Immediate effects of simultaneous application of transcutaneous electrical nerve stimulation and ultrasound phonophoresis on active myofascial trigger points: a randomized controlled trial

Objective was to investigate the efficacy of phonophoresis with combined therapy (PH-CT) on active myofascial trigger points (MTrPs). Participants One hundred participants with acute mechanical neck pain and at least one active MTrP in the upper trapezius were randomly assigned into 4 equal groups. Intervention Groups consisted of; diclofenac PH-CT; diclofenac phonophoresis (PH); ultrasound (US) with coupling gel and sham-US; applied for 10 minutes over MTrP. Measurements included pressure pain threshold (PPT) and active cervical lateral flexion. Results There were statistically significant improvements in post-intervention PPT and range of motion (ROM) values in treatment groups (P<.0001 as for the sham-us no significant difference was found between pre- and post-intervention values>.05). Bonferroni correction test revealed that there was a significant difference between all the four groups in PPT values (P<.0001 however it was non-significant>0.05) for ROM. Conclusion Diclofenac PH-CT, PH, and US were all effective in increasing PPT values and ROM. Additionally, PH-CT was shown to be superior over PH, and PH was superior over US in terms of reducing pain sensitivity. However, none of the treatment groups were found to be superior over the other in increasing ROM. Correspondence (for publication) for contact purposes: Name-Mary Kamal Nassif Takla, Department-Basic Sciences for Physical Therapy, Institution-Faculty of Physical Therapy, Cairo University, Country-Egypt. Email-marynassif@pt.cu.edu.eg Ethics approval: The Board Council of Higher Education of the School of Physical Therapy, the Institutional Review Board of Higher Education and Research of Cairo University, and the Supreme Council of Universities at Egypt approved this study. The study is prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616001677493). All participants gave written informed consent before data collection began. Conflict of interests: None Source(s) of support and Funding: None Pervious presentation or publication: None Financial benefits to the authors: None Acknowledgements: None Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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