Effect of Integrated Neuromuscular Inhibition Technique on Hand Grip Strength in Upper Trapezius Myofascial Trigger Points
Effect of Integrated Neuromuscular Inhibition Technique on Hand Grip Strength in Upper Trapezius Myofascial Trigger Points
This study aims to investigate the effects of the integrated neuromuscular inhibition technique on patients with upper trapezius myofascial trigger points by evaluating its impact on neck pain intensity, pressure pain threshold, hand grip strength, pinch grip strength, wrist joint range of motion, and upper extremity function.
Myofascial pain syndrome (MPS) is one of the most common musculoskeletal disorders. Approximately, 30% to 85% of the population with musculoskeletal disorders would experience Myofascial trigger points (MTrPs) in their life. Also, the prevalence of MTrP has been reported as 21%, 30%, and 93% in the patients of a general orthopedic clinic.
Myofascial trigger points (MTrPs) are hypersensitive, cord-like or nodular tender spots found in a skeletal muscle. They are painful on palpation, compression or stretch. The prevalence of affection of these trigger points have found to be more in postural muscles such as the trapezius. It has been found that 85% of people who come to pain clinics show presence of trigger points in the neck, and that occurs more commonly in women than men.
The trigger point sites in the upper trapezius commonly refer pain along the posterolateral aspect of the neck, behind the ear to the temple. MTrP in the upper trapezius is known to usually present with complains of neck pain, headache, muscle stiffness, restricted range of motion (ROM) of the cervical joint, and insomnia by the patient. It is frequently caused by poor posture, acute trauma, muscle stress, and psychological stress.
The trapezius muscle has a supporting and stabilizing function on the movement of the upper extremities, such as in many everyday work tasks (computer work, cleaning, eating). The trapezius muscle is involved in many activities related to the high prevalence of neck pain. This muscle participates in long-term low-level activity, which is typically appreciated by office workers. Tightness of the upper trapezius lead to muscle imbalance in the scapulothoracic region, leading to neck pain and cervicogenic headaches.
The most important functions of the upper extremity for independent and smooth activities of daily living are the functions of the hand. A representative function of the hand is to hold something. The strength of the fingers when holding something is known as grip strength and it is an important index in the evaluation of motor function of the hand.
It is widely accepted that grip strength provides an objective index of the functional integrity of the upper extremity. Physical and occupational therapists commonly measure grip strength to monitor the success or failure of their treatment programs, besides, grip strength serves to be an important contributor to quality of life, functional ability, and independence.
A previous study has revealed the effectiveness of conventional treatment in reducing neck pain in patients with upper trapezius trigger points. Stretching techniques, Myofascial release, proprioceptive neuromuscular facilitation, and ischemic compression are a few types of manual therapy. Applying massage therapy to the sensitive region is one of the treatment modalities that patients choose in addition to their therapies for greater relaxation.
Integrated neuromuscular inhibition (INI) has also been proposed to alleviate neck pain, improve cervical range of motion, and eliminate neck dysfunction. INI has been approved as an efficient treatment for MTrPs, allowing the use of the three techniques in a single and coordinated manner. It was suggested that combination of Muscle energy technique (MET), ischemic compression and Strain Counter-strain (SCS) producing a most effective, targeted approach to TrP release. This method is termed as integrated neuromuscular inhibition technique (INIT). The benefit of the technique lies in its multifaceted approach allowing delivery of the techniques in a single coordinated manner.
Neuromuscular Inhibition Technique (INIT) has gained attention for its potential efficacy in deactivating MTrPs and enhancing musculoskeletal function. It was revealed that results with INIT in reducing pain and improving function in patients with upper trapezius MTrPs. For instance, a previous study has demonstrated that a single session of INIT significantly lowered pain intensity and pressure pain threshold in individuals with chronic neck pain.
There is a gap in the literature regarding the effect of integrated neuromuscular inhibition technique on hand grip strength in upper trapezius trigger points.
So, this study will conduct to discuss the effect of integrated neuromuscular inhibition technique on neck pain intensity level, pressure pain threshold (PPT), hand grip strength, pinch grip strength, wrist joint range of motion, and upper extremity function in upper trapezius myofascial trigger points.
Inclusion Criteria:
Exclusion Criteria: