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Analyzing Positional Release Therapy and Dry Needling

29 augustus 2026 bijgewerkt door: Iram Iqbal Shamsi, University of Karachi

Analyzing Positional Release Therapy and Dry Needling to Improve Pain and Function in Levator Scapulae Syndrome

Levator scapulae syndrome (LSS) is a common musculoskeletal disorder that affects people in a variety of vocations, especially those that require extended static postures and repetitive motions. It is frequently characterized by persistent neck and shoulder pain. Among them, cosmetics professionals Desk top professional and are particularly vulnerable because of the nature of their employment, which involves tasks like prolonged, uncomfortable postures that lead to muscular imbalance.along them Levator Scapulae Syndrome (LSS) is quite common in manual laborers because of heavy lifting, overhead reaching, and repetitive lifting. This results in significant discomfort, stiffness, and limited neck movement due to persistent muscular tension, decreased flexibility, and trigger points in the neck and upper back.

Studie Overzicht

Toestand

Werving

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Following the screening, participants will be randomized to receive the experimental or the controlled treatment in a1:1 ratio. Computer-generated random numbers will be used for Randomization. After obtaining the basic information, a unique code will be provided to each included patient. The outcome assessor will be blinded to the type of treatment. Patients and investigator could not be blinded due to the nature of treatment. Group "A "(experimental group) will receive Positional Release Technique on Levator Scapulae (Both if Necessary) Group "B" (control group) will receive (control group) will receive Dry needling treatment ,along with Neck strengthening exercises.

All patients will be Assessed for Pain , ROM and Functional Activities at base line and after 4 weeks.

Visual Analogue Scale(VAS) and CROM will be used for pain and ROM respectively.Neck Disability Index (NDI), Oxford Scale, ) will be used for Muscle strength and Daily life disaility Global Rating for patient's assessment of their own progress or decline during a particular course of treatment. and finaly EuroQol-5D (EQ-5D) to evaluate health-related quality of life. Mobility, self-care, routine activities, pain/discomfort, and anxiety/depression are the five main variables that are assessed.

Studietype

Ingrijpend

Inschrijving (Geschat)

102

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

  • Pakistan
    • Sindh
      • Karachi, Sindh, Pakistan, 74200
        • Werving
        • Sind Institute of Physical Medicine & Rehabilitation
        • Contact:

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen

Accepteert gezonde vrijwilligers

Nee

Beschrijving

Inclusion Criteria:

18-40 years Willing to participate Having Positive Levator scapulae Test -

Exclusion Criteria:

Any history related to spinal surgery, Previous administration of epidural injections. Neck pain due to specific pathology, Neurological deficits (Myelopathy) and Clinical disorder contraindicated to exercise

-

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Enkel

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Positional Release Technique PRT

Group "A"(experimental group) will receive Positional Release Technique on Levator scapulae (may be both if necessary).along with Neck strengthening exercises.

Patient will be in supine lying with the elbows to the side of the upper body therapist sitting behind stabilizing superior border of scapula, with other hand holding the occiput region. Palpating tender points around superior-medial border of scapula and with occipital hand move the head and neck towards painful side. Pressure will be applied to a Pain perception of 10 and than Physiotherapis MOve the Neck in Different combilation of Movemnt Like Flexion , Side bending Rotation or Extension untill Patient start to feel a minimum releif of Tender point of 75 %. three sets on each side with 30 seconds hold on tender point. A rest of 15 seconds will be given between all sets. Following exercises will be given Rowing, horizontal abduction, shrug, horizontal abduction with ER, prone shoulder extension
Ander: Positional release Technique
This Techniques Introduce in 1980 by DO Jones. By name of Spontaneous Release than Strain Counterstrain but Now Term PRT is Used Gobally. Muscle rlaxation is Achieved by Putting the muscle in Mos comfortable postion
Ander: Dry Needling
Despite using the same type of filiform (solid) needles, it is not the same as acupuncture. While acupuncture regulates the body's energy flow through conventional channels, dry needling is a Western medical treatment used specifically to relieve pain and release tight muscle knots.
Actieve vergelijker: Active Comparator: Dry Needling Therapy

Group "B" (control group) will receive Dry needling treatment consisting along with Neck strengthening exercises.

Patient will be in prone lying with the elbows adducted the upper body weight rests on the elbows, for further enhancement patient flexes the neck and lets the shoulder girdle relax. A pillow will be placed under shoulder to protrude scapula, exposing the super medial border for palpation and Introducing needles from a superior to inferio posterior angle to avoid lung lobe. With therapist wearing glove Alcohol swaps will be used to clean the area to be treated, A 30-40mm (0.32-0.35 gauge) needle will be used depending on body size.

Following exercises will be given Rowing, horizontal abduction, shrug, horizontal abduction with ER, prone shoulder extension
Ander: Positional release Technique
This Techniques Introduce in 1980 by DO Jones. By name of Spontaneous Release than Strain Counterstrain but Now Term PRT is Used Gobally. Muscle rlaxation is Achieved by Putting the muscle in Mos comfortable postion
Ander: Dry Needling
Despite using the same type of filiform (solid) needles, it is not the same as acupuncture. While acupuncture regulates the body's energy flow through conventional channels, dry needling is a Western medical treatment used specifically to relieve pain and release tight muscle knots.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
VAS Visual Analogue Scale VAS Visual Analogue Scale
Tijdsspanne: Baseline and After Four weeks of Treatment
The visual analogue scale is used for measurement of pain intensity. It is a continuous scale. It comprises a horizontal/vertical 10 centimeters or 100 millimeters line. The higher scores shows higher pain intensity and lower scores shows lower pain intensity.Left Anchor (0 cm): Represents "No pain" and The Right Anchor (100 cm): Represents "Worst possible pain". Increase in cm indicate worsening of the pain.
Baseline and After Four weeks of Treatment
The Oxford Muscle Scale
Tijdsspanne: Baseline and After Four weeks of Treatment
The Oxford muscular Scale, sometimes called the Medical Research Council or MRC scale, as a standardized instrument to measure muscular strength and power, Evaluate and grade manual muscle strength and power on a standardized scale from 0 to 5. Where 0 Means No contraction (lowest) and grade 5 (highest) muscle exhibits normal strength and can move through a full range of motion against maximal, firm resistance. Increase in Grades represent Improving in Strength and recovery while decrease in grade shows weakness and decline in strength.
Baseline and After Four weeks of Treatment
Cervical Range of Motion (CROM) Universal Goniometery
Tijdsspanne: Baseline and After Four weeks of Treatment
The cervical spine's (neck's) functional mobility is determined using the Cervical Range of Motion (CROM) test. It determines how far a person can move their head in various directions, to assist diagnose neck discomfort, evaluate the healing process following an accident, and monitor the course of rehabilitation.Cervical goniometry is the clinical method of measuring neck mobility using a standard handheld universal goniometer. The goniometer's stationary arm always tracks a fixed reference line relative to the ground or torso. The moving arm follows the structural movement of the skull. Measures CROM in degrees. Increase in degrees denote improvement and increase ROM
Baseline and After Four weeks of Treatment
EuroQol-5D (EQ-5D)
Tijdsspanne: Baseline and After Four weeks of Treatment
Measure generic health-related quality of life (HRQoL). It is one of the most widely used Patient-Reported Outcome Measures (PROMs) globally. The EQ-5D descriptive system is a preference-based HRQL measure with one question for each of the five dimensions that include mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The EQ-5D questionnaire also includes a Visual Analog Scale (VAS), by which respondents can report their perceived health status with a grade ranging from 0 (the worst possible health status) to 100 (the best possible health status).
Baseline and After Four weeks of Treatment

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Neck Disability Index (NDI)
Tijdsspanne: Baseline and After Four weeks of Treatment
The gold-standard Client reported questionnaire to measure how much neck discomfort interferes with day-to-day functioning is the Neck Disability Index (NDI).Measure how much neck pain affects a patient's daily activities and to track their progress over time. It consists of 10 sections covering areas like pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation. Each section is scored from 0 (no disability) to 5 (severe disability), giving a total possible raw score of 50. Scores of 0-4 means No disability, Neck pain has negligible impact on daily living where scores of 25 - 34 reflects complete disability, Patient is bedbound or severely incapacitated by pain.
Baseline and After Four weeks of Treatment
Global Rating of Change (GRC)
Tijdsspanne: Baseline and After Four weeks of Treatment
A simple, self-filled questionnaire used to gauge a patient's perceived progress or decline over time. It enables patients to list the extent to which their condition has improved since beginning an intervention. A single-item outcome measure used in clinical practice and research to quantify a patient's self-perceived improvement or deterioration over a specific period. The most heavily validated and widely used version is the 15-point scale (ranging from -7 to +7. Positive Scores (+1 to +7): Indicate improvement, where +1 represents "a tiny bit better" and +7 represents "a very great deal better", Neutral Score (0): Indicates the condition is unchanged or exactly "the same". Negative Scores (-1 to -7): Indicate worsening, where -1 represents "a tiny bit worse" and -7 represents "a very great deal worse". Scores of +4 or +5 and above indicate a definitive, highly successful clinical outcome.
Baseline and After Four weeks of Treatment

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

University of Karachi

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 september 2026

Primaire voltooiing (Geschat)

2 september 2027

Studie voltooiing (Geschat)

2 september 2027

Studieregistratiedata

Eerst ingediend

16 augustus 2026

Eerst ingediend dat voldeed aan de QC-criteria

16 augustus 2026

Eerst geplaatst (Werkelijk)

20 augustus 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

1 september 2026

Laatste update ingediend die voldeed aan QC-criteria

29 augustus 2026

Laatst geverifieerd

1 augustus 2026

Meer informatie

Termen gerelateerd aan deze studie

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • IIShamsi

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Beschrijving IPD-plan

Due to ethical obligations, inadequate infrastructure, and the need to preserve scientific control.

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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