Immediate effects of variable durations of pressure release technique on latent myofascial trigger points of the levator scapulae: a double-blinded randomised clinical trial

Abstract

Objective: Latent myofascial trigger points (MTrPs) of the levator scapulae have a high prevalence and may influenceconditions of the neck and shoulder. The pressure release technique is one of the most recommended manual therapy techniques. The aim of this study was to determine the effect of varying durations of the pressure release technique application on latent MTrPs of the levator scapulae. Methods: In a three-arm (1:1:1 ratio), double-blinded, parallel, randomised clinical trial, 60 healthy university students (23 men, 37 women) with a mean±SD age of 20.0±2.67 years were recruited. Subjects were assigned to receive pressure release in one latent MTrP of the levator scapulae lasting 30s (T30s; n=17), 60s (T60s; n=22) or 90s (T90s; n=21). Active cervical range of movement (CROM), strength, pressure pain threshold (PPT) and neck pain intensity at full stretch were measured immediately before and after treatment. Results: Mixed-model analyses of variance showed statistically significant differences for PPT (P=0.045; partial Eta2=0.103), comparing T60s versus T30s (P=0.009; Cohen’s d=1.044) and T90s versus T30s groups (P=0.001; Cohen’s d=1.253), and for left side bending strength (P=0.043; partial Eta2=0.105), comparing T90s versus T30s (P=0.023; Cohen’s d=0.907). The rest of the comparisons did not present any significant differences (P⩾0.05). Conclusions: The 60 s and 90 s applications of the pressure release technique may be recommended to increase PPT and strength, respectively, in latent MTrPs of the levator scapulae in the short term. Trial registration number: NCT03006822.

Evaluation of Short-Term Effectiveness of Orthopedic Manual Therapy in Signs and Symptoms of Myofascial Pain: A Controlled Clinical Trial.

“…The explanation about the lack of change in the diagnosis after the muscle manipulation is based on the time that is required to manage the inflammatory process. The findings of this study concur with the results of Calixtre et al 15 In that systematic review, they concluded that OMT (release and myofascial massage) would relieve pain and increase pain threshold under pressure in subjects with signs and symptoms of temporomandibular disorders. However, the authors indicated that the results may vary depending on the therapeutic technique used.…”

“…27,28 It is possible that, in patients with MFP, the muscles are affected by a decrease in the blood flow due to a vasoconstriction produced after an increase of activity. 15 Under this situation, nutrients and metabolites would be altered and inflammatory mediators could sensitize the nociceptors and provoke pain. 29,30 Moreover, the trigger points will cause referred pain, movement difficulties, fatigue, and other muscles dysfunctions.…”

“…14 A recent study demonstrated that applications of a pressure release technique for 60 to 90 seconds on the levator scapulae increases pressure pain threshold and strength. 15 OMT should improve blood circulation, decrease muscle spasm, induce muscle relaxation around the joint, break muscle adhesions, increase mobility range, and decrease pain. 16 There is a lack of evidence for the application of manual therapy in the masticatory muscles.…”

Effect of Variants of Positional Release Technique vs. Ischemic Compression Technique on trigger point in Myofascial Pain Syndrome: A randomized controlled trial

“…The method of sampling utilized was the lottery method. Sample size was calculated statistically based on the previous research studies 15 . The inclusion criteria were patients with active MTrP's over the trapezius muscle, both male and female subjects between the age group of 18-24 years whereas the exclusion criteria were patients with more than one active MTrP, those having other co-morbidities like diabetes, hypertension etc.…”

“…14 On the other hand, the positional release technique is suggested to be a better treatment option than ischemic compression because its lower compression and thus inturns allows adequate oxygenation to the muscle. 15 Although conventional PRT is known to be effective when given in combination, low pressure and a long duration, or high compression and short duration, may be more effective for immediate pain reduction. 16 There are evidences of numerous research studies which have investigated the efficacy of PRT as well as ICT on MTrP's.…”