Evaluation of the immediate effect of acupuncture on pain, cervical range of motion and electromyographic activity of the upper trapezius muscle in patients with nonspecific neck pain: study protocol for a randomized controlled trial

Abstract

Background: Nonspecific neck pain can cause considerable suffering, possible disability and reductions in quality of life and productivity. The aim of the proposed study is to evaluate the immediate effect of acupuncture on pain, cervical range of motion and electromyographic activity of the upper trapezius muscle in patients with nonspecific neck pain.

Methods/design: A total of 12 patients with nonspecific neck pain and 12 healthy subjects will be enrolled in a randomized, single-blind crossover study. Each subject will receive two forms of treatment in random order: a single session of traditional acupuncture (acupoints: triple energizer 5, 'Wai-guan' and large intestine 11, 'Qu-chi') and sham acupuncture. To eliminate carry-over treatment effects, a one-week wash-out period will be respected between sessions. Surface electromyography will be used to determine motor control in the upper trapezius muscle before and after treatment. The outcome measures in the group with neck pain will be a numerical pain rating scale (range: 0 (no pain) to 10 (maximum pain)), documentation of the pain area on a body chart and cervical range of motion. Comparisons before and after acupuncture treatment will demonstrate whether acupoints affect the activity of the upper trapezius muscle, pain and cervical range of motion.

Discussion: The purpose of this randomized clinical trial is to evaluate the immediate effect of acupuncture on pain, cervical range of motion and electromyographic activity of the upper trapezius muscle in patients with nonspecific neck pain. Data will be published after the study is completed. The study will support the practice of evidence-based physical therapy for individuals with nonspecific neck pain.

Trial registration: This trial was registered with Clinicaltrials.gov (identifier: NCT0984021 ) on 7 November 2013 ( https://clinicaltrials.gov/ct2/show/NCT01984021 ).

Figure 1

Flowchart of the study.

Figure 2

Flow sequence diagram of data recording. (EV1, pain and cervical range of motion evaluation; EV2, Second pain and cervical range of motion evaluation, EV3, Third pain and cervical range of motion evaluation; EV4, Fourth pain and cervical range of motion evaluation; EMG-1, First electromyographic evaluation ; EMG-2, Second electromyographic evaluation; ROM, Range of motion; EMG, Electromyography; MVC, Maximal voluntary contraction).

Figure 3

Details of experimental setup. Two straps over the acromion -one attached directly to the chair and one attached to the support of a load cell (A); Force and electromyography activity ((B) surface electrode) of the upper trapezius muscle will be measured simultaneously during shoulder elevation movements. Feedback will be provided from the projection of a 20-inch screen on a white wall in front of the subject.