Comparison of IMES Versus DN on ATrPs of AC

Riphah International University44 enrolled

Overview

The aim of our study to compare DN and IMES for pressure pain threshold, ROM and the shoulder function in active trigger points with adhesive capsulitis. This study will add to the growing body of knowledge that if these two techniques yield comparable outcomes and if one technique is superior to the other, which should be the alternative of therapy. Moreover, it would add to the society as there are very limited researches done in Pakistan using needling for trigger points in adhesive capsulitis.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Shoulder Pain

Interventions

Dry needlingOTHER

AROM 10 repetitions ×2 set×30 sec ,6days\\week, Shoulder strengthening exercises: Isometric pain free (elastic Thera-band) 10 repetitions ×2 set×30 sec ,6days\\week, Maitland mobilization grade 3 and 4 10 repetitions ×2 set×30 sec ,6days\\week Total of 6 session were given each consisting of 30min

intramusuar electrical stimulationOTHER

Myofascial trigger point would be targeted by direct intramuscular electrical stimulation by using direct electrode placement method, where anode pole and the cathode pole of the stimulator connected to the needles of the MTrPs of the shoulder girdle muscles .AROM 10 repetitions ×2 set×30 sec ,6days\\week, Shoulder strengthening exercises: Isometric pain free (elastic Thera-band) 10 repetitions ×2 set×30 sec ,6days\\week, Maitland mobilization grade 3 and 4 10 repetitions ×2 set×30 sec ,6days\\week Total of 6 session were given each consisting of 30 min

Eligibility

Sex: ALLMin age: 40 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age 40 to 60 year of both genders * Diagnosed patients of stage 3 Adhesive capsulitis with type I and II diabetes * Involvement of at least 3 shoulder girdle muscles in Active MTrPs (subscapularis, latissimus dorsi, deltoid (anterior, middle, posterior) * Active MTrPs in shoulder girdle muscles (subscapularis, supraspinatus, deltoid (anterior, middle, posterior), teres minor, latissimus dorsi) * Reproduction of the patient's symptoms at active trigger point, Taut band, Hypersensitive spot, Referred pain pattern, local twitch response * Minimum 60 degrees of active/passive shoulder abduction range of movement. Exclusion Criteria: * Systemic inflammatory joint disease of shoulder joint (RA, OA polymyalgia rheumatic) * Cerebral Vascular Accident * Fibromyalgia, neurological deficits of upper limb (Nerve root entrapment, Cervical radiculopathy, Thoracic outlet syndrome) * History of Fracture, Dislocation, Acute soft tissue injury, Acute bursitis * Avascular necrosis of humeral head or visceral referred pain to shoulder * Pregnancy, Hypothyroidism, skin infection * Patients who are using Antiplatelet Therapy with in past 3 days of study * Extreme fear of needles

Locations (1)

Railway general hopsital

Rawalpindi, Punjab Province, Pakistan

Outcomes

Primary Outcomes

Algometer (pressure pain threshold)

This tool can be used to assess the participant pressure pain at baseline ,2nd week,3rd week post assessment. Pressure pain threshold is measured at active trigger point at subscapularis, deltoid (ant, middle, post), latissimus dorsi, teres minor, supraspinatus. The PPT are measured by mean and standard deviation kg\\cm2

Time frame: 3rd week

Secondary Outcomes

ROM Shoulder (Flexion)

Changes from baseline,2nd week,3rd week ROM range of motion of shoulder flexion was taken

Time frame: 3rd week

ROM Shoulder (Abduction)

Changes from baseline,2nd week,3rd week ROM range of motion of shoulder abduction was taken

Time frame: 3rd week

ROM Shoulder (External rotation)

Changes from baseline,2nd week,3rd week ROM range of motion of shoulder External rotation was taken with the help of Digital Goniometer

Time frame: 3rd week

ROM Shoulder (Internal Rotation)

Changes from baseline,2nd week,3rd week ROM range of motion of shoulder Internal rotation was taken with the help of Digital Goniometer

Time frame: 3rd week

American shoulder and elbow surgeons scale

Changes from baseline,2nd week,3rd week, American shoulder and elbow surgeons scale (ASES) Scale scoring was done at 2 level, pain questionnaire 5× (10-Q7 value), ADL Questionnaire (5× (raw score) divided by 3, final scoring is done by adding pain score and ADL score. A total 100-point scale Minimum score 0 which mean worst shoulder function and maximum score 100 which mean better shoulder function.

Time frame: 3rd week

Data from ClinicalTrials.gov

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