COMPARISON OF MUSCLE ENERGY TECHNIQUES WITH ULTRASOUND THERAPY IN MYOFASCIAL TRIGGER POINT TREATMENT IN UPPER TRAPEZIUS

BACKGROUND AND OBJECTIVE: Various treatments of electrotherapy and manual therapy were suggested for management of trigger points, but there were not randomized controlled trials to compare these two methods. The purpose of this study was to compare the treatment effect of muscle energy technique and ultrasound therapy on myofascial trigger points in upper trapezius.METHODS: In this randomized controlled trial 45 patients with trigger points in upper trapezius were randomly assigned to one of three groups: ultrasound group (N=15), muscle energy group (N=15) and control group (N=15). In ultrasound group, frequency of ultrasound 1 MHz, continuous mode, intensity 1.5 W/cm2 and duration 4.5 min was selected. In muscle energy group, Jandas approach (post-isometric relaxation with stretching) was used, and control group did not receive any treatment. A 10 session treatment program which lasted 2 weeks was performed for interventional groups, and follow-up was done 3 months after treatment. Outcome was based on self–reported pain (neck disability index (0-50 scores) and shoulder pain and disability questionnaire (0-130 scores)) (ordinal), range of motion (degrees) and muscles strength (kg) were measured immediately before, after and three months after intervention. Data were analyzed using one-way ANOVA and repeated measurement tests.FINDINGS: Neck disability index scale was decreased from 19.1±7.3 to 7.8±4.6 (ordinal) in ultrasound group (p<0.05), and from 17.2±8.4 to 6.8±3.2 (ordinal) in muscle energy group (p<0.05), and in control group neck disability index scale was decreased from 21.2±5.1 to 20.4±5.5 (ordinal) that was not seen significant decrease. Results of follow-up showed that significant difference was not seen in score of neck and disability index in ultrasound group, but shoulder disability score was increased in ultrasound group after three months of treatment.CONCLUSION: The results of this study support the effectiveness of ultrasound and muscle energy technique to reduce disability and pain in the short term in patients with myofascial trigger points. However, muscle energy therapy had more long benefit effect than ultrasound therapy therefore this method for treatment of trigger point was suggested.