COMPARISE STUDY BETWEEN

INTEGRATED
NEUROMUSCULARINHIBITOR
TECHINQUE AND ISOMETRIC EXERCISE
ON UPPER TRAPEZIUS TRIGGER POINT
SUBJECTIVE WITH NON SPECIFIC NECK
PAIN
BY
GOPIKRISHNAN.C.G
IST MPT(MUSCULOSKELETAL AND SPORT )

INTRODUCTION

Non-specific neck pain is defined as

mechanical pain located
anywherebetween the occiput and
upper thoracic spine and surrounding
muscles without any specific etiology.
. A frequently seen cause of the neck
pain is awkward occupational postures,
heavy lifting and physically demanding
work

When a joint develops dysfunction, its

normal range of movement may be
affected and it can become painful.
In addition, joint dysfunction can lead
to a muscle imbalance and muscle pain
and a vicious cycle:

The muscles related to that joint can

subsequently become tense or,
conversely, underactive.
The resulting muscle imbalance can
place increased stress on the joint,
aggravating the joint dysfunction that
already exists

There are many potential contributing factors to

non specific neck pain, one area that has
received little scientific emphasis is the trigger
point (TrP).

The etiology of TrP development is currently

unknown, recent studies have hypothesized that
the pathogenesis results from the overloading
and injury of muscle tissue, leading to
involuntary shortening of localized fibers

Chaitow, the combination of MET,

ischemic compression and SCS
produces the most effective, targeted
approach to TrP release. This method is
termed the integrated
neuromuscularinhibition technique
(INIT)

REVIEW OF LITERATURE

Amit V. Nagrale, Paul Glynn, Aakanksha Joshi,

Gopichand Ramteke (2010)conducted studied
on The efficacy of an integrated neuromuscular
inhibition technique on upper trapezius trigger
point in patient with nonspecific neck pain.
study included 60 patient using random
number method .they concluded that
integrated neuromuscular inhibition technique
is benefit in nonspecific neck pain

Strikaran somprasong,keerin mekhora ,

roongttwa vachalathitti(2011)
conducted studied .the purpose effect
of strain counter strain and stretching
techniques in active myofascial
syndrome. study included 20 patient
using random method they concluded
that scs treatment relive pain one hour
after treatment in subject with MPS.

Gupta ,s.jaiswal conducted study on a comparative study

between ost isometric relaxation and isometric exercise in non
specific

neck

pain.

study

inclued

40

patient

anThe

experimental group (n=19) received post isometric relaxation

and control group (n=18) received isometric exercises and
studied concluded thatPostisometric relaxation may be more
effective in decreasing pain and disability and increasing
cervical
range of motion in patients with non-specific neck pain

Sibby, George Mathew, Kavitha Vishal (2009)

conducted studied onEffectiveness of
Integrated Neuromuscular Inhibitory
Technique and LASER with Stretching In the
Treatment of Upper Trapezius Trigger Points
study included 20 patient using random
method they concluded the studied that both
INIT and Laser with stretching are equally
effective in managing subjects with neck pain
due to upper trapezius trigger point

NEED FOR THE STUDY

No studies had done comparise study

between integrated neuromuscularinhibitor
techinque and isometric exercise on upper
trapezius trigger point subjective with non
specific neck pain
Compare effect of both techinque in which
good for reducing pain and increase in ROM

HYPOTHESIS
Alternative hypothesis
There will be significant difference in pain and
ROM in patient with non specific neck pain
afterIntegratedneuromuscularinhibition
technique
Hull hypothesis
There will be no significant difference in pain
and ROM in patient with non specific neck pain
after Integratedneuromuscularinhibition
technique

STUDY DESIGN AND SETTING

STUDY DESIGN Pre Verus post test

experimental study

SOURCE DATA :pateint with nonspecific

pain from out patient Bethany
navajeevan college of physiotherapy

METHOLOGY

POPLUATION : patient with non specific neck pain

INCLUSION CRITERIA:

individuals between 18 and 55 years of age, suffering

from non-specific neck pain, defined as non-articular
or non-systemic as per the referring physician.
Subjects were required to have neck pain of less than
3 months duration as well as active TrPs in the upper
trapezius muscle.

EXCLUSION CRITERIA:

a motor vehicle collision or significanttrauma,

if there were signs of serious pathology (e.g.malignancy,
infection, inflammatory disorder, orfracture),
if there were signs of cervical spinal cord compromise (e.g.
diffuse sensory abnormality, diffuseweakness, hyperreflexia,
or the presence of clonus)two or more signs of nerve root
involvement (e.g.dermatomal sensation changes, myotomal
weakness,or diminished/absent tendon jerk reflexes),
a historyof neck surgery during the previous 12 months,
history of cervical degenerative joint disease as per
radiographs, endocrine disorders, and autoimmuneconditions
(e.g. rheumatoid arthritis, fibromyalgia.

SAMPLING

SAMPLING METHOD : purposive

sampling

SAMPLE SIZE :30 PATIENT

PROCEDURE

Based on the inclusion criteria 30

subject with non specific neck pain will
be included in the study . They will be
individed into two group ,Group
A(experimental group) and
GroupB(control group)
Pre test will be conducted VAS for pain
and Lateral flexion ROMwithin pain
limitation

PROCEDURE

After a breif demonstration about

integrated neuromuscularinhibition
technique and postural correction
exercise GroupA will be
subjectintegrated
neuromuscularinhibition Group B
isometric exercise for 4 week with 4
session per week

Duration of this study : 4 week

Material used : couch
Out come measurement :
1) pain VAS
2) fuction activities: neck disability
index
3)ROM : goinometer