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The current study is a randomized controlled trail comparing the effectiveness of IASTM and Myofascial Release for individuals with DOMS at cervicothoracic region. The trail aims to evaluate improvements in pain, ROM, and neck disability. Interventions will be delivered twice weekly for a specific duration. The primary outcomes is pain reduction, while the secondary outcomes include improved disability level and ROM. To conclude, IASTM demonstrated a significantly higher improvement compared to MFR in acute cervicothoracic DOMS in terms of pain, disability level, and ROM in all directions tested in adults.
Delayed onset muscle soreness (DOMS) is a physiological condition that develops in the course of time after strenuous unaccustomed physical exertion. In particular, DOMS occurs mostly in response to eccentric muscle actions, i.e., when muscle fibers lengthen while still performing work. Examples of eccentric actions may be, among others, lowering the load (weight training), downhill running, decelerating movements, and controlled return phase of resistance exercise (1). Unlike most types of physiological phenomena, DOMS usually develops after some period of time. Typically, it appears 12-24 hours after the workout and reaches its peak in 24-72 hours; afterwards, it will subside gradually over several days. DOMS is considered a normal adaptation reaction of the muscle. However, despite being physiologically beneficial and helping to adapt skeletal muscles to subsequent exercises through repeated bout phenomenon, DOMS may lead to considerable discomfort and even affect a person's quality of life. As the result of damage of muscle fibers and adjacent connective tissue in response to unaccustomed mechanical load, inflammatory reaction, swelling, and stimulation of pain receptors occurs. These processes are responsible for characteristic soreness associated with DOMS, which may impair individual's ability to perform certain activities and exercise.
The randomization process took place after participants were screened and underwent baseline assessment. Then, those who met the criteria were randomly allocated to Group A and Group B. Those patients in Group A were assigned to receive Instrument Assisted Soft Tissue Mobilization, whereas those participants who belonged to Group B were subjected to Myofascial Release. Random allocation was performed by a computer and carried out through opaque sealed envelopes opened by an independent individual.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| IASTM | Experimental | Instrument-Assisted Soft Tissue Mobilization (IASTM) is a type of therapy where the practitioner utilizes unique instruments that are made of either metals or hard plastics that have smooth curved surfaces to glide on the skin surface to work on soft tissues. IASTM helps in identifying and breaking down areas of muscle tightness and adhesion. Blood flow is stimulated, pain, stiffness, and soreness are minimized, and mobility of the tissues is enhanced, thereby increasing joint range of motion. |
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| Myofascial Release | Active Comparator | Myofascial Release (MFR) is an effective therapeutic massage technique that can be utilized to relieve muscle and fascia pain and tightness. The practitioner uses a series of gentle stretching or applying sustained pressure on areas where tension is felt until the fascia releases. Such release eases pain, improves circulation, joint mobility and muscle motion, enhances flexibility and posture |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| IASTM | Procedure | The participants in this group were given the Instrument Assisted Soft Tissue Mobilization (IASTM). They were rubbed with a very small amount of gel or lotion to allow easy mobilization of the tool over the skin. The instrument has been developed to treat conditions of the cervical-thoracic joint region. The instrument was applied over the upper trapezius muscle and the cervicothoracic joint region using controlled unidirectional strokes for 8-10 minutes each day with moderate pressure. The process was done once every day for 2-3 days after the occurrence of Delayed Onset Muscle Soreness |
| Measure | Description | Time Frame |
|---|---|---|
| Visual Analog Scale (VAS) for pain | The Visual Analog Scale (VAS) is a 100 mm continuous line used to self-report cervicothoracic pain intensity. The scale ranges from 0 mm (indicating "no pain") to 100 mm (indicating "worst imaginable pain"). Participants mark a point on the line that represents their current pain perception at rest and during active movement. | Baseline (pre-induction), Post-DOMS induction (24 hours), 48 hours, and 72 hours. |
| Measure | Description | Time Frame |
|---|---|---|
| Cervical Range of Motion (CROM) | Active cervical range of motion will be measured in degrees using a digital inclinometer or a cervical range of motion instrument. Movement planes will include cervical flexion, extension, lateral flexion (left and right), and rotation (left and right). Decreased ranges indicate higher functional restriction due to muscle soreness. | Baseline (pre-induction), Post-DOMS induction (24 hours), 48 hours, and 72 hours. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Iqra Majeed Principal Investigator | Green International University, Lahore, Punjab | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Green International University | Lahore | Sheikhupura | Pakistan |
Only IPD used in the results publication will be shared
It will be available after the completion of study.
Through the corresponding author.
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This study uses a randomized, parallel-group design in which participants diagnosed with DOMS at cervicothoracic region are assigned into one of two intervention arms. Participants randomly allocated to either ( 1) IASTM or Myofascial Release alone. Before the baseline assessment was conducted on them, no form of treatment has been done on the participants. Participants were asked not to engage in any form of therapy or take medication throughout the study period. The interventions will be delivered over a 4 week period, and the outcomes will be compared between groups to evaluate the effects IASTM and MFR.
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The study uses a single masking in which the outcome assessor is blinded to group allocation. Participants will be assigned to either the IASTM group or the Myofascial Release group by an independent researcher who is not involved in the assessment. The assessor responsible for recording baseline and post intervention outcomes ( VAS, NDI, Universal goniometer) will not be informed of the participants intervention group. To maintain blinding, participants will be instructed not to disclose their group assignment during assessments.
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| MFR | Procedure | Group B: Myofascial Release Those who fell under Group B were subjected to myofascial release. The physiotherapist used hands to apply slow and gentle pressure on the tissues that needed release. Fascia and muscles of the upper trapezius, levator scapulae, and cervicothoracic paraspinal muscles were applied pressure on until there was release of the |
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| Pressure Pain Threshold (PPT) | Pressure pain threshold will be measured in kilograms per square centimeter (kg/cm²) using a digital hand-held pressure algometer applied over standardized trigger points in the upper trapezius and levator scapulae muscles. PPT determines the minimum pressure at which a sensation of pressure changes to pain. | Baseline (pre-induction), Post-DOMS induction (24 hours), 48 hours, and 72 hours. |
| ID | Term |
|---|---|
| D063806 | Myalgia |
| ID | Term |
|---|---|
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D059352 | Musculoskeletal Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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