An interventional study of Deep Transverse Friction Massage (DTFM) and Instrument-Assisted Soft Tissue Mobilization (IASTM) in Trapezius Myalgia, sponsored by Ibadat International University, Islamabad. Recruiting at 1 site in Pakistan. Open to participants aged 18 Years to 45 Years. Per ClinicalTrials.gov, last updated 2026-09-15.
Sponsored by Ibadat International University, Islamabad · Not applicable, Interventional, and Treatment
This randomized controlled trial compares the effectiveness of Instrument-Assisted Soft Tissue Mobilization (IASTM) and Deep Transverse Friction Massage (DTFM) in patients with trapezius myalgia. A total of 42 participants aged 18-45 years will be randomly assigned to either intervention group. Both groups will also receive conventional physiotherapy consisting of TENS, hot packs, range-of-motion exercises, and stretching. Treatment will be provided four sessions per week for four weeks. Outcomes include pain intensity, cervical range of motion, muscle strength, and functional disability.
Trapezius myalgia is a common musculoskeletal disorder characterized by pain, muscle tightness, stiffness, fatigue, and reduced cervical movement. It commonly develops due to poor posture, prolonged desk work, repetitive upper-limb activities, and occupational stress. These symptoms reduce functional ability and quality of life.
Although both Instrument-Assisted Soft Tissue Mobilization (IASTM) and Deep Transverse Friction Massage (DTFM) are widely used in physiotherapy, evidence comparing their effectiveness is limited. Therefore, this study aims to determine which intervention provides greater improvements in pain, cervical range of motion, muscle strength, and functional disability.
The study will be conducted as a randomized controlled trial at the Department of Physical Therapy, Ibadat International University Islamabad. Forty-two participants will be recruited using a sample size calculated through OpenEpi. Eligible participants will be randomly allocated into two intervention groups.
Both groups will receive conventional physiotherapy consisting of Transcutaneous Electrical Nerve Stimulation (TENS), hot pack application, active range-of-motion exercises, and stretching exercises. Treatment will be administered four sessions per week for four weeks (16 sessions).
The DTFM group will receive manual deep transverse friction massage over the upper trapezius muscle to reduce pain, release adhesions, and improve tissue mobility. The IASTM group will receive soft tissue mobilization using stainless-steel instruments to improve circulation, release fascial restrictions, and promote tissue healing.
Outcome measures will include the Numeric Pain Rating Scale (NPRS), Bubble Inclinometer for cervical range of motion, Hand-Held Dynamometer for muscle strength, and Neck Disability Index (NDI). Data will be analyzed using SPSS version 25 with appropriate parametric or non-parametric statistical tests. Statistical significance will be set at p ≤ 0.05.
The findings will contribute to evidence-based physiotherapy practice by identifying the more effective manual therapy technique for treating trapezius myalgia.
Tenderness over the upper trapezius muscle. NPRS pain score greater than 4. Cervical flexion less than 60° and extension less than 50°. Able to understand the study procedures and provide written informed consent.
Exclusion Criteria:
Open wounds, skin infections, or dermatological conditions over the treatment area.
Cervical spine or upper limb surgery within the previous 12 months. Cervical radiculopathy, cervical spondylosis, herniated disc, or whiplash injury.
Participants will receive Deep Transverse Friction Massage over the upper trapezius muscle along with conventional physiotherapy, including TENS, hot packs, stretching, and active range-of-motion exercises. The intervention aims to reduce pain, improve tissue mobility, increase cervical range of motion, enhance muscle strength, and improve functional ability
Other: Deep Transverse Friction Massage (DTFM)
Participants will receive Instrument-Assisted Soft Tissue Mobilization using stainless-steel instruments together with the same conventional physiotherapy protocol. The intervention aims to reduce soft tissue restrictions, improve circulation, decrease pain, enhance cervical mobility, increase muscle strength, and improve functional outcomes.
Other: Instrument-Assisted Soft Tissue Mobilization (IASTM)
Participants will receive Deep Transverse Friction Massage over the upper trapezius muscle along with conventional physiotherapy, including TENS, hot packs, stretching, and active range-of-motion exercises. The intervention aims to reduce pain, improve tissue mobility, increase cervical range of motion, enhance muscle strength, and improve functional ability.
Participants will receive Instrument-Assisted Soft Tissue Mobilization using stainless-steel instruments together with the same conventional physiotherapy protocol. The intervention aims to reduce soft tissue restrictions, improve circulation, decrease pain, enhance cervical mobility, increase muscle strength, and improve functional outcomes
Bubble Inclinometer
Cervical range of motion measured using a Bubble Inclinometer.
Time frame: Baseline and after four weeks of treatment.
Numeric Pain Rating Scale (NPRS).
Pain intensity measured using the Numeric Pain Rating Scale (NPRS).
Time frame: Baseline and after four weeks of treatment.
Neck Disability Index (NDI).
Functional disability assessed using the Neck Disability Index (NDI).
Time frame: Baseline and after four weeks of treatment
Hand-Held Dynamometer.
Muscle strength measured using a Hand-Held Dynamometer.
Time frame: Baseline and after four weeks of treatment.
Plan to share: No
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Ibadat International University, Islamabad