Treatment of Pectoralis Trigger Points in Patients With Pseudo Angina (GT-LIC)

July 22, 2026 updated by: Muhammad Muneeb Jafar, University of Faisalabad

Comparative Effects of Graston Technique Versus Local Ischemic Compression on Trigger Points of Pectoralis Major and Minor Among Pseudo-angina Patients

Pseudo-angina is a musculoskeletal condition characterized by chest pain that resembles angina but occurs due to non-cardiac causes, particularly myofascial trigger points in the chest wall muscles. Trigger points in the pectoralis major and minor muscles may contribute to pain, discomfort, and functional limitations by affecting muscle activity and movement. Manual therapy techniques such as the Graston Technique and Local Ischemic Compression (LIC) are commonly used to manage soft tissue dysfunction and myofascial trigger points. This study aims to compare the effects of the Graston Technique and Local Ischemic Compression on pain reduction and functional improvement in patients with pseudo-angina.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This is Multiple-center, randomized controlled trail. Participants age 25-50 years with diagnosed pseudo angina will be referred from cardiology department of Aziz Fatima and Faisal hospital to Madina Teaching hospital (MTH) Physiotherapy ward and Jafar Physiotherapy Clinic. After informed consent Participants will be randomly assign to one of two parallel groups using a random number generator. Group A (Experimental): Receive Graston technique 3 sessions per week for total duration 4 weeks. Group B (Active Comparator) receive the LIC 3 sessions per week for total duration 4 weeks. Outcome measures (pain via NPRS, Shoulder Pain and Disability Index (SPADI)) are taken at baseline and end of treatment. Data will be analyzed using Spss version 20.

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 Contact Backup

Study Locations

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

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:

  • Participants which fulfill the Simon's Trigger Point Diagnostic Criteria
  • Referred by Cardiologist • Patients with Trigger Points in chest Muscles and left Pectoralis Major and Minor muscles.

Exclusion Criteria:

  • Spinal Deformity • Gastric Problems • Any cardiac disease • Heart Burns • Panic Attacks • Pleurisy • Pulmonary Embolism • Pericarditis.

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: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Graston Technique
articipants assigned to this arm received the Graston Technique, an instrument-assisted soft tissue mobilization intervention, applied to the identified myofascial trigger points of the pectoralis major and pectoralis minor muscles. The intervention was performed after a gentle Z-stretch of the targeted muscles as baseline treatment. A stainless-steel Graston instrument was applied using controlled strokes at approximately a 45° angle to the skin surface, following the direction of the muscle fibers and across the fibers to mobilize soft tissue restrictions. The treatment was applied for approximately 40-120 seconds over each targeted area.
Other: Graston Technique
A stainless-steel Graston instrument was applied using controlled strokes at approximately a 45° angle to the skin surface, following the direction of the muscle fibers and across the fibers to mobilize soft tissue restrictions. The treatment was applied for approximately 40-120 seconds over each targeted area.
Experimental: Local Ischemic Compression
Participants assigned to this arm received LIC applied to the identified myofascial trigger points of the pectoralis major and pectoralis minor muscles. Following a gentle Z-stretch of the targeted muscles as baseline treatment, sustained manual pressure was applied gradually over each trigger point until a tolerable level of discomfort was achieved. The compression was maintained for approximately 90 seconds per trigger point and repeated 1-3 times during each treatment session according to patient tolerance and clinical response. The technique was performed using the therapist's thumb, finger, or knuckle depending on the location and depth of the trigger point. Participants received four physiotherapy sessions over a two-week period, with sessions conducted on alternate days.
Other: Local Ischemic Compression
Sustained manual pressure was applied gradually over each trigger point until a tolerable level of discomfort was achieved. The compression was maintained for approximately 90 seconds per trigger point and repeated 1-3 times during each treatment session according to patient tolerance and clinical response. The technique was performed using the therapist's thumb, finger, or knuckle depending on the location and depth of the trigger point

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Shoulder Pain Disability Index
Time Frame: Baseline and 4 week post intervention
The Shoulder Pain and Disability Index is a well-known neutral measure for assessing the level of pain and functional impairment experienced by people with shoulder issues. It is frequently used in clinical and research settings to assess the severity of shoulder problems and track therapy efficacy. It consists of 13 elements organized into two subscales. The Pain Subscale consists of five items that determine how intense pain is in various circumstances, such as at rest or during activities. The disability subscale consists of eight items: it assesses the level of difficulty with specific everyday shoulder-related tasks, such as lifting weights or putting on a shir
Baseline and 4 week post intervention
Numeric Pain Rating Scale
Time Frame: Baseline and 4 week post intervention
NPRS was used as a primary outcome measure to evaluate pain intensity in patients with pseudo-angina. On the scale, 0 represents no discomfort and 10 represents severe pain. At rest and while engaging in activities, participants were asked to rate their level of pain.
Baseline and 4 week post intervention

Collaborators and Investigators

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

Sponsor

University of Faisalabad

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

  • This citation will not be hyperlinked on ClinicalTrials.gov. The effectiveness of instrument- assisted soft tissue mobilization technique (ergonš technique), cupping and ischaemic pressure techniques in the treatment of amateur athletes΄ myofascial trigger points. Journal of Novel Physiotherapy S (3): 1-7.
  • This citation wilnot be hyperlinked on ClinicalTrails.gov. Fousekis K, Kounavi E and Doriadis S (2016) The Effectiveness of instrument- assisted soft tissue mobilization technique, cupping and ischemic pressure techniques in the treatment of amateur athlete's myofascial trigger points. Journal of Novel Physiotherapies 3(2): 1-7.

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)

July 25, 2026

Primary Completion (Estimated)

October 1, 2026

Study Completion (Estimated)

November 1, 2026

Study Registration Dates

First Submitted

July 22, 2026

First Submitted That Met QC Criteria

July 22, 2026

First Posted (Actual)

July 27, 2026

Study Record Updates

Last Update Posted (Actual)

July 27, 2026

Last Update Submitted That Met QC Criteria

July 22, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • TUF/EIRB/136/2025

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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