (active cervical range of motion exercises, myofascial release to upper trapezius muscle and postural advices at home).
Interferential current treatment parameters will be as following; carrier frequency 2 KHz and beat frequency 15 Hz performed for 45 minutes per session.The intensity will be raised according to the subject's tolerance, remaining in the sensory level.
Interferential current treatment parameters will be as following; carrier frequency 4 KHz and beat frequency 15 Hz performed for 45 minutes per session.The intensity will be raised according to the subject's tolerance, remaining in the sensory level.
Faculty of Physical Therapy Cairo University
Giza, Egypt
Change in pressure pain threshold
Pressure pain threshold will be measured by digital pressure algometer
Time frame: Immediately after the end of the treatment
Change in Pressure pain threshold
Pressure pain threshold will be measured by digital pressure algometer
Time frame: 12 weeks following the end of the treatment
Change in neck disability
Neck disability will be measured by Arabic neck disability index
Time frame: Immediately after the end of the treatment
Change in neck disability
Neck disability will be measured by Arabic neck disability index
Time frame: 12 weeks following the end of the treatment
Change in cervical range of motion
Cervical range of motion will be measured by cervical range of motion device
Time frame: Immediately after the end of the treatment
Change in cervical range of motion
Cervical range of motion will be measured by cervical range of motion device
Time frame: 12 weeks following the end of the treatment
Change in upper trapezius muscle activity
Muscle activity will be measured by electromyography in the form of root mean square
Time frame: Immediately after the end of the treatment
Change in upper trapezius muscle activity
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Interferential current treatment parameters will be as following; carrier frequency 8 KHz and beat frequency 15 Hz performed for 45 minutes per session.The intensity will be raised according to the subject's tolerance, remaining in the sensory level.
Interferential current intensity will not be raised.
Muscle activity will be measured by electromyography in the form of root mean square
Time frame: 12 weeks following the end of the treatment