Effect of Instrument-Assisted Soft Tissue Mobilization Combined With Lidocaine Phonophoresis on Tension-Type Headache: A Randomized Clinical Trial

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics Pub Date : 2025-07-01 Epub Date: 2025-11-09 DOI:10.1016/j.jmpt.2025.09.010

Nada G. Saad Mohamed BSC , Abeer A. Yamany PhD , Amr A. Azzam MD , Mariam O. Grase PhD

{"title":"Effect of Instrument-Assisted Soft Tissue Mobilization Combined With Lidocaine Phonophoresis on Tension-Type Headache: A Randomized Clinical Trial","authors":"Nada G. Saad Mohamed BSC , Abeer A. Yamany PhD , Amr A. Azzam MD , Mariam O. Grase PhD","doi":"10.1016/j.jmpt.2025.09.010","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to investigate the effects of instrument-assisted soft tissue mobilization (IASTM) and lidocaine phonophoresis combined or separated on trigger points in patients with tension-type headache (TTH).</div></div><div><h3>Methods</h3><div>A double-blind randomized trial. A total of 60 participants with TTH were randomized into 4 equal groups. All groups received conventional treatment at the National Institute of Neuromotor System. Group A received conventional treatment only; group B received IASTM; group C received lidocaine phonophoresis; and group D received IASTM and phonophoresis. Visual analog scale (VAS), Arabic neck disability index (ANDI), headache frequency, and pressure pain threshold (PPT) were among the outcome measurements. All variables were measured before treatment and 4 weeks post-treatment.</div></div><div><h3>Results</h3><div>Within the group's analysis, multiple pairwise comparison tests revealed improvements at all measurement variables (<em>P</em> < .01) in all groups. Post-treatment, results showed a significant difference in groups D versus group A, groups B, and C with mean difference (MD) and 95% CI in VAS [3.18 (2.379-3.981), 1.133 (0.332-1.935), and 1.907 (1.105-2.708) respectively], ANDI [10.267 (8.382-12.151), 4.2 (2.316-6.084) 7 (5.116-8.884) respectively], headache frequency [1.9 (1.246-2.554), 0.8 (0.146-1.454), and 1.4 (0.764-2.054) respectively], and PPT. Additionally, there was a significant difference in all variables between group A and group B with MD in VAS, ANID, and headache frequency (2.047, 6.067, and 1.1 respectively) in favor of group B. Moreover, there was a statistically significant difference between group A and group C in VAS, ANDI, and PPT of left the suboccipital muscles on the side of group C. In group B versus group C, there was a statistically significant difference in ANDI and PPT of the left upper fibers of the trapezius muscles as <em>P</em> < .05 in favor of group B.</div></div><div><h3>Conclusion</h3><div>Both conventional treatments, IASTM, lidocaine phonophoresis, and the combination of IASTM and phonophoresis had statistically significant effects in relieving pain, increasing neck functional ability, decreasing headache frequency, and improving PPT in participants with TTP. Adding IASTM and lidocaine phonophoresis to conventional treatment was more effective than the other treatments.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 643-655"},"PeriodicalIF":1.4000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Manipulative and Physiological Therapeutics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0161475425000223","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/11/9 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

The purpose of this study was to investigate the effects of instrument-assisted soft tissue mobilization (IASTM) and lidocaine phonophoresis combined or separated on trigger points in patients with tension-type headache (TTH).

Methods

A double-blind randomized trial. A total of 60 participants with TTH were randomized into 4 equal groups. All groups received conventional treatment at the National Institute of Neuromotor System. Group A received conventional treatment only; group B received IASTM; group C received lidocaine phonophoresis; and group D received IASTM and phonophoresis. Visual analog scale (VAS), Arabic neck disability index (ANDI), headache frequency, and pressure pain threshold (PPT) were among the outcome measurements. All variables were measured before treatment and 4 weeks post-treatment.

