Shakeel Ahmad, Sana Komal, Sadaf Shafique, Thamer Altaim.
Comparison of effectiveness of myofascial trigger point release with manual therapy and myofascial release in combination with self stretching in upper cross syndrome.
J Riphah Coll Rehab Sci Jan ;7(1):3-6.

BACKGROUND: Mechanical neck pain is the most common musculoskeletal disorder of general population. Mechanical neck pain is also known as axial neck pain or nonspecific neck pain as it is non radiating pain and has an acute or sudden onset without known etiology. The goal of ergonomic modifications is to create environment suitable for the physical needs of patients and to guide patients to perform workplace exercises Ergonomic modifications results in the enhancement of working posture and decline in incidence of musculoskeletal symptoms. Ergonomic guidelines, which include avoid slouch posture, sit upright, Frequently used items should be within close reach, Alternate activities like drinking water, speaking on phone, speaking to a colleague, whole body stretch should be done, Avoid maintaining same position for long period. OBJECTIVE: To compare the effectiveness of isometric exercises and stretching versus isometric exercises and stretching with ergonomic modifications for mechanical neck pain. MATERIAL AND METHODS: This is an RCT randomized control trial, single blind study which consists of 30 subjects (n=30) of age 20-45 years, with 15 subjects (n=15) in experimental group (isometric exercises and stretchings with ergonomic modifications were applied) and 15 subjects (n=15) in control group (isometric exercises and stretchings were applied).Duration of study was 6 months. Pre and post treatment assessment was done. Interventions were applied with moderate intensity 3 times a week (10rep/ 3 set per day) for 4 weeks (12 sessions) in both groups. Questionnaire, visual analogue scale (VAS) for pain intensity and neck disability index (NDI) for functional disability was used as data collection tools. Level of significance a= 5 % or 0.05, P value 0.05, Confidence interval0.95 and power 0.8. Sample size was calculated through epitool. RESULTS: Both VAS and NDI scores showed more improvement in experimental group (isometric neck exercises and stretching with ergonomic modifications) as compared to control group (isometric neck exercises and stretching). One way ANOVA was used for between group analysis and paired t-test was used for within group analysis. As P-value < 0.05 so we rejected null hypothesis, there is a significant difference between groups. CONCLUSION: This study concluded that ergonomic modifications with isometric exercises and stretching result in improvement of posture, reduce muscle stress, increase muscle balance, increase range of motion as compared to isometric exercises and stretching. Isometric exercises and stretchings cause removal of waste product from neck muscles by improving blood circulation that reduce muscle stiffness and spasm which causes pain relief and improves range of motion and ergonomic modifications improve posture alignment of body that reduce stress, increase muscular balance and reduce muscle spasm. KEYWORDS: Ergonomic modifications, Isometric exercises, mechanical neck pain, stretching.

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