Efficacy of Ischaemic Compression Technique in Combination with Strain Counterstrain Technique in Managing Upper Trapezius Myofascial Trigger Point Pain
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Objective
To establish the best possible long term effective choice of treatment program for deactivating MTrPs by using the combination of ischaemic compression technique with strain-counterstrain technique.
Design
Pretest-Posttest control group design.
Setting
Outpatient physiotherapy department, Northern Railway Central Hospital, New Delhi.
Patients
Fourty five subjects (only male) with Myofascial Trigger Points Pain. Subjects were randomly placed into three groups: Experimental group A (n=15), Experimental group B (n=15) and a control group C (n=15).
Intervention
The experimental group A received ischaemic compression technique in combination with straincounterstrain technique and experimental group B received ischaemic compression technique alone whereas control group received conventional treatment only. Main Outcome Measures: Pain pressure threshold was assessed with the pressure threshold meter (PTM). Pain and functional status of the patients were measured by a visual analogue scale (VAS) and the Neck Disability Index scores respectively.
Results
Within group analysis revealed significant improvement in pain pressure threshold, functional status and reduction in pain intensity in all groups. Between group analysis revealed significant difference between group A, group B and group C. Further post hoc analysis revealed significant difference between group A and B, group A and C and group B and C for all variables even after one week of follow up after the termination of intervention.
Conclusion
The combination of ischaemic compression technique with strain-counterstrain has been shown to produce greater improvement in pain pressure threshold on pressure threshold meter, function status on neck disability index scores and reduction in pain intensity on visual analogue scores even after one week of the termination of intervention. This shows the long term effectiveness of combination of two manual techniques. This study may provide a rationale for the clinical use of these two manual techniques in deactivating the myofascial trigger points pain.
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