This randomized controlled trial aims to assess the effectiveness of tele-rehabilitation, including self-myofascial release and exercise therapy, in reducing pain, improving functional range of motion, and decreasing neck disability in patients with rhomboid trigger points associated with myofascial pain syndrome.
Participants falling in this category would be recruited into the study.
Age 18-35 years
Both Genders: Male and Female
Paitents experiencing Neck and upper back pain due to active trigger points.(16) According to Travell and Simons (1999)criteria, active myofascial trigger points (MTrPs) are identified.
Participants falling in this category would be excluded from the study.
Participants fall in this category would be excluded of the study.
Patients currently taking analgesics (painkillers) or muscle relaxants.
Any inflammatory pathology, neurological impairment, and cervical tumor.
Parallel
Tele-rehabilitation (ET + Self-Myofascial Release)
Other intervention1. Self-Myofascial Release: Using a tennis ball against the wall targeting rhomboid region (5 mintues in total). 2. Stretching Exercises: Upper trapezius and levator scapulae stretch (30 seconds hold × 5 repetitions). 3. Postural correction Exercises: cervical retraction and shoulder blade squeezing /retraction ( 5 repetitions). 4. Postural and ergonomic education . 5. Mode of Delivery: Live/video-guided tele-rehabilitation sessions.
Conventional Myofascial Release Treatment
Other intervention1. Manual Myofascial Release: Therapist performe myofascial release on rhomboid trigger points.( 5 mintues in total) 2. Stretching Exercises: Upper trapezius and levator scapulae stretch (30 seconds hold × 5 repetitions). 3. Postural correction Exercises: cervical retraction and shoulder blade squeezing /retraction ( 5 repetitions). 4. Postural and ergonomic education .
Inclinometer for functional range of motion
An inclinometer is a reliable and valid instrument used to measure cervical range of motion (ROM) in flexion, extension, rotation, and lateral flexion. It provides objective and reproducible angular measurements of spinal movement. Studies have reported excellent intra-rater and inter-rater reliability (ICC = 0.85-0.98) for cervical motion assessment using a dual inclinometer.
Numeric Pain Rating Scale (NPRS)
The Numerical Pain Rating Scale (NPRS) is a simple, reliable, and valid tool used to assess pain intensity. It consists of an 11-point scale ranging from 0 to 10.The NPRS shows strong construct and concurrent validity when compared with other established pain assessment tools.The NPRS has demonstrated excellent test-retest reliability (r = 0.95) is across various musculoskeletal and rehabilitation populations
Neck Disability Index (NDI)
The Neck Disability Index (NDI) is a standardized questionnaire used to assess the impact of neck pain on daily activities. It consists of 10 items, each scored from 0 to 5, with higher scores indicating greater disability. The NDI has shown excellent reliability (ICC = 0.89-0.94) and strong validity for evaluating functional limitations in patients with neck and upper back pain.
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