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CTRI Number  CTRI/2025/08/093001 [Registered on: 13/08/2025] Trial Registered Prospectively
Last Modified On: 12/08/2025
Post Graduate Thesis  Yes 
Type of Trial  Interventional 
Type of Study   Physiotherapy (Not Including YOGA) 
Study Design  Other 
Public Title of Study   Effect of Muscle Relaxation Technique on Neck Pain, Movement, and Function in patients with Upper Back Muscle Stiffness  
Scientific Title of Study   Effectiveness of Integrated Neuromuscular Inhibition Technique on pain pressure threshold, Cervical range of motion and functionality in patient with upper trapezius trigger point: An Experimental Study 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  NISHAD SIDDHARTH 
Designation  PG STUDENT 
Affiliation  SPB Physiotherapy college surat  
Address  SPB Physiotherapy College OPD (Musculoskeletal Department) Ugat Bhesan Road Morabhagal Surat
SPB Physiotherapy College OPD (Musculoskeletal Department) Ugat Bhesan Road Morabhagal Surat
Surat
GUJARAT
395009
India 
Phone  7359785061  
Fax    
Email  siddharthnishad73@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  DR BHUMIKA PARMAR  
Designation  ASSISTANT PROFESSOR 
Affiliation  SPB PHYSIOTHERAPY COLLEGE  
Address  SPB Physiotherapy College OPD (Musculoskeletal Department) Ugat Bhesan Road Morabhagal Surat
SPB Physiotherapy College OPD (Musculoskeletal Department) Ugat Bhesan Road Morabhagal Surat
Surat
GUJARAT
395005
India 
Phone  7738360449  
Fax    
Email  bhumikapatelmpt@gmail.com  
 
Details of Contact Person
Public Query
 
Name  DR BHUMIKA PARMAR  
Designation  ASSISTANT PROFESSOR 
Affiliation  SPB PHYSIOTHERAPY COLLEGE  
Address  SPB Physiotherapy College OPD (Musculoskeletal Department) Ugat Bhesan Road Morabhagal Surat
SPB Physiotherapy College OPD (Musculoskeletal Department) Ugat Bhesan Road Morabhagal Surat
Surat
GUJARAT
395005
India 
Phone  7738360449  
Fax    
Email  bhumikapatelmpt@gmail.com  
 
Source of Monetary or Material Support  
SPB Physiotherapy College OPD Ugat Bhesan Road Morabhagal Surat Gujarat India 395005  
 
Primary Sponsor  
Name  NISHAD SIDDHARTH 
Address  SPB Physiotherapy College OPD Ugat Bhesan Road Morabhagal Surat Gujarat India 395005  
Type of Sponsor  Other [SELF] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
NISHAD SIDDHARTH  SPB Physiotherapy College   SPB Physiotherapy College OPD (Musculoskeletal Department)Ughat Bhesan Road Morabhagal Surat Gujarat India 395005
Surat
GUJARAT 
7359785061

siddharthnishad73@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
Institutional Ethical Committee SPB Physiotherapy College  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: M624||Contracture of muscle,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  Conventional treatment  Conventional treatment for neck and upper back dysfunction often includes a combination of chin tuck exercises, active neck movements, neck isometrics, shoulder bracing, and trapezius self-stretching. This approach focuses on improving posture, reducing muscle tension, and enhancing strength and flexibility. Chin tucks help in correcting forward head posture by strengthening deep neck flexors, while active neck movements promote mobility and reduce stiffness. Neck isometrics involve static muscle contractions to build strength without joint movement, ideal for early rehabilitation. Shoulder bracing supports proper shoulder alignment and reduces strain on neck muscles. Lastly, trapezius self-stretching targets tight upper trapezius muscles, relieving tension and improving range of motion. duration is 10min 
Intervention  Integrated Neuromuscular Inhibition Technique  The Integrated Neuromuscular Inhibition Technique (INIT) is a manual therapy approach used in physiotherapy to manage muscle pain, tightness, and dysfunction, particularly involving myofascial trigger points. It combines three soft tissue techniques: Ischemic Compression , Muscle Energy Technique (MET), and Strain-Counterstrain (SCS). TPR involves applying pressure to deactivate painful trigger points; MET uses the patient’s voluntary muscle contractions against resistance to relax and lengthen tight muscles; and SCS is a passive technique that places the muscle in a position of comfort to reduce spasm and reset muscle spindle activity. By integrating these methods, INIT helps reduce pain, release muscle tension, improve range of motion, and restore neuromuscular balance. It is commonly used for conditions like neck and back pain, myofascial pain syndrome, postural issues, and sports injuries, offering a safe, effective, and non-invasive treatment option. Duration is 20min 
Comparator Agent  nil  nil 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  35.00 Year(s)
Gender  Both 
Details  Both males and females, Patients with bilateral trapezitis, Presence of active MTrPs identifiable by spot tenderness in a taut, muscular band, Patients with grade 3 and 4 trapezius muscle Tenderness, and Pain pressure threshold in upper trapezius less than or equal to 2.5 kg/cm 
 
