Effects of post-isometric relaxation, myofascial trigger point release and routine physical therapy in management of acute mechanical neck pain: a randomized controlled trial.

OBJECTIVES: To compare the effects of post-isometric relaxation, myofascial trigger point release and routine physical therapy on pain, disability and cervical range of motion in patients with acute mechanical neck pain. METHODS: The randomised control trial was conducted at the District Headquarter Hospital in Nowshehra, Pakistan, from July to December 2017 and comprised subjects of either gender aged 16-49 years with acute neck pain. They were randomised into three groups; post-isometric relaxation group 1, myofascial trigger point release group 2 and routine physical therapy group 3. Neck disability index, numeric pain rating scale and cervical goniometry were documented before intervention, after the first session and after 6 sessions in two weeks. Data was analysed using SPSS 21. RESULTS: Of the 60 patients, there were 20(33.3%) in each of the three groups. Mean age in group 1 was 32.25±9.56 years, group 2 2.35±9.05 years and in group 3 it was 32.75±7.82 years. Scores for neck disability index and numeric pain rating scale as well as rotation to right and left showed significant difference among the groups post-treatment (p<0.05). Within group analysis showed significant improvements in all parameters post-treatment in all the groups (p<0.0001). CONCLUSIONS: Acute mechanical neck pain treated with post-isometric relaxation technique had more and faster effect in decreasing pain and disability and in improving mobility.

Comparison of Spencer muscle energy technique and Passive stretching in adhesive capsulitis: A single blind randomized control trial.

OBJECTIVE: To compare the effects of Spencer muscle energy technique and passive stretching in adhesive capsulitis. METHODS: The single-blind randomised control trial was conducted at the District Headquarter Hospital and Fatima Hospital, Sargodha, Pakistan, from February to May 2018, and comprised patients of either gender aged 30-55 years with idiopathic frozen shoulder stage 1 and 2 or stiff painful shoulder joint for at least 3 months. They were randomised into two equal groups using the sealed envelope method. Group 1 was exposed to muscle energy technique, while group 2 was exposed to passive stretching. Pain, shoulder range of motion and function were assessed by numeric pain rating scale, goniometer, shoulder pain and disability index and the quick version of the disabilities of the arm, shoulder and hand questionnaire. Measurements were taken at baseline, 2nd and 4th week. Data was analysed using SPSS 20. RESULTS: Of the 60 patients, there were 30(50%) in each of the two groups. There were 39(65%) females and 21(35%) males with an overall mean age of 45.84±5.88 years. All parameters significantly improved in group 1 compared to group 2 t post-intervention (p<0.001). CONCLUSIONS: Spencer technique was found to be more effective than passive stretching in treating patients with adhesive capsulitis.

Comparison between Manual Traction, Manual Opening technique and Combination in Patients with cervical radiculopathy: Randomized Control Trial.

OBJECTIVE: To compare the effects of manual traction, manual intervertebral foramen opening technique and combination of the two techniques in patients with cervical radiculopathy. METHODS: The single-blind randomised control trial was conducted at Fauji Foundation Hospital, Rawalpindi, Pakistan, from July 2017 to January 2018, and comprised patients of either gender having unilateral upper extremity pain, paresthesia or numbness. The subjects were placed into groups I, II and III using sealed envelope method. Group I was treated with the opening of intervertebral foramen technique, while group II received manual traction of cervical spine, and group III received both techniques. Three sessions were conducted per week for 3 weeks. The outcome measures were neck disability index, Numeric pain rating scale, patient-specific functional scale, and range of motions of cervical spine. SPSS 21 was used for data analysis. RESULTS: Of the 40 patients, 17(30%) were males and 23(70%) were females. There were 13(32.5%)patients each in groups I and II, while group III had 14(35%). Mean age in group I was 42.41±6.86 years, in group II 40.95±7 .32 years and in group III 42.50±5.77 years. There was no statisticallysignificant difference among the three groups with respect to any parameter (p>0.05). Individual group analysis showed significant improvement (p<0.05) in all parameters . CONCLUSIONS: Manual intervertebral foramen opening technique, manual traction, and combination of both techniques were equally effective in decreasing pain, level of disability and improved cervical mobility in patients with cervical radiculopathy.