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Combined Therapy and Jones Technique for Upper Trapezius Myofascial Trigger Points

10 de julho de 2026 atualizado por: Isabel de Almeida Paz

Clinical Effects of Combined Therapy, Jones Technique, and Their Combination in Women With Upper Trapezius Myofascial Trigger Points: A Four-Arm Randomized Controlled Trial

Myofascial trigger points in the upper trapezius muscle are a common cause of neck pain and may negatively affect pressure pain threshold, upper limb function, sleep quality, and quality of life. This randomized, sham-controlled clinical trial aimed to compare the effects of the Jones Technique, combined therapy (therapeutic ultrasound plus transcutaneous electrical nerve stimulation [TENS]), their combination, and a sham intervention in women with active upper trapezius myofascial trigger points. The primary outcome was pressure pain threshold. Secondary outcomes included pain intensity, upper limb disability, sleep quality, quality of life, physical activity level, and participant satisfaction.

Visão geral do estudo

Status

Concluído

Condições

Intervenção / Tratamento

Descrição detalhada

Myofascial trigger points (MTrPs) in the upper trapezius muscle are frequently associated with neck pain, reduced pressure pain threshold, and impaired upper limb function. Several conservative interventions have been proposed for the treatment of MTrPs; however, evidence comparing manual therapy and combined electrotherapy remains limited.

This single-center, randomized, sham-controlled, parallel-group clinical trial evaluated the effects of the Jones Technique and combined therapy (therapeutic ultrasound plus transcutaneous electrical nerve stimulation [TENS]) in women aged 18 to 40 years presenting with active myofascial trigger points in the upper trapezius muscle.

Participants were randomly allocated (1:1:1:1) into four groups: (1) Jones Technique; (2) combined therapy; (3) combined therapy plus Jones Technique; and (4) sham control. Randomization was performed using block randomization stratified by age. Participants underwent a single treatment session.

Baseline assessments included demographic data, pain intensity measured using the Visual Analog Scale (VAS), pressure pain threshold measured with a pressure algometer, upper limb disability (DASH), sleep quality (Pittsburgh Sleep Quality Index), quality of life (SF-36), and physical activity level (IPAQ). Immediately after the intervention, pain intensity, pressure pain threshold, and participant satisfaction were reassessed.

The primary outcome was pressure pain threshold. Secondary outcomes included pain intensity, upper limb disability, sleep quality, quality of life, physical activity level, and participant satisfaction.

Tipo de estudo

Intervencional

Inscrição (Real)

40

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

  • Brasil
    • Rio Grande do Sul
      • São Leopoldo, Rio Grande do Sul, Brasil
        • Physical Therapy Teaching Clinic, Universidade do Vale do Rio dos Sinos (UNISINOS)

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Adulto

Aceita Voluntários Saudáveis

Sim

Descrição

Inclusion Criteria:

  • Female participants aged 18 to 40 years.
  • Presence of active myofascial trigger points in the upper trapezius muscle for no longer than 12 weeks.
  • Neck pain lasting less than 3 months.
  • Pain intensity of at least 3 cm on the 10-cm Visual Analog Scale (VAS).
  • Ability to understand the study procedures and provide written informed consent.

Exclusion Criteria:

