The Effect of Counterstrain Technique on Muscle Stiffness and Pain on Trapezius Tender Points in Medical Students

Medical students are prone to developing neck pain due to prolonged studying and poor posture. This can manifest as tender points in the upper trapezius region. Counterstrain (CS) is an osteopathic manipulative technique that has shown efficacy in previous studies in treating tender points. The MyotonPRO is a myotonometric device that can be used to measure various muscle parameters such as muscle stiffness. There is limited research regarding the use of osteopathic manipulative medicine to produce measurable changes in muscle stiffness by the MyotonPRO. This educational study aims to establish the efficacy of CS technique in decreasing the pain level of upper trapezius tender points in medical students as well as determining if CS causes a significant decrease in muscle stiffness in treated tender points as measured by the MyotonPRO. The investigators hope this educational study will encourage further studies on how osteopathic manipulative techniques affects the physiologic parameters of muscles.

Study Overview

• Status: Completed
• Conditions: Tender Points; Counterstrain; MyotonPRO
• Intervention / Treatment: Other: Counterstrain

• Study Type: Interventional
• Enrollment (Actual): 27
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New York
    • Glen Head, New York, United States, 11545
      • NYIT College of Osteopathic Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Subject is at least 18 years of age

Exclusion Criteria:

• Traumatized (sprained or strained) tissues, which would be negatively affected by the positioning of the patient
• Illness or other conditions in which strict positional restrictions preclude treatment
• Instability of the area being positioned that has the potential to produce unwanted neurologic or vascular side effects
• Vascular or neurologic syndromes, such as basilar insufficiency or neural foraminal compromise whereby the position of treatment has the potential to exacerbate the condition
• Severe degenerative spondylosis with local fusion and no motion at the level where treatment positioning would normally take place
• Pregnancy
• Positive for COVID-19 as well as symptoms indicating a SARS-CoV-2 infection

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Tender point treatment with Counterstrain; A tender point was located in the upper trapezius region of the test subject and treated with counterstrain. The side with the highest initial pain level was used as the treatment side. Pain level was measured before and after treatment. The MyotonPRO was also used to measure physiologic parameters of the muscle before and after treatment.	Other: Counterstrain; Counterstrain is a hands-on OMM technique that involves shortening the muscle to resolve the dysfunctional muscle stretch reflex and holding it for 90 seconds. The patient is then brought back to a neutral position and reassessed.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain level	Pain level of the tender point as rated by the test subject out of a scale of 1 to 10, 1 being very little pain and 10 being the most pain the test subject has ever felt.	This was done immediately before and immediately after counterstrain treatment. Counterstrain treatment is a hands-on osteopathic manipulative technique that involves shortening the muscle belly of the painful region.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Muscle Stiffness	Muscle stiffness measured by the MyotonPRO, a myotonometric device that applies a brief mechanical impulse to the targeted muscle, used to measure physiologic parameters such as muscle stiffness.	This was done immediately before and immediately after counterstrain treatment. Counterstrain treatment is a hands-on osteopathic manipulative technique that involves shortening the muscle belly of the painful region.

Collaborators and Investigators

• Sponsor: New York Institute of Technology

Study record dates

Study Major Dates

• Study Start (Actual): March 10, 2021
• Primary Completion (Actual): April 14, 2021
• Study Completion (Actual): April 14, 2021

Study Registration Dates

• First Submitted: January 12, 2022
• First Submitted That Met QC Criteria: January 25, 2022
• First Posted (Actual): February 7, 2022

Study Record Updates

• Last Update Posted (Actual): February 7, 2022
• Last Update Submitted That Met QC Criteria: January 25, 2022
• Last Verified: January 1, 2022

More Information

Terms related to this study

• Keywords: Medical Students; Tender points; Counterstrain; MyotonPRO
• Other Study ID Numbers: #BHS-1561

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No