Integrated Neuromuscular Inhibition Technique Research Articles

Pendampingan Kesehatan Fisik bagi Pembatik sebagai Upaya Mengurangi Risiko dan Keluhan Work-related Musculoskeletal Disorder (WMSD) di Kampung Batik Laweyan

The high incidence of Work-related Musculoskeletal Disorder (WMSD) in workers is caused by various factors from the individual and the work environment. Musculoskeletal complaints in workers also occur and disrupt productivity for batik workers. Batik itself has several types and several divisions of work. Workload, duration, and poor work posture cause excess work on the muscles which results in functional disorders of the structural muscles in the neck and causes myofascial trigger point syndrome (MTPS). This service activity is carried out to resolve complaints, prevent further impacts, and increase worker productivity. The program is provided in the form of Integrated Neuromuscular Inhibition Technique (INIT) and Self Stretching combined with infrared radiation. Apart from that, educational efforts are also being made regarding Musculoskeletal Disorders and ergonomic working positions. Measurement of activity effectiveness is carried out using the VAS, NDI, NBM and WERA instruments. Based on the results of the activities carried out, it can be concluded that health assistance efforts for batik workers in Laweyan Batik Village in the form of providing therapeutic and educational measures have proven effective in reducing complaints and incidents of WMSD. By reducing complaints, the work output and productivity of batik makers increases.

Instrument Assisted Soft Tissue Mobilization versus Integrated Neuromuscular Inhibition Technique in Nonspecific Chronic Neck Pain: Single-blinding Randomized Trial

ObjectiveThis study aimed to compare the effects of instrument-assisted soft tissue mobilization (IASTM) vs integrated neuromuscular inhibition technique (INIT) on pain intensity, pressure pain threshold, neck disability, and electrophysiological properties in nonspecific chronic neck pain. MethodsWe performed a pre-post prospective randomized controlled trial on 90 participants with nonspecific chronic neck pain. The participants were chosen randomly from physical therapy out-patient clinics in the Giza governorate and allocated randomly by permuted block to the following 3 groups: Group A received INIT on the upper trapezius in addition to supervised traditional therapy (STT) as hot pack, stretching and strengthening exercises, Group B received IASTM on the upper trapezius in addition to STT, and Group C received STT only. Treatment was 3 times per week for 4 weeks. Pain intensity by visual analog scale (VAS), pressure pain threshold (PPT) by commander algometer, neck disability by Arabic Neck Disability Index (ANDI), and electrophysiological properties in the form of muscle amplitude by root mean square (RMS), and fatigue by median frequency (MDF) were measured at baseline and after 4 weeks. ResultsIn the within-group analysis, there was a statistically significant decrease in VAS, ANDI, and RMS% values within each group with favor to INIT. In PPT and MDF, there was a significant increase within each group with regard to INIT as P value <.05. In the between-group analysis at posttreatment, the results reported a statistically significant difference between INIT and STT, and also between IASTM and STT in all variables. Between INIT and IASTM, there was no statistically significant difference in VAS and NDI, but there was a statistically significant difference in PPT, RMS%, and MDF. The post hoc test reported improvement in all variables in all groups, with more favor to the INIT group in PPT and electrophysiological properties only. ConclusionIn this study, we found no statistically significant differences between INIT and IASTM in VAS and ANDI posttreatment, but there were differences between INIT and STT group and IASTM and STT group.

POSTURAL CORRECTION PADA INTERVENSI INIT DAN ULTRASOUND THERAPY DALAM MENURUNKAN DISABILITAS PADA NYERI LEHER NON SPESIFIK

