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. 2010 Mar;18(1):37-43.
doi: 10.1179/106698110X12595770849605.

The efficacy of an integrated neuromuscular inhibition technique on upper trapezius trigger points in subjects with non-specific neck pain: a randomized controlled trial

Amit V Nagrale  1 , Paul Glynn, Aakanksha Joshi, Gopichand Ramteke
Affiliations

The efficacy of an integrated neuromuscular inhibition technique on upper trapezius trigger points in subjects with non-specific neck pain: a randomized controlled trial

Amit V Nagrale et al. J Man Manip Ther. 2010 Mar.

Abstract

Currently, large levels of practice variability exist regarding the clinical deactivation of trigger points. Manual physical therapy has been identified as a potential means of resolving active trigger points; however, to date the ideal treatment approach has yet to be elucidated. The purpose of this clinical trial was to compare the effects of two manual treatment regimens on individuals with upper trapezius trigger points. Sixty patients, 19-38 years of age with non-specific neck pain and upper trapezius trigger points, were randomized into one of two, 4 week physical therapy programs. One group received muscle energy techniques while the second group received an integrated neuromuscular inhibition technique (INIT) consisting of muscle energy techniques, ischemic compression, and strain-counterstrain (SCS). Outcomes including a visual analog pain scale (VAS), the neck disability index (NDI), and lateral cervical flexion range of motion (ROM) were collected at baseline, 2 and 4 weeks after the initiation of therapy. Results revealed large pre-post-effect sizes within the INIT group (Cohen's d = 0.97, 0.94 and 0.97). Additionally, significantly greater improvements in pain and neck disability and lateral cervical flexion ROM were detected in favor of the INIT group (0.29-0.57, 0.57-1.12 and 0.29-0.57) at a 95% CI respectively. The findings of this study indicate the potential benefit of an integrated approach in deactivating upper trapezius trigger points. Further research should be performed to investigate the long-term benefits of the current treatment approach.

Keywords: Integrated neuromuscular inhibition technique; Ischemic compression; Muscle energy technique; Strain–counterstrain; Trigger points.

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Figures

Figure 1
Figure 1
Example of a muscle energy technique (MET) used in the study.
Figure 2
Figure 2
Identification of upper trapezius trigger point by the pincer method.
Figure 3
Figure 3
Example of an ischemic compression therapy technique used in the study.
Figure 4
Figure 4
Example of a positional release therapy technique used in the study.
Figure 5
Figure 5
Study inclusion flow chart. INIT  =  integrated neuromuscular inhibition technique; MET  =  muscle energy technique.
See this image and copyright information in PMC

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