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This pilot study aimed to compare the immediate effects of two manual therapy techniques, strain counterstrain (SCS) and the fascial distortion model (FDM), on pain-related outcomes and neuromuscular function in individuals with latent myofascial trigger points of the upper trapezius muscle. Twenty healthy adults with identified latent trigger points were randomly assigned to receive a single session of either SCS or FDM. Cervical range of motion, proprioception, pressure pain threshold, and cervical muscle strength were assessed before and immediately after the intervention. This study was conducted to obtain preliminary data regarding the short-term effects of two manual therapy approaches with contrasting stimulation characteristics.
Musculoskeletal pain of the cervical region is a prevalent health problem, and the upper trapezius muscle is frequently involved due to postural overload and mechanical stress. These factors are commonly associated with the development of latent myofascial trigger points, which may restrict range of motion and impair neuromuscular function even in the absence of spontaneous pain.
Various manual therapy techniques have been used to manage myofascial trigger points. Strain counterstrain (SCS) is an indirect, low-intensity technique that aims to reduce nociceptive input and muscle spindle activity by positioning the body in a pain-free posture. In contrast, the fascial distortion model (FDM) is a direct manual therapy approach that applies relatively high-intensity pressure to specific fascial distortions identified through patient body language and palpation.
This study was designed as a pilot, parallel-group, pre-post comparative trial to explore the immediate effects of SCS and FDM on pain-related and neuromuscular outcomes in individuals with latent myofascial trigger points of the upper trapezius. Twenty healthy adults were randomly assigned to receive a single session of either SCS or FDM. Cervical range of motion, joint position error, pressure pain threshold, and cervical muscle strength were assessed before and immediately after the intervention. The findings of this study are intended to provide preliminary evidence to inform future large-scale clinical trials comparing manual therapy techniques with differing stimulation characteristics.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Strain Counterstrain Group | Experimental | Participants received a single session of strain counterstrain manual therapy applied to latent myofascial trigger points of the upper trapezius muscle. |
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| Fascial Distortion Model Group | Experimental | Participants received a single session of fascial distortion model manual therapy applied to latent myofascial trigger points of the upper trapezius muscle. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Strain Counterstrain | Other | Strain counterstrain is an indirect manual therapy technique in which the body is passively positioned in a pain-free posture to reduce nociceptive input and muscle tension. In this study, a single session of strain counterstrain was applied to latent myofascial trigger points of the upper trapezius muscle. |
| Measure | Description | Time Frame |
|---|---|---|
| Cervical Range of Motion | Active cervical range of motion was measured using a Cervical Range of Motion (CROM) device in flexion, extension, lateral flexion, and rotation. | Before and immediately after the intervention |
| Pressure Pain Threshold | Pressure pain threshold at the latent myofascial trigger point of the upper trapezius muscle was measured using a digital algometer. | Before and immediately after the intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Cervical Proprioception | Cervical proprioception was assessed using joint position error during cervical lateral flexion measured with a CROM device. | Before and immediately after the intervention |
| Cervical Muscle Strength |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| JiYoung Kim, PT, PhD | Kyungnam University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kyungnam University | Changwon | Gyeongsangnam-do | 51767 | South Korea |
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| Fascial Distortion Model | Other | The fascial distortion model is a direct manual therapy approach that applies localized, high-intensity pressure to specific fascial distortions identified through patient body language and palpation. In this study, a single session of fascial distortion model intervention was applied to latent myofascial trigger points of the upper trapezius muscle. |
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Isometric cervical muscle strength was measured using a digital muscle tester during flexion, extension, lateral flexion, and rotation.
| Before and immediately after the intervention |