Randomized Clinical Trial
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jul 18, 2023; 14(7): 572-581
Published online Jul 18, 2023. doi: 10.5312/wjo.v14.i7.572
Instrumented assisted soft tissue mobilization vs extracorporeal shock wave therapy in treatment of myofascial pain syndrome
Nourhan Elsayed Shamseldeen, Mohammed Moustafa Aldosouki Hegazy, Nadia Abdalazeem Fayaz, Nesreen Fawzy Mahmoud
Nourhan Elsayed Shamseldeen, Mohammed Moustafa Aldosouki Hegazy, Nadia Abdalazeem Fayaz, Nesreen Fawzy Mahmoud, Department of Physical Therapy for Musculoskeletal Disorders & Its Surgery, Faculty of Physical Therapy, Cairo University, Cairo 14531, Egypt
Author contributions: Shamseldeen NE and Hegazy MMA were responsible for the study conception and design; Shamseldeen NE performed the trial procedure and drafted the manuscript; Hegazy MMA revised the manuscript; Fayaz NA reviewed the design, supervised the process of research, and approved the final version to be published; Mahmoud NF supervised the process of research, helped in writing the discussion, and was responsible for the final revision; All authors approved the final manuscript.
Institutional review board statement: This study was approved by the Research Ethics Committee of the Faculty of Physical Therapy (P.T.REC/012/003180).
Clinical trial registration statement: This study is registered at Department of Physical Therapy for Musculoskeletal Disorders & Its Surgery, Faculty of Physical Therapy, Cairo University.
Informed consent statement: All study participants provided an informed consent statement before enrollment.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nesreen Fawzy Mahmoud, MSc, PhD, Lecturer, Physiotherapist, Senior Research Fellow, Department of Physical Therapy for Musculoskeletal Disorders & Its Surgery, Faculty of Physical Therapy, Cairo University, Dokki, Giza, Cairo 14531, Egypt. dr_nesreenfawzy@cu.edu.eg
Received: January 9, 2023
Peer-review started: January 9, 2023
First decision: April 26, 2023
Revised: May 10, 2023
Accepted: May 31, 2023
Article in press: May 31, 2023
Published online: July 18, 2023
Processing time: 189 Days and 22.4 Hours
ARTICLE HIGHLIGHTS
Research background

Active myofascial trigger points (MTrPs), commonly occurring in the upper region of the upper trapezius (UT), can be a significant source of neck, shoulder, upper back, and headache pain. This can negatively impact daily routine functioning, work-related productivity, and overall quality of life. With the rising prevalence of musculoskeletal pain and disability, it is critical to identify the most effective interventions to improve patient outcomes. This will reduce the societal burden.

Research motivation

Instrument assisted soft tissue mobilization (IASTM) and extracorporeal shock wave therapy (ESWT) are two treatment methods for MTrPs. Each method was tested independently and compared to another modality. To the author’s knowledge, this is the first study to compare IASTM vs ESWT on MTrPs of the UT.

Research objectives

This study compared the effects of IASTM vs ESWT in patients with UT MTrPs. These findings are critical in guiding the therapist in selecting treatment methods based on availability, cost, therapist experience, and patient preference.

Research methods

Forty patients (28 females and 12 males) with active TrP in the UT muscle were randomly assigned to one of two equal groups (A and B). Group A received IASTM, while group B received ESWT. Each group received treatment twice a week for 2 weeks. Both groups received muscle energy technique for the UT muscle. Patients were assessed twice (pre-treatment and post-treatment) for pain intensity using the visual analog scale and pain pressure threshold (PPT) using a pressure algometer. A paired t-test was used to compare the pre-treatment and post-treatment mean values of all variables within both groups. For comparing all the dependent variables pre-treatment and post-treatment between both groups, we used an independent t-test. The significance level of a P value of ≤ 0.05 was considered statistically significant with a 95% confidence interval.

Research results

In group A (treated with IASTM) as well as in group B (treated with ESWT), there were significant differences between pre-treatment and post-treatment for pain intensity of TrP1 and TrP2 (P = 0.0001) and PPT for TrP1 and TrP2 (P = 0.0002 and P = 0.0001, respectively). There were no significant differences for pain intensity for TrP1 (P = 0.9), pain intensity for TrP2 (P = 0.76), PPT for TrP1 (P = 0.09), and PPT for TrP2 (P = 0.91) when comparing the post-treatment mean values between both groups.

Research conclusions

IASTM and ESWT are effective methods for treating pain and PPT in patients with UT muscle TrPs. However, there is no statistically significant difference between the two methods.

Research perspectives

Future research will be required to investigate the effect of only using IASTM and ESWT without other techniques that may influence the outcome.