Pendahuluan: Nyeri leher non spesifik jika tidak ditindaklanjuti dengan tepat akan berdampak pada aktivitas, produktivitas dan pendapatan serta kualitas hidup seseorang. Penatalaksanaan klinis kasus ini dapat berupa terapi Integrated Neuromuscular Inhibition Technique (INIT) dan Ultrasound Therapy yang dikombinasikan dengan postural correction. Tujuan dari penelitian ini adalah untuk mengetahui efektivitas kombinasi postural correction, INIT dan Ultrasound Therapy dalam mengurangi disabilitas leher pada pasien nyeri leher non spesifik.&#x0D; Metode: Penelitian ini merupakan quasi eksperimental dengan jenis rancangan one group pre-test and post-test group design. Penelitian dilakukan di praktek mandiri fisioterapi di Denpasar dan Badung, Bali terhitung mulai bulan Agustus-September 2022. Terdapat 12 orang sampel yang diberikan intervensi sebanyak tiga kali tiap minggu selama empat minggu. Pengukuran disabilitas dilakukan dengan Neck Disability Index (NDI).&#x0D; Hasil: Hasil uji hipotesis berpasangan pada kelompok didapatkan nilai p&lt;0,001 yang menyatakan bahwa terdapat perubahan yang signifikan sebelum dan sesudah intervensi.&#x0D; Simpulan: Intervensi Postural Control, Integrated Neuromuscular Inhibition Technique dengan Ultrasound Therapy dapat mengurangi disabilitas leher pada penderita nyeri leher non spesifik di Indonesia. Data yang didapat bermanfaat bagi peneliti dan praktisi di ranah klinis untuk mengimplementasikan hasil penelitian pada populasi nyeri leher non-spesifik.&#x0D; &#x0D; Kata kunci: postural correction, init, ultrasound therapy, nyeri leher non spesifik

Effect of myofascial cupping vs integrated neuromuscular inhibition techniques on pain and neck movement in individuals with latent trigger point in trapezius.

Pain is the most common symptom for seeking therapeutic alternative to conventional medicine. Trigger points (TrP) being the most debilitating cause of nonspecific neck pain, are found to be more prevalent in trapezius muscle. Various instrument-based and other manual therapy techniques are effective in the treatment of TrP. To compare the effect of Myofascial Cupping (MFC) and Integrated Neuromuscular Inhibition Technique (INIT) on the upper trapezius latent TrP on pain intensity, pressure pain threshold (PPT) & cervical range. A randomized trial controlled on 40 individuals aged 20-40 years, both gender with latent TrPs in upper trapezius excluding ones who have taken treatment for upper trapezius TrPs within 6 months. Participants were randomly allocated into 2 groups by chit method, one group received MFC and other INIT. Pre- and post-intervention assessment was done using NPRS, pressure algometer and goniometer. Within group, pain has significantly reduced after MFC and INIT with mean difference of and , respectively (). PPT increased in both groups () with mean difference of and , respectively. Comparison between the groups showed significant difference in pain intensity () suggesting MFC was more effective in reducing pain. However, a PPT (p=0.606) and neck lateral flexion to the contralateral side of TrP () were not significant. MFC was more effective than INITs in improving pain, however both interventions showed similar effect on PPT and neck lateral flexion on latent TrP in trapezius.

Integrated neuromuscular inhibition technique versus spray and stretch technique in neck pain patients with upper trapezius trigger points: a randomized clinical trial

ABSTRACT Objective This study aimed to investigate the difference between the integrated neuromuscular inhibition technique (INIT) and spray and stretch technique in patients with neck pain and upper trapezius active trigger points. Methods: A convenience sample of 60 patients with neck pain and active trigger points were recruited from physiotherapy students and allocated randomly to three groups INIT plus stretching exercise spray and stretch technique plus stretching exercise, and stretching exercise only. Treatment was three times per week for four weeks. Pain intensity by visual analogue scale (VAS), pain pressure threshold (PPT), neck disability by Arabic neck disability index (ANDI), and muscle amplitude in the form of root mean square (RMS) by electromyography (EMG) were measured at baseline and after four weeks. Results: Between groups analysis; the results revealed statistical significant difference between three groups after four weeks of intervention as p =0.0001. Within the group analysis, post hoc tests reported improvement at all variables in both INIT and spray and stretch technique groups with mean differences 64.5 and 65.1 in VAS, 20 and 18.15 in ANDI, −1.45 and −0.81 in PPT, and 2.47 and 1.88 in muscle amplitude, respectively. But there was no statistically significant difference in stretching only group in all variables except VAS. Conclusion Both INIT and spray and stretch techniques had a clinical and statistical effects on pain, function, PPT, and RMS. According to results, there were statistical significant differences between INIT and spray and stretch groups at post-treatment in all variables except VAS with more favor to INIT group, but there were no clinical differences between INIT and spray and stretch groups.

Integrated Neuromuscular Inhibition Technique Versus Mulligan Mobilization on Functional Disability in Subjects With Nonspecific Low Back Pain: A Comparative Study.

Background Pain lasting more than three months is termed chronic pain. Treating chronic pain is always a challenge for the therapist. Low back pain (LBP) with a high prevalence is a point of concern. Various treatment methods are available. The two treatment methods are integratedneuromuscular inhibition technique (INIT) and Mulliganmobilization with movement (MWM). In this study, we have compared INIT with MWM. Method It was an interventional study carried out at Ravi Nair Physiotherapy College and Acharya Vinoba Bhave Rural Hospital. A total of 80 participants with nonspecific LBP were included in the study. The participants were randomly divided into two groups and treated for two weeks with three weekly sessions. Statistical analysis and result Statistical analysis was done post the completion of sampling. Paired and unpaired t-tests were used. A p-value of <0.05 was consideredsignificant. The result was obtained after comparing the pre- and post-values of the numerical pain rating scale (NPRS), modified Oswestry disability index (MODI), and range of motion (ROM) of the lumbar joint. After two weeks of treatment, a reduction in functional disability and pain was seen in the INIT and MWM groups. ROM was increased after two weeks of treatment in both INIT and MWM groups. When compared, INIT showed better results than MWM. Conclusion In conclusion, we saw that the integrated neuromuscular inhibition technique might be a better technique than Mulligan mobilization with movement in terms of reducing pain and functional disability.

Within-Subject Changes in Shoulder Girdle Muscle Activation After Soft Tissue Mobilization of the Upper Trapezius

ObjectiveThe purpose of this study was to investigate the effect of the integrated neuromuscular inhibition technique (INIT) of the upper trapezius (UT) on shoulder muscle activity in chronic shoulder pain. MethodsTwenty-two patients (mean age 42.5 ± 16.07) with chronic unilateral shoulder pain with UT myofascial trigger points (MTrPs) (n = 27) and scapular dyskinesis received a single session of INIT (∼15 minutes for each MTrP). The pain on the visual analog scale, along with surface electromyographic activity, maximum voluntary contraction in % (in arm raising and lowering in scapular plane), and pressure pain threshold (PPT) of 5 girdle muscles UT, lower trapezius, serratus anterior, middle deltoid, and infraspinatus were measured before and immediately after treatment. Wilcoxon signed-rank test was used for analysis (at α ≤ 0.05). ResultsMuscle activity of all the muscles, especially the lower trapezius, was reduced during arm raising in the scapular plane (76.69%-71.14% [p = 0.003]). UT activity decreased during arm lowering also (56.70%-45.99% [p ˂ 0.001]). The intensity of shoulder pain reduced (50.50 mm to 22 mm, [p ˂ 0.001]), and PPT values of all 5 muscles improved post-treatment. ConclusionThe findings of this study provide preliminary evidence for the application of a single session of INIT on UT MTrPs in reducing activity in the scapular muscles, improving shoulder pain, and PPT in chronic unilateral shoulder pain.

Impact of integrated neuromuscular inhibition technique versus electro-acupuncture stimulation of posterior tibial nerve in males with chronic pelvic pain of myofascial origin

The aim of the study was to examine the impact of the integrated neuromuscular inhibition technique and electro-acupuncture stimulation of posterior tibial nerve in males diagnosed with chronic pelvic pain of myofascial origin. Sixty male patients with chronic pelvic pain participated in this randomized, single-blind, active-controlled trial and they were randomly divided into 3 groups of equal size. The group A (20 patients) received integrated neuromuscular inhibition technique (INIT) and pelvic floor exercise, the group B (20 patients) received posterior tibial nerve electroacupuncture using TENS acupuncture as a noninvasive pelvic floor muscle neuromodulation technique and pelvic floor exercise, and the control group C (20 patients) received pelvic floor exercise only. Serum cortisol level (SCL) measurement was done, and the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaire score was used to assess the severity of symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The measurements were done at baseline and after the next two months. Comparing the three groups post treatment, our results show that there are statistically significant differences in serum cortisol level and in the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaire score in both group A and B (p&lt;0.05). There are no statistically significant differences in the control group C (p&gt;0.05). The findings of this research showed a significant reduction of blood cortisol level and improvement of NIH CPSI questionnaire total value in men with chronic pelvic pain who used an integrated neuromuscular inhibition technique and percutaneous posterior tibial nerve stimulation, and a non-significant difference in the control group C. The INIT has superiority over electro-acupuncture stimulation of the posterior tibial nerve in reducing pain and improving quality of life.

Effectiveness of Integrated Neuromuscular Inhibition Technique and Instrument Assisted Soft Tissue Mobilisation in the Management of Upper Trapezius Myofascial Trigger Points

Background: This study was designed to inspect the effectiveness of Integrated NeuromuscularInhibition Technique (INIT) and Instrument Assisted Soft Tissue Mobilisation (IASTM) on UpperTrapezius Myofascial Trigger Points.Purpose: To compare the effectiveness of integrated neuromuscular inhibition technique and instrumentassisted soft tissue mobilization in the management of upper trapezius myofascial trigger pointMaterials and Methods: Sixty subjects with Active Trigger Points (53 females and 7 males) weredivided randomly into two equal groups. Group “A” received INIT three times/week while Group“B” received IASTM once/week for two weeks. Numeric Pain Rating Scale (NPRS), Neck DisabilityIndex (NDI) and Active Cervical Range Of Motion (CROM) were used to evaluate subjects at twointervals (Pre-Treatment and Post-Treatment).Results: Statistical analysis show that there is a significant change within-group for NPRS, NDI andCROM (Lateral Flexion) pre and post treatment with a p&lt;0.0001 for both Groups A and B. Betweengroupanalysis is statistically significant with p=0.0026 for NPRS, p=0.0569 for NDI and p&lt;0.0001 forAROM thus with superiority for INIT in reducing pain and improving ROM.Conclusion: Integrated Neuromuscular Inhibition Technique is more effective than InstrumentAssisted Soft Tissue Mobilisation in the Management of Upper Myofascial Trigger Points.

Effect of integrated neuromuscular inhibition technique compared with positional release technique in the management of piriformis syndrome.

Studies have indicated that the muscle energy technique (MET) and the positional release technique (PRT) are effective in the management of piriformis syndrome (PS); however, evidence is scarce regarding the combination of these techniques in the form of an integrated neuromuscular inhibition technique (INIT) in the management of individuals with PS. Although a previous trial investigated the effect of INIT for PS, that study did not integrate Ruddy's reciprocal antagonist facilitation (RRAF) method into the INIT protocol, nor did the authors diagnose PS according to established criteria. To examine the effects of INIT with integrated RRAF compared with PRT in the management of patients diagnosed with PS. This study was designed as a single blind randomized clinical trial in which participants diagnosed with PS were randomly allocated into INIT and PRT groups. Each group attended two treatment sessions per week for 8weeks. Patients in the INIT group received a protocol in which the patient's tender point or trigger point was palpated in the belly of the piriformis approximately halfway between the inferior lateral angle of the sacrum and the greater trochanter, at which point the therapist applied an intermittent or sustained pressure and maintained the pressure for 20-60seconds (depending on the participant's response to pain reduction). For INIT patients, that protocol was also followed by RRAF, a method in which a patient introduces a series of tiny/miniature contractions or efforts (20 times per 10seconds) against a therapist's resistance. Patients in the PRT group were treated by palpating the same trigger point described in the INIT group, followed by application of light pressure at the location of the trigger point, which was maintained the pressure for 2minutes or until the pain subsided (determined by asking the participant to report a pain score using a visual analog scale at 30second intervals). For both groups, three repetitions of the INIT or PRT treatment were performed over 10minutes at each clinical visit. Additionally, each group also received stretching exercises immediately after the INIT or PRT treatment session. Each participant was assessed at baseline, immediately posttreatment, and at 4months posttreatment for pain, sciatica, functional mobility, quality of life, hip abduction, and internal rotation. A repeated measures analysis of variance (ANOVA) of within-between group interactions was used to analyze the treatment effect. Forty eight participants (age range, 25-47 years; mean age±standard deviation, 32.81±3.27 years) were randomized into the INIT and PRT groups, with 24 participants in each group. No significant between-group differences (p>0.05) were observed in the baseline demographic and clinical variables of the participants. A repeated-measures ANOVA indicated that there was a significant time effect for all outcomes, with a significant interaction between time and intervention (p<0.001). The Bonferroni post hoc analyses of time and intervention effects indicated that the INIT group improved significantly compared with the PRT group in all outcomes (p<0.05) immediately posttreatment and at the 4months follow up period. INIT was more effective than PRT in the management of individuals with PS. It should be noted the significant improvement achieved in both the groups may have also been contributed to by the stretching exercises that were used as adjunct therapies by both groups.

