Comparing Two Muscle Relaxation Techniques for Neck Pain (PRT-PIR-LS)

Comparative Effectiveness of Positional Release Technique and Post Isometric Relaxation on Pain, ROM and Functional Disability in Patient With Levator Scapulae Tightness

Levator scapulae muscle tightness is a common cause of neck pain due to poor posture. This study compares two manual therapy techniques: Positional Release Technique (PRT) and Post Isometric Relaxation (PIR). The goal is to determine which technique is more effective at reducing pain, improving neck range of motion, and decreasing functional disability in patients with this condition. Participants will be randomly assigned to receive either PRT or PIR for 4 weeks

Study Overview

• Status: Active, not recruiting
• Conditions: Myofascial Pain Syndromes; Levator Scapulae Tightness
• Intervention / Treatment: Procedure: Positional Release Technique; Procedure: post isometric relaxation

Detailed Description

This is a double-blind, randomized clinical trial. A sample of 44 participants aged 25-40 with levator scapulae tightness will be recruited from hospitals in Faisalabad. Participants will be randomly assigned to two groups (n=22 each). Group A will receive the Positional Release Technique (PRT) involving a 90-second hold of the scapula in a specific position. Group B will receive Post Isometric Relaxation (PIR) involving a 10-second contraction followed by a 10-second stretch. Both groups will receive a 10-minute hot pack before their respective techniques. Interventions will occur 3 times per week for 4 weeks (12 sessions total). Outcome measures include the Numeric Pain Rating Scale (NPRS), cervical goniometry, and the Neck Disability Index (NDI), measured at baseline and after 4 weeks

• Study Type: Interventional
• Enrollment (Actual): 44
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Faisalabad, Punjab Province, Pakistan, 38000
      • The University of Faisalabad

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age between 25 to 40 years.
• Both male and female.
• Presence of a trigger point in levator scapulae (palpable tender spot with jump sign).
• Score greater than 20% on the Neck Disability Index.
• Unilateral non-specific neck pain.
• Confirmation of trigger point via algometer.

Exclusion Criteria:

• History of trauma or fracture to the scapula or cervical spine.
• Pregnancy.
• Previous cervical spine surgery.
• Diagnosis of cancer, cardiac condition, or infectious disease.
• Specific neck pathology (e.g., disc prolapse, nerve root compression, whiplash).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Positional Release Technique (PRT); Patient lies prone. The therapist palpates the levator scapulae and uses the far hand to translate the scapula upward and apply rotation. The superior angle of the scapula is tilted downward. This position is held for 90 seconds. 10 repetitions for 3 sets per session	Procedure: Positional Release Technique; Patient lies prone. The therapist palpates the levator scapulae and uses the far hand to translate the scapula upward and apply rotation. The superior angle of the scapula is tilted downward. This position is held for 90 seconds. 10 repetitions for 3 sets per session.
Active Comparator: Post Isometric Relaxation (PIR); Patient lies supine. The therapist stabilizes the shoulder and supports the neck. The patient performs an isometric contraction by moving the head back against resistance for 10 seconds. After relaxation, a passive stretch is applied for 10 seconds. 10 repetitions for 3 sets per session.	Procedure: post isometric relaxation; Patient lies supine. The therapist stabilizes the shoulder and supports the neck. The patient performs an isometric contraction by moving the head back against resistance for 10 seconds. After relaxation, a passive stretch is applied for 10 seconds. 10 repetitions for 3 sets per session.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Pain Intensity	Measured using the Numeric Pain Rating Scale (NPRS). Participants rate their average neck pain on an 11-point scale where 0 = 'no pain' and 10 = 'worst imaginable pain'	Baseline and at 4 weeks (post-intervention)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Cervical Range of Motion	Measured using a universal goniometer. Active range of motion will be assessed for cervical flexion, extension, lateral flexion, and rotation, measured in degrees	Baseline and at 4 weeks (post-intervention)
Change in Functional Disability	: Measured using the Neck Disability Index (NDI), a 10-item questionnaire. Total scores range from 0 (no disability) to 50 (complete disability), reported as a percentage	Baseline and at 4 weeks (post-intervention)

Collaborators and Investigators

• Sponsor: University of Faisalabad

Study record dates

Study Major Dates

• Study Start (Actual): February 15, 2026
• Primary Completion (Estimated): June 15, 2026
• Study Completion (Estimated): July 10, 2026

Study Registration Dates

• First Submitted: June 8, 2026
• First Submitted That Met QC Criteria: June 8, 2026
• First Posted (Actual): June 12, 2026

Study Record Updates

• Last Update Posted (Actual): June 12, 2026
• Last Update Submitted That Met QC Criteria: June 8, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: levator scapulae tightness; PIR in levator scapule tightness
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Muscular Diseases; Myofascial Pain Syndromes
• Other Study ID Numbers: 2024-MS-PT-059; TUF/EIRB/ 216 /26 (Other Identifier: ethical institutional review board, The University of Faisalabad)

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