  • Presence of a cardiac pacemaker or other contraindications to electrotherapy.
  • Pregnancy.
  • Uncontrolled cardiovascular disease.
  • Psychiatric disorders that could interfere with study participation.
  • Thrombosis or coagulation disorders.
  • History of tumors or neoplasms.
  • Physical therapy or myofascial treatment within the previous 3 weeks.
  • Treatment for myofascial trigger points within the previous 3 months.
  • Current use of analgesic medications.
  • Cervical musculoskeletal disorders (e.g., cervical osteoarthritis or other cervical lesions).
  • History of cervical trauma or surgery.
  • Cervical spondylosis or spondylolisthesis with radiculopathy.
  • Fibromyalgia or other systemic rheumatic diseases.
  • Other musculoskeletal disorders that could interfere with the study outcomes.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Solteiro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Jones Technique
Participants received a single session of the Jones Technique for the treatment of active myofascial trigger points in the upper trapezius muscle.
Procedimento: Jones Technique
Manual therapy technique applied to active myofascial trigger points of the upper trapezius muscle. Participants were positioned in prone lying, and sustained pressure with positional release was applied to each trigger point for 90 seconds. Five trigger points were treated during a single treatment session.
Experimental: Combined Therapy
Participants received a single session of combined therapy consisting of therapeutic ultrasound combined with transcutaneous electrical nerve stimulation (TENS) applied to active myofascial trigger points in the upper trapezius muscle.
Dispositivo: Combined Therapy (Therapeutic Ultrasound + TENS)
Combined therapy consisting of pulsed therapeutic ultrasound (1 MHz, 20% duty cycle, 1.0 W/cm²) delivered simultaneously with transcutaneous electrical nerve stimulation (TENS; biphasic asymmetric waveform, 200 μs pulse duration, 100 Hz). Treatment was applied to five active upper trapezius myofascial trigger points during a single 10-minute session.
Experimental: Combined Therapy + Jones Technique
Participants received the Jones Technique followed immediately by combined therapy (therapeutic ultrasound plus transcutaneous electrical nerve stimulation [TENS]) during a single treatment session.
Produto combinado: Combined Therapy + Jones Technique
Participants received the Jones Technique followed immediately by combined therapy (therapeutic ultrasound plus transcutaneous electrical nerve stimulation [TENS]) during a single treatment session.
Comparador Falso: Sham Control
Participants underwent all study assessments and received sham treatment consisting of inactive combined therapy (device turned off) and a simulated Jones Technique without therapeutic pressure.
Procedimento: Sham Intervention
Participants underwent sham treatment consisting of inactive combined therapy with the device turned off and a simulated Jones Technique performed without therapeutic pressure.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Pressure Pain Threshold (PPT)
Prazo: Baseline and immediately after the intervention (single treatment session)
Pressure pain threshold assessed using a pressure algometer at five active myofascial trigger points in the upper trapezius muscle. The pressure pain threshold is recorded in kg/cm². Higher values indicate greater pressure tolerance and therefore a better outcome.
Baseline and immediately after the intervention (single treatment session)
Pain Intensity
Prazo: Baseline and immediately after the intervention
Pain intensity assessed using the Visual Analog Scale for Pain (VAS). Scores range from 0 to 10 cm, where 0 indicates no pain and 10 indicates the worst pain imaginable. Higher scores indicate worse pain.
Baseline and immediately after the intervention

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Upper Limb Disability
Prazo: Baseline
Upper limb disability assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Scores range from 0 to 100, where 0 indicates no disability and 100 indicates the most severe disability. Higher scores indicate worse upper limb function.
Baseline
Sleep Quality
Prazo: Baseline
Sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI). Total scores range from 0 to 21, where higher scores indicate poorer sleep quality.
Baseline
Quality of life
Prazo: Baseline
Quality of life assessed using the 36-Item Short Form Health Survey (SF-36). Scores for each domain range from 0 to 100, where higher scores indicate better health-related quality of life.
Baseline
Physical Activity Level
Prazo: Baseline
Physical activity level assessed using the International Physical Activity Questionnaire (IPAQ). Participants are classified into low, moderate, or high physical activity levels based on the questionnaire scoring protocol. Higher physical activity classification indicates a better outcome.
Baseline
Participant Satisfaction
Prazo: Immediately after the intervention
Participant satisfaction assessed immediately after treatment using a 7-point Likert scale. Scores range from 1 (strongly disagree/very dissatisfied) to 7 (strongly agree/very satisfied). Higher scores indicate greater participant satisfaction.
Immediately after the intervention

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Isabel de Almeida Paz

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

7 de outubro de 2024

Conclusão Primária (Real)

20 de outubro de 2024

Conclusão do estudo (Real)

20 de dezembro de 2024

Datas de inscrição no estudo

Enviado pela primeira vez

4 de julho de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

4 de julho de 2026

Primeira postagem (Real)

10 de julho de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

14 de julho de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

10 de julho de 2026

Última verificação

1 de julho de 2026

Mais Informações

Termos relacionados a este estudo

Palavras-chave

Termos MeSH relevantes adicionais

Outros números de identificação do estudo

  • 7.119.287

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

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