Effect of ice massage with integrated neuromuscular inhibition technique on pain and function in subjects with mechanical neck pain: randomized controlled trial

BackgroundMyofascial trigger point (MTrP) plays a major role in the genesis of mechanical neck pain, which may lead to chronic disorders. The purpose of the study is to investigate and compare the effect of ice massage plus integrated neuromuscular inhibition technique (INIT) versus INIT alone on active trigger points in the upper trapezius of persons having mechanical neck pain. Forty participants diagnosed as mechanical neck pain with upper trapezius active myofascial trigger points. They were randomized into two equal groups. Group A (experimental) received ice massage for 10 min plus INIT, while group B (control) received INIT alone. The treatment program continued for 2 weeks (3 sessions/week). The outcome measures are the pain intensity, pain pressure threshold, cervical lateral side bending and neck daily functions.ResultsThe results showed that there were significant improvements in VAS at p = .899 and F = .78, PPT at p = .288 and F = .553, cervical side bending at p = .094 and F < 0.00001, and NDI at p = .164 and F = 0.00001 in both groups, while there were no statistically significant differences between both groups as p > 0.05.ConclusionIce massage and INIT are effective methods in managing active trigger points in the upper trapezius of persons having mechanical neck pain without statistically significant difference.

Effect of the intergrated neuromuscular inhibition technique on upper trapezius myofascial trigger points: A case series

Objective: This study aimed to determine the effectiveness of the Integrated Neuromuscular Inhibition Technique (INIT) for treating Myofascial Trigger Points (MTrPs) in the upper trapezius muscle on outcomes of pain, Range of Motion (ROM) and disability. Methods: 18 patients mean age 27± of 14.78 years were screened for inclusion/exclusion criteria. The INIT was administered three times a week for 4 weeks. The verbal Numerical Pain Rating scale (NPRS), cervical lateral flexion ROM and Neck Disability Index (NDI) were recorded at baseline, 2 and 4 weeks. Results and Conclusion: There were positive changes in all outcome measures for all eighteen participants. An increase in ROM and reduced levels of pain and disability were noted. This case series suggests that a short-term multimodal therapy would be beneficial for individuals with upper trapezius MTrPs. Important preliminary data was collected that will inform more rigorous research in this field of research.

Effect of Integrated Neuromuscular Inhibition Technique in the Management of Piriformis Syndrome: A Case Report

Introduction: Piriformis syndrome (PS) is one of the most commonly misdiagnosed neuromuscular conditions characterized by buttock pain which radiates down the ipsilateral lower extremity. This case report describes the use of integrated neuromuscular inhibition technique (INIT) in the management of a patient with piriformis syndrome (PS). Case Presentation: A 40-year-old man presented with a complaint of right buttock pain which radiated to the ipsilateral lower limb. The patient was diagnosed as having PS. The treatment of the patient included INIT followed by stretching exercises for 6-weeks. Outcome measurements included visual analogue scale (VAS), Rolland-Morris disability questionnaire (RMDQ), Sciatica bothersome index (SBI), Sciatica frequency index (SFI), and global rating of change scale (GROC) and were assessed at baseline (T0), at 3 (T1) and 6-weeks (T2) of intervention, and then at 12-weeks (T3) follow-up. Conclusions: At 12-weeks follow-up (T3), the outcomes indicated improvement in all symptoms (VAS = 0, RMDQ = 0, SBI = 0, SFI = 0, and GROC = +7). Integrated neuromuscular inhibition technique is effective in the management of a patient with piriformis syndrome.

