Effects of Myofascial Trigger Point Release Versus Neil Asher Technique Oin Patients With Rotator Cuff Syndrome

June 8, 2026 updated by: Riphah International University

Effects of Myofascial Trigger Point Release Versus Neil Asher Technique on Pain, Range of Motion, and Disability in Patients With Rotator Cuff Syndrome

Rotator cuff syndrome is a common cause of shoulder pain and functional limitation, often associated with myofascial trigger points. Myofascial Trigger Point Release (MFTR) and the Neil Asher Technique (NAT) are manual therapies aimed at reducing pain and improving mobility. This study compares their effects on pain, range of motion, and disability in individuals with rotator cuff syndrome.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This will be a randomized Clinical trial conducted on 36 participants. Data will be collected from Jinnah hospital and The University of Lahore Teaching Hospital, Lahore by using non-probability convenience sampling technique. Adults aged 40 to 60 years with non-surgical rotator cuff-related shoulder pain, confirmed by positive Neer's or Hawkins-Kennedy tests and experiencing symptoms for more than four weeks, will be included in this study. Individuals with cardiac conditions, pregnancy, trauma-related shoulder injuries, or a history of shoulder surgery will be excluded. Group A will receive Myofascial Trigger Point Release (MFTR) along with conservative physiotherapy, while Group B will receive the Neil Asher Technique (NAT) combined with conservative physiotherapy. Each session will last 35 minutes-20 minutes for the primary intervention and 15 minutes for conventional therapy-administered four times per week for four weeks. Pre- and post-treatment evaluations will include the Numeric Pain Rating Scale (NPRS), range of motion (using a Universal Goniometer), and disability (measured via SPADI). Data will be analyzed using SPSS version 27.0.

Study Type

Interventional

Enrollment (Estimated)

36

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • University of Lahore Teaching Hospital, Lahore HOD Physio Department

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age 40-60 years
  • Positive Neer's and Hawkins Kennedy test (27)
  • Grade 1 or 2 rotator cuff syndrome (non-surgical)

Exclusion Criteria:

  • Cardiac issues (e.g., myocardial infarction)
  • Fibromyalgia
  • Pregnancy
  • Trauma-related shoulder pain
  • History of shoulder surgery
  • Numbness, tingling
  • Corticosteroid injections

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Myofascial Trigger Point Release (MFTR)+ conservative physiotherapy Group)
This group will be given Myofascial Trigger Point Release (MFTR) with basic physiotherapy care.
Other: Myofascial Trigger Point Release (MFTR)+ conservative physiotherapy Group

lateral border of the scapula, just below the infraspinatus.

• Compression is followed by horizontal abduction and external rotation to stretch the muscle.

Ischemic Compression: Each active trigger point is treated with 2 sets of deep pressure, applied using the therapist's fingers, thumb, or elbow.

Duration: Each compression lasts 20-30 seconds, gradually increasing pressure to the patient's tolerance.

Post-Compression Stretching: Gentle passive stretching of the treated muscle follows immediately after each compression set to restore muscle length.

Each session will last 35 minutes (5 minutes hot pack, 10 minutes stretching, 20 minutes Myofascial Trigger Point Release)
Active Comparator: Neil Asher Technique (NAT) + conservative physiotherapy Group
This group will be given Neil Asher Technique (NAT) along with basic physiotherapy care.
Other: Neil Asher Technique (NAT) + conservative physiotherapy Group

The NAT is a non-invasive trigger point therapy that applies a specific sequence of ischemic compressions to deactivate active trigger points, stimulate reflex responses, and promote muscular balance.

Apply several deep strokes over the fibrous band and then each trigger point is treated with sustained manual pressure for 20-30 seconds, repeated 2-3 times per session.

Hot Pack Application: A moist hot pack will be applied over the affected shoulder for 5 minutes using a protective towel.

Shoulder Stretching Routine: Includes flexion/extension, abduction/adduction, and internal/external rotation (each stretch held for 20-30 seconds and repeated 3-5 times).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Numeric Pain Rating Scale (NPRS) - Pain Assessment
Time Frame: upto 4 weeks
The Numeric Pain Rating Scale (NPRS) is a unidimensional, patient-reported outcome measure used to assess pain intensity. Participants are asked to rate their current pain level, or average pain over a specified recall period (e.g., past 24 hours or past week), using an 11-point scale ranging from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst imaginable pain."
upto 4 weeks
Universal Goniometer (UG) - Range of Motion (ROM)
Time Frame: upto 4 weeks

The Universal Goniometer (UG) is a standard clinical instrument used for measuring joint range of motion (ROM) in degrees. It consists of a fulcrum, stationary arm, and movable arm, allowing precise angular measurement of joint movement.

For ROM assessment, the participant is positioned according to standardized protocols (supine, prone, or sitting depending on the joint being assessed). Anatomical landmarks are used for alignment to ensure accuracy and reliability. The stationary arm is aligned with the proximal segment of the joint, while the movable arm follows the distal segment.
upto 4 weeks
Shoulder Pain and Disability Index (SPADI) - Disability Outcome
Time Frame: upto 4 weeks

The Shoulder Pain and Disability Index (SPADI) is a validated, self-administered questionnaire designed to measure pain and functional disability in patients with shoulder conditions.

It consists of 13 items divided into two subscales:

Pain subscale (5 items) - assesses severity of shoulder pain during specific activities Disability subscale (8 items) - assesses difficulty in performing functional tasks such as dressing, reaching, lifting, and carrying objects

Each item is scored on a Visual Analog Scale (0-10), where higher scores indicate greater pain and disability. The total SPADI score is calculated as a percentage, with 0% representing no disability and 100% representing maximum disability.
upto 4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Iqra Nazir, MSPT*, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 30, 2026

Primary Completion (Estimated)

September 30, 2026

Study Completion (Estimated)

October 30, 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

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR&AHS/25/0116 Iqra

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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