Impact Of Progressive Pressure Technique Versus Traditional Physical Therapy In Treatment Of Patients With Lower Back Myofascial Pain Syndrome: A Randomized Clinical Trial

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Ahmed Mohamed Fathi Elshiwi , Amr Moustafa Yehia Mohammed , Abdulrahman Mohammed Abdullah Al-Amri , Reham Awad Al-Wadei and Ghada Mohamed Rashad Koura


Background: Is a major health problem in modern society. Myofascial pain syndrome is a condition characterized by muscles shortening with increased tone and associated with trigger points that aggravated with activity of daily living. Objective of the study: To assess the effect of progressive pressure technique versus traditional physical therapy in treatment of patients with lower back myofascial pain syndrome. Subjects and Methods: Thirty patients their age ranged from 18 - 43 years participated in our study and divided randomly into two equal groups suffering from myofascial low back pain. The first group (A) consist of 15 patients receiving progressive pressure technique over trigger points of back muscles followed by stretching exercise, the second group (B) consist of 15 patients receiving traditional physical therapy program (Infrared radiation, ultrasonic, stretching and strengthening exercises for back muscles). The following parameters including pain severity, functional disability and lumbar range of motion (flexion, extension, right side bending and left side bending) were measured before and after treatment. Results: The Statistical Package for Social Science (SPSS) software version 23 for Windows was used for all statistical analyses. Covariance homogeneity and data normality are tested using the Box's test and the Shapiro-Wilk test, respectively. 2x 2 mixed design MANOVA was used to compare the tested variables of interest in different test groups and measurement times. The alpha level was set at 0.05. Regarding within group's comparison, it revealed that there was significant increase (p <0.05) in Range of flexion and extension and significant reduction (p<0.05) in pain severity, right and left side bending and functional disability at both groups post- treatment. Regarding between subject effects multiple pairwise comparisons revealed that there was significant difference between both groups pre- treatment and post- treatment in pain severity, functional disability, and back  range of motion (p<0.05) at post- treatment in favor to group A compared to group B. Conclusion: On the basis of the present date, it is possible to conclude that both progressive pressure technique and traditional physical therapy were effective in reducing pain severity and functional disability and improve range of motion in treatment of patients with lower back myofascial pain syndrome. However, progressive pressure technique is more effective than traditional physical therapy in treatment of patients with lower back myofascial pain.                                                                                                                            

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