Effects of Exercise and an Integrated Neuromuscular Inhibition Technique Program in the Management of Chronic Mechanical Neck Pain: A Randomized Controlled Trial

ObjectiveThe aim of this study was to evaluate the effect of adding the integrated neuromuscular inhibition technique (INIT) to therapeutic exercise (TE) in individuals with chronic mechanical neck pain (CMNP). MethodsIn this 34-week, assessor-blind randomized controlled trial, 40 participants (men and women) with CMNP with active or latent myofascial trigger points on the neck muscles were divided into 2 groups. The participants followed 4 treatments per week for 10 weeks. The intervention group followed a TE program in combination with the INIT, whereas the control group followed the same program without the INIT. Both protocols were applied by physiotherapists. Pain, disability, pressure pain threshold, active range of motion, and health-related quality of life were evaluated before, during, and after the intervention, whereas patients were followed for 6 months after completion of treatment. Repeated-measures ANOVA was applied. ResultsBoth groups showed a significant improvement in all dependent measures after the intervention (P < .05). However, the intervention group showed greater improvement in the visual analog scale and neck disability index score, in the neck muscles pressure pain threshold, in the range of motion, and in the 36-Item Short Form Health Survey score, than the control group. In many of the above variables this improvement was seen from the second week and was maintained for 6 months after the intervention. ConclusionThe results of this preliminary study suggest that the addition of the INIT to a TE program had a positive effect on pain, functionality, and the quality of life in individuals with CMNP.

Effect of integrated neuromuscular inhibition technique on trigger points in patients with nonspecific low back pain: Randomized controlled trial

Background and Objective: Trigger points in the myofascial system form the major reason for pain and tenderness in nonspecific low back pain (NSLBP). These points can be treated using manual therapy techniques such as integrated neuromuscular inhibition technique (INIT). Due to lack in the literature about its effect in NSLBP condition, the present study was undertaken to evaluate the effects of INIT on trigger points in patients with NSLBP. Materials and Methods: Forty-four patients with NSLBP were randomly assigned to either of the two study groups using envelope method. Group A (n = 22) was treated with stretching and strengthening exercises, whereas Group B (n = 22) was treated with INIT. Both the groups received hot moist pack and therapeutic ultrasound as common treatment. Five consecutive sessions of intervention were given over 5 days. Outcome measures in terms of pain pressure threshold (quadratus lumborum [QL] and erector spinae [ES]), lumbar range of motion (ROM), and disability were measured at baseline and end of the fifth session of treatment. Results: The within-group analysis showed a reduction in pain, improved ROM, and disability in both the study groups (P 0.05). Conclusion: The present study concluded that INIT is superior to stretching and strengthening exercises in reducing trigger point tenderness and better functionality in patients with nonspecific low back pain.

Kinesio Taping on Trapezius Trigger Points After Integrated Neuromuscular Inhibition Technique (INIT)

Kinesio Taping on Trapezius Trigger Points After Integrated Neuromuscular Inhibition Technique (INIT)

Effects of an integrated neuromuscular inhibition technique program on neck muscle strength and endurance in individuals with chronic mechanical neck pain

BackgroundThe aim of this study was to investigate whether the application of the integrated neuromuscular inhibition technique (INIT) combined with therapeutic exercise (TE) can provide faster and greater improvement in maximum isometric strength and isometric endurance of the neck muscles in patients with chronic mechanical neck pain (CMNP). MethodsIn this 10-week, single-blind clinical trial, 40 participants (men and women) with CMNP were divided into two groups. The intervention group (IG) followed a TE program in combination with the INIT, while the control group (CG) followed the same TE program without the INIT technique. Changes in maximum isometric strength and isometric endurance of the neck muscles were evaluated before, during, and after the intervention, with follow-up measurements taken at 1, 3, and 6 months after the intervention. Analysis of variance with repeated measures was applied. ResultsBoth groups showed a significant improvement in all dependent measures after the intervention (p < .05). These changes were maintained for both groups 6 months after the intervention. However, the IG showed a greater improvement in the maximum isometric strength of neck flexion and an improved craniocervical flexion test score compared with the CG. ConclusionThe combination of TE and INIT had a positive effect on neck muscle strength and endurance in individuals suffering from CMNP as compared with TE alone.

Does improvement towards a normal cervical sagittal configuration aid in the management of cervical myofascial pain syndrome: a 1- year randomized controlled trial

