title: Effectiveness of a home program of ischemic pressure followed by sustained stretch for treatment of myofascial trigger points.
abstract: OBJECTIVE
  Myofascial trigger points (TPs) are found among patients who have neck and upper back pain. The purpose of this study was to determine the effectiveness of a home program of ischemic pressure followed by sustained stretching for the treatment of myofascial TPs.
  
  
  METHODS
  Forty adults (17 male, 23 female), aged 23 to 58 years (mean=30.6, SD=9.3), with one or more TPs in the neck or upper back participated in this study.
  
  
  METHODS
  Subjects were randomly divided into 2 groups receiving a 5-day home program of either ischemic pressure followed by general sustained stretching of the neck and upper back musculature or a control treatment of active range of motion. Measurements were obtained before the subjects received the home program instruction and on the third day after they discontinued treatment. Trigger point sensitivity was measured with a pressure algometer as pressure pain threshold (PPT). Average pain intensity for a 24-hour period was scored on a visual analog scale (VAS). Subjects also reported the percentage of time in pain over a 24-hour period. A multivariate analysis of covariance, with the pretests as the covariates, was performed and followed by 3 analyses of covariance, 1 for each variable. RESULTS Differences were found between the treatment and control groups for VAS scores and PPT. No difference was found between the groups for percentage of time in pain.
  
  
  CONCLUSIONS
  A home program, consisting of ischemic pressure and sustained stretching, was shown to be effective in reducing TP sensitivity and pain intensity in individuals with neck and upper back pain. The results of this study indicate that clinicians can treat myofascial TPs through monitoring of a home program of ischemic pressure and stretching.
authors.affiliation: School of Physical Therapy, Texas Woman's University, 1130 MD Anderson Blvd, Houston, TX 77030, USA. hf_hanten@twu.edu
authors.forename: W P
authors.initials: WP
authors.lastname: Hanten
authors.forename: S L
authors.initials: SL
authors.lastname: Olson
authors.forename: N L
authors.initials: NL
authors.lastname: Butts
authors.forename: A L
authors.initials: AL
authors.lastname: Nowicki
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001416:Back Pain / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000503:physiopathology / Q000628:therapy*; D019547:Neck Pain / Q000503:physiopathology / Q000628:therapy; D010147:Pain Measurement / Q000379:methods; D026741:Physical Therapy Modalities; D011312:Pressure; D012684:Sensory Thresholds; D016896:Treatment Outcome