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Purpose of the study: To determine the efficacy of neck muscles positional release for Neck Pain during lactation.Methods:Fifty patient with postpartum neck pain will be recruited. Patients will be randomly assigned into two groups, group A and group B . Patients in both groups will receive posture correction advices during lactation and posture correction exercises but group A will receive additional positional release for upper trapezius. All patients will be evaluated for Pressure pain threshold (PPT) of upper trapezius by algometry, neck disability using Arabic version of neck disability index, pain intensity using 11-numerical rating scale.
Treatment procedure Both groups will receive posture education advices during lactation and Posture correction exercise program which will include Strengthening Exercise Program and Spinal Stretches.Spinal stretches were also included .In the intervention program mothers who underwent normal delivery were advised to start home based exercise program after 5 weeks and the caesarean mothers after 2 months of delivery Group (A): will receive Positional release of neck muscles in addition to Posture correction.Positional release technique For deactivation of Trigger Points (TrPs) and decrease spasm Manual approaches. [PRT] was developed by Lawrence H. PRT is a method in which muscles are placed in a position of greatest comfort, and this causes normalization of muscle hypertonicity and fascial tension. Also, it decreases joint hypomobility, increases circulation, followed by a reduction in swelling, decreased pain, and increase muscle strength. The practical section of the study will be undertaken in 4 weeks (3 sessions a week). Measurement will be taken before the start of treatment program then after the end of 4 weeks treatment program.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Positional Release | Experimental | Positional Release For upper trapezius + Posture correction advices during lactation + posture correction exercises |
|
| Posture correction | Other | Posture correction advices during lactation + posture correction exercises |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| positional release | Other | All participants in group (A) will receive the same program of group B added to positional release . In order to make the positional release , the therapist will pick up the trigger points by palpation in the upper trapezius muscle by pincer palpation method and distinguished with dots on the skin. Participants will be made supine lying and relaxed by maintaining the cervical spine in a neutral position. Lateral flexion of subject's head toward the side of a tender point, the therapist grasps the subject's forearm and abducts shoulder to approximately 90° and adds slight flexion or extension to fine-tune.The most comfortable position achieved will be held for 90 seconds and after that passive return of the body part to an anatomically neutral position will be maintained for 5 minutes. All participants will be treated three times per week for 4 consecutive weeks and will be instructed to maintain their normal activities while avoiding any undue stress to the neck. |
| Measure | Description | Time Frame |
|---|---|---|
| Intensity of neck pain | Neck pain intensity will be measured by 11- numerical rating scale.Primary outcome updated to pain intensity to better reflect the study objective. | baseline and four weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Pressure pain threshold (PPT) | Pressure pain threshold (PPT) of upper trapezius will be measured by digital pressure algometer. | baseline and four weeks |
| functional status related to neck disability |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of physical therapy kafr Elsheikh university | KafrElSheikh | kafrElsheikh | 33516 | Egypt |
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| ID | Term |
|---|---|
| D019547 | Neck Pain |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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|
|
| Posture correction | Other | Posture correction advices during lactation + posture correction exercises |
|
Functional status related to neck disability will be measured by Arabic version of Neck
| baseline and four weeks |