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Effect of integrated neuromuscular inhibition technique on trigger points in patients with nonspecific low back pain: randomized controlled trial
Metgud S, Monteiro S, Heggannavar A, d' Silva P
Indian Journal of Physical Therapy and Research 2020 Jul-Dec;2(2):99-105
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND AND OBJECTIVE: Trigger points in the myofascial system form the major reason for pain and tenderness in nonspecific low back pain (NSLBP). These points can be treated using manual therapy techniques such as integrated neuromuscular inhibition technique (INIT). Due to lack in the literature about its effect in NSLBP condition, the present study was undertaken to evaluate the effects of INIT on trigger points in patients with NSLBP. MATERIALS AND METHODS: Forty-four patients with NSLBP were randomly assigned to either of the two study groups using envelope method. Group A (n = 22) was treated with stretching and strengthening exercises, whereas group B (n = 22) was treated with INIT. Both the groups received hot moist pack and therapeutic ultrasound as common treatment. Five consecutive sessions of intervention were given over 5 days. Outcome measures in terms of pain pressure threshold (quadratus lumborum (QL) and erector spinae (ES)), lumbar range of motion (ROM), and disability were measured at baseline and end of the fifth session of treatment. RESULTS: The within-group analysis showed a reduction in pain, improved ROM, and disability in both the study groups (p < 0.001). However, the between-group analysis reported that INIT was more effective than the control group in terms of reducing trigger point tenderness of QL (p = 0.0011) and ES (p = 0.0001) as well as reducing functional disability (p = 0.0481) but not the ROM (p > 0.05). CONCLUSION: The present study concluded that INIT is superior to stretching and strengthening exercises in reducing trigger point tenderness and better functionality in patients with nonspecific low back pