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Analyzing Positional Release Therapy and Dry Needling

29. august 2026 oppdatert av: 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.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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

Intervensjonell

Registrering (Antatt)

102

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

  • Pakistan
    • Sindh
      • Karachi, Sindh, Pakistan, 74200
        • Rekruttering
        • Sind Institute of Physical Medicine & Rehabilitation
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen

Tar imot friske frivillige

Nei

Beskrivelse

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

-

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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
Annen: 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
Annen: 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.
Aktiv komparator: 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
Annen: 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
Annen: 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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
VAS Visual Analogue Scale VAS Visual Analogue Scale
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Neck Disability Index (NDI)
Tidsramme: 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)
Tidsramme: 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

Samarbeidspartnere og etterforskere

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Sponsor

University of Karachi

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. september 2026

Primær fullføring (Antatt)

2. september 2027

Studiet fullført (Antatt)

2. september 2027

Datoer for studieregistrering

Først innsendt

16. august 2026

Først innsendt som oppfylte QC-kriteriene

16. august 2026

Først lagt ut (Faktiske)

20. august 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

1. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

29. august 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • IIShamsi

Plan for individuelle deltakerdata (IPD)

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NEI

IPD-planbeskrivelse

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

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Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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