Results

Within the group's analysis, multiple pairwise comparison tests revealed improvements at all measurement variables (P < .01) in all groups. Post-treatment, results showed a significant difference in groups D versus group A, groups B, and C with mean difference (MD) and 95% CI in VAS [3.18 (2.379-3.981), 1.133 (0.332-1.935), and 1.907 (1.105-2.708) respectively], ANDI [10.267 (8.382-12.151), 4.2 (2.316-6.084) 7 (5.116-8.884) respectively], headache frequency [1.9 (1.246-2.554), 0.8 (0.146-1.454), and 1.4 (0.764-2.054) respectively], and PPT. Additionally, there was a significant difference in all variables between group A and group B with MD in VAS, ANID, and headache frequency (2.047, 6.067, and 1.1 respectively) in favor of group B. Moreover, there was a statistically significant difference between group A and group C in VAS, ANDI, and PPT of left the suboccipital muscles on the side of group C. In group B versus group C, there was a statistically significant difference in ANDI and PPT of the left upper fibers of the trapezius muscles as P < .05 in favor of group B.

Conclusion

Both conventional treatments, IASTM, lidocaine phonophoresis, and the combination of IASTM and phonophoresis had statistically significant effects in relieving pain, increasing neck functional ability, decreasing headache frequency, and improving PPT in participants with TTP. Adding IASTM and lidocaine phonophoresis to conventional treatment was more effective than the other treatments.

查看原文本刊更多论文

器械辅助软组织动员联合利多卡因音游治疗紧张性头痛的随机临床试验

目的：探讨器械辅助软组织动员（IASTM）和利多卡因联合或分离对紧张性头痛（TTH）患者触发点的影响。方法：双盲随机试验。将60例TTH患者随机分为4组。所有组在国家神经运动系统研究所接受常规治疗。A组仅给予常规治疗；B组采用IASTM；C组接受利多卡因语音电泳；D组接受IASTM和语音电泳。结果测量包括视觉模拟量表（VAS）、阿拉伯颈残疾指数（ANDI）、头痛频率和压痛阈值（PPT）。在治疗前和治疗后4周测量所有变量。结果：在组的分析中，多个两两比较检验显示所有组的所有测量变量均有改善（P < 0.01）。治疗后，结果显示D组与a、B、C组比较，VAS的平均差异（MD）和95% CI分别为3.18（2.379-3.981）、1.133（0.332-1.935）和1.907 (1.105-2.708),ANDI[10.267（8.382-12.151）、4.2(2.316-6.084)7(5.116-8.884)]，头痛频率[1.9（1.246-2.554）、0.8（0.146-1.454）、1.4 (0.764-2.054)]，PPT均有显著差异。此外，a组与B组在VAS、ANID、头痛频次上的MD（分别为2.047、6.067、1.1）均有显著差异，B组优势明显。a组与C组在左侧枕下肌VAS、ANDI、PPT上的差异有统计学意义。b组斜方肌左上纤维的ANDI和PPT差异有统计学意义，P < 0.05。结论：常规治疗、IASTM联合利多卡因音游、IASTM联合音游对TTP患者疼痛缓解、颈部功能能力增强、头痛频率降低、PPT改善均有统计学意义。在常规治疗基础上加用IASTM和利多卡因吸音效果较好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Manipulative and Physiological Therapeutics 医学-康复医学

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

29 weeks

期刊介绍： The Journal of Manipulative and Physiological Therapeutics (JMPT) is an international and interdisciplinary journal dedicated to the advancement of conservative health care principles and practices. The JMPT is the premier biomedical publication in the chiropractic profession and publishes peer reviewed, research articles and the Journal''s editorial board includes leading researchers from around the world. The Journal publishes original primary research and review articles of the highest quality in relevant topic areas. The JMPT addresses practitioners and researchers needs by adding to their clinical and basic science knowledge and by informing them about relevant issues that influence health care practices.