BackgroundThere is a growing interest concerning the understanding of and rehabilitation of the sagittal configuration of the cervical spine as a clinical outcome. However, the literature on the topic specific to conservative treatment outcomes of patients with chronic myofascial cervical pain syndrome (CMCPS) has not adequately addressed the relationship between cervical sagittal alignment and improved pain, disability and range of motion.MethodsA randomized controlled study with a 1-year follow-up. Here, 120 (76 males) patients with chronic CMCPS and defined cervical sagittal posture abnormalities were randomly assigned to the control or an intervention group. Both groups received the Integrated neuromuscular inhibition technique (INIT); additionally, the intervention group received the denneroll cervical traction device. Alignment outcomes included two measures of sagittal posture: cervical angle (CV), and shoulder angle (SH). Patient relevant outcome measures included: neck pain intensity (NRS), neck disability (NDI), pressure pain thresholds (PPT), cervical range of motion using the CROM. Measures were assessed at three intervals: baseline, 10 weeks, and 1 year after the 10 week follow up.ResultsAfter 10 weeks of treatment, between group statistical analysis, showed equal improvements for both the intervention and control groups in NRS (p = 0.36) and NDI (p = 0.09). However, at 10 weeks, there were significant differences between groups favoring the intervention group for PPT (p<0.001) and all measures of CROM (p<0.001). Additionally, at 10 weeks the sagittal alignment variables showed significant differences favoring the intervention group for CV p<0.001 and SH (p<0.001) indicating improved CSA. Importantly, at the 1-year follow-up, between group analysis identified a regression back to baseline values for the control group for the non-significant group differences (NRS and NDI) at the 10-week mark. Thus, all variables were significantly different between groups favoring the intervention group at 1-year follow up: NRS (p<0.001), NDI (p<0.001), PPT p<0.001), CROM (p<0.001), CV (p<0.001), SH (p<0.001).ConclusionThe addition of the denneroll cervical orthotic to a multimodal program positively affected CMCPS outcomes at long term follow up. We speculate the improved sagittal cervical posture alignment outcomes contributed to our findings.Trial registrationPan African Clinical Trial Registry Clinical Trial Registry: PACTR201801002968301, registered 11 January 2018 (retrospectively registered).

Integrated Neuromuscular Inhibition Technique Versus Kinesiotape on Upper Trapezius Myofascial Trigger Points a Randomized Clinical Trial

Background: This study was designed to inspect the effects of integrated neuromuscular inhibition technique (INIT) and kinesiotape (KT) on upper trapezius myofascial trigger points. Methods: Sixty subjects with active trigger points (53 females and seven males) were divided haphazardly into three equal groups. Group "A" received INIT three times/week while group "B" received KT twice per week for four weeks. Group "C" (control group) didn’t receive any treatment but follow instructions. Visual Analogue Scale (VAS), Arabic Neck disability index (ANDI) and cervical range of motion (CROM) were used to evaluate subjects at two intervals (pretreatment and post-treatment). Results: Statistical analysis shown that there was a significant change within-group of VAS, ANDI, side bending at both side pre-post treatment at groups A, B and C while (p&lt;0.05). Between-group analysis there was no significant change in pre value of all variables as (p&gt;0.05) while post-treatment there was a significant change in all variables as (p&lt;0.05).&nbsp; Conclusion: INIT and KT are most effective methods in the management of subjects with active trigger points at upper trapezius myofascial trigger points with superiority for INIT.

THE DIFFERENCE INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUE WITH DEEP TISSUE MASSAGE AND CONTRACT-RELAX STRETCHING TO IMPROVE RANGE OF MOTION CERVICAL JOINT IN MYOFASCIAL PAIN SYNDROME UPPER TRAPEZIUS MUSCLE AT SMA NEGERI 1 SEMARAPURA

ABSTRACTMyofascial pain syndrome is a collection of sensory, motor, and autonomic symptoms that cause local andreffered pain, limited range of motion and weakness of the affected muscles. The limitations range of motion will beannoying than the daily activities. Interventions that can improve range of motion of cervikal are IntegratedNeuromuscular Inhibition Technique, Deep Tissue Massage and Contract-Relax Stretching. The results show GroupNeuromuscular Inhibition Technique with Wilcoxan Sign Rank Test obtained a mean difference of 13.7 with p = 0.000,while the test results Hypothesis Group Contract-Relax Stretching with Paired Sample T-test showed a mean differenceof 12.1 with p = 0.000. Test the difference between Mann Whitney U-test showed no significant difference between theother group are obtained p = 0.420. These results indicate that there is no difference in increasing range of motion inboth groups.Keywords: Range of motion of cervical, Upper Trapezius Muscle,Myofascial Pain Syndrome, IntegratedNeuromuscular Inhibition Technique, Deep Tissue Massage, Contract-relax Stretching, Goniometer