An interventional study of Graston Technique and Local Ischemic Compression in Pseudo Angina, Myofascial Pain Syndromes and Pectoralis Muscles, sponsored by University of Faisalabad. Not yet recruiting at 1 site in Pakistan. Open to participants aged 25 Years to 50 Years. Per ClinicalTrials.gov, last updated 2026-07-27.
Sponsored by University of Faisalabad · Not applicable, Interventional, and Treatment
Pseudo-angina is a musculoskeletal condition characterized by chest pain that resembles angina but occurs due to non-cardiac causes, particularly myofascial trigger points in the chest wall muscles. Trigger points in the pectoralis major and minor muscles may contribute to pain, discomfort, and functional limitations by affecting muscle activity and movement. Manual therapy techniques such as the Graston Technique and Local Ischemic Compression (LIC) are commonly used to manage soft tissue dysfunction and myofascial trigger points. This study aims to compare the effects of the Graston Technique and Local Ischemic Compression on pain reduction and functional improvement in patients with pseudo-angina.
This is Multiple-center, randomized controlled trail. Participants age 25-50 years with diagnosed pseudo angina will be referred from cardiology department of Aziz Fatima and Faisal hospital to Madina Teaching hospital (MTH) Physiotherapy ward and Jafar Physiotherapy Clinic. After informed consent Participants will be randomly assign to one of two parallel groups using a random number generator. Group A (Experimental): Receive Graston technique 3 sessions per week for total duration 4 weeks. Group B (Active Comparator) receive the LIC 3 sessions per week for total duration 4 weeks. Outcome measures (pain via NPRS, Shoulder Pain and Disability Index (SPADI)) are taken at baseline and end of treatment. Data will be analyzed using Spss version 20.
339 studies on the registry are indexed under Myofascial Pain Syndromes; 66 are open to participants now.
This study's planned enrollment of 36 is below the median of 50 across 307 interventional studies indexed under Myofascial Pain Syndromes.
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Exclusion Criteria:
articipants assigned to this arm received the Graston Technique, an instrument-assisted soft tissue mobilization intervention, applied to the identified myofascial trigger points of the pectoralis major and pectoralis minor muscles. The intervention was performed after a gentle Z-stretch of the targeted muscles as baseline treatment. A stainless-steel Graston instrument was applied using controlled strokes at approximately a 45° angle to the skin surface, following the direction of the muscle fibers and across the fibers to mobilize soft tissue restrictions. The treatment was applied for approximately 40-120 seconds over each targeted area.
Other: Graston Technique
Participants assigned to this arm received LIC applied to the identified myofascial trigger points of the pectoralis major and pectoralis minor muscles. Following a gentle Z-stretch of the targeted muscles as baseline treatment, sustained manual pressure was applied gradually over each trigger point until a tolerable level of discomfort was achieved. The compression was maintained for approximately 90 seconds per trigger point and repeated 1-3 times during each treatment session according to patient tolerance and clinical response. The technique was performed using the therapist's thumb, finger, or knuckle depending on the location and depth of the trigger point. Participants received four physiotherapy sessions over a two-week period, with sessions conducted on alternate days.
Other: Local Ischemic Compression
A stainless-steel Graston instrument was applied using controlled strokes at approximately a 45° angle to the skin surface, following the direction of the muscle fibers and across the fibers to mobilize soft tissue restrictions. The treatment was applied for approximately 40-120 seconds over each targeted area.
Sustained manual pressure was applied gradually over each trigger point until a tolerable level of discomfort was achieved. The compression was maintained for approximately 90 seconds per trigger point and repeated 1-3 times during each treatment session according to patient tolerance and clinical response. The technique was performed using the therapist's thumb, finger, or knuckle depending on the location and depth of the trigger point
Shoulder Pain Disability Index
The Shoulder Pain and Disability Index is a well-known neutral measure for assessing the level of pain and functional impairment experienced by people with shoulder issues. It is frequently used in clinical and research settings to assess the severity of shoulder problems and track therapy efficacy. It consists of 13 elements organized into two subscales. The Pain Subscale consists of five items that determine how intense pain is in various circumstances, such as at rest or during activities. The disability subscale consists of eight items: it assesses the level of difficulty with specific everyday shoulder-related tasks, such as lifting weights or putting on a shir
Time frame: Baseline and 4 week post intervention
Numeric Pain Rating Scale
NPRS was used as a primary outcome measure to evaluate pain intensity in patients with pseudo-angina. On the scale, 0 represents no discomfort and 10 represents severe pain. At rest and while engaging in activities, participants were asked to rate their level of pain.
Time frame: Baseline and 4 week post intervention
Plan to share: No
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University of Faisalabad