ExclusionCriteria 
Details  Patients with Cervicogenic headache, Patients who have history of any traumatic brain injury, whiplash injury and cervical spine surgery, Patients with fibromyalgia and other musculoskeletal disorders such as ankylosing spondylitis, rheumatoid arthritis, Patients with any deformity e.g. spasmodic torticollis, Sprengel’s deformity, scoliosis, Patients undergoing any other treatment for the same condition from any other health practitioner. 
 
Method of Generating Random Sequence   Coin toss, Lottery, toss of dice, shuffling cards etc 
Method of Concealment   An Open list of random numbers 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
Pain Pressure Threshold, Cervical Range of Motion, Functionality   At Baseline, 4 Week 
 
Secondary Outcome  
Outcome  TimePoints 
NIL  NIL 
 
Target Sample Size   Total Sample Size="50"
Sample Size from India="50" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   01/10/2025 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="0"
Months="8"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary  

Title : Effectiveness of Integrated Neuromuscular Inhibition Technique on Pain Pressure Threshold, Cervical Range of Motion and Functionality in Patients with Upper Trapezius Trigger Points: An Experimental Study

Trapezitis is defined as inflammation of trapezius muscle. The upper trapezius muscle is designated as postural muscle and it is highly susceptible to over use. The pain is present even during rest and is aggravated by activity; it may be referred to other area from the site of primary inflammation.

The Integrated Neuromuscular Inhibition Technique (INIT) is a manual therapy approach used in physiotherapy to manage muscle pain, tightness, and dysfunction, particularly involving myofascial trigger points. It combines three soft tissue techniques: Ischemic Compression , Muscle Energy Technique (MET), and Strain-Counterstrain (SCS). TPR involves applying pressure to deactivate painful trigger points; MET uses the patient’s voluntary muscle contractions against resistance to relax and lengthen tight muscles; and SCS is a passive technique that places the muscle in a position of comfort to reduce spasm and reset muscle spindle activity. The purpose of the study is to check the effect of this techniques in patients with upper trapezius trigger points and to study its effectiveness on PPT, Cervical ROM and functionality in  the patients with Upper Trapezius Trigger points.

Patients with Upper Trapezius Trigger points of age 18 to 35years, both males and females, Presence of active MTrPs identifiable by spot tenderness in a taut, muscular band.  The patient will be screened on the basis of inclusion and exclusion criteria and their demographic data will be taken by an assessment Performa. Prior to the commencement of the study, detailed procedure of the study will be explained to the patients and assigned informed consent form will be taken from them. Then the patient will be randomly assigned to a 4-week intervention protocol and allocated randomly to Group A and Group B.  Group A = Integrated Neuromuscular Inhibition Technique (INIT) + Conventional treatment (total duration – 20 mins)  In INIT includes 3 techniques i.e Ischemic compression, Positional release technique and Muscle energy technique. GroupB = Control group. Conventional treatment (total duration-10 mins)

SPSS Version 29.0 will be used for statistical analysis and Microsoft Excel 2019 will be used for tabulation and graphical presentation of data. Based on the normality of distribution, either parametric/non parametric test will be used, for analysis of intergroup and intragroup differences.

 

 
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