Pseudo-angina is a musculoskeletal condition characterized by chest pain that resembles angina but occurs due to non-cardiac causes, particularly myofascial trigger points in the chest wall muscles. Trigger points in the pectoralis major and minor muscles may contribute to pain, discomfort, and functional limitations by affecting muscle activity and movement. Manual therapy techniques such as the Graston Technique and Local Ischemic Compression (LIC) are commonly used to manage soft tissue dysfunction and myofascial trigger points. This study aims to compare the effects of the Graston Technique and Local Ischemic Compression on pain reduction and functional improvement in patients with pseudo-angina.
This is Multiple-center, randomized controlled trail. Participants age 25-50 years with diagnosed pseudo angina will be referred from cardiology department of Aziz Fatima and Faisal hospital to Madina Teaching hospital (MTH) Physiotherapy ward and Jafar Physiotherapy Clinic. After informed consent Participants will be randomly assign to one of two parallel groups using a random number generator. Group A (Experimental): Receive Graston technique 3 sessions per week for total duration 4 weeks. Group B (Active Comparator) receive the LIC 3 sessions per week for total duration 4 weeks. Outcome measures (pain via NPRS, Shoulder Pain and Disability Index (SPADI)) are taken at baseline and end of treatment. Data will be analyzed using Spss version 20.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
36
A stainless-steel Graston instrument was applied using controlled strokes at approximately a 45° angle to the skin surface, following the direction of the muscle fibers and across the fibers to mobilize soft tissue restrictions. The treatment was applied for approximately 40-120 seconds over each targeted area.
Sustained manual pressure was applied gradually over each trigger point until a tolerable level of discomfort was achieved. The compression was maintained for approximately 90 seconds per trigger point and repeated 1-3 times during each treatment session according to patient tolerance and clinical response. The technique was performed using the therapist's thumb, finger, or knuckle depending on the location and depth of the trigger point
The University of Faisalabad
Faisalābad, Punjab Province, Pakistan
Shoulder Pain Disability Index
The Shoulder Pain and Disability Index is a well-known neutral measure for assessing the level of pain and functional impairment experienced by people with shoulder issues. It is frequently used in clinical and research settings to assess the severity of shoulder problems and track therapy efficacy. It consists of 13 elements organized into two subscales. The Pain Subscale consists of five items that determine how intense pain is in various circumstances, such as at rest or during activities. The disability subscale consists of eight items: it assesses the level of difficulty with specific everyday shoulder-related tasks, such as lifting weights or putting on a shir
Time frame: Baseline and 4 week post intervention
Numeric Pain Rating Scale
NPRS was used as a primary outcome measure to evaluate pain intensity in patients with pseudo-angina. On the scale, 0 represents no discomfort and 10 represents severe pain. At rest and while engaging in activities, participants were asked to rate their level of pain.
Time frame: Baseline and 4 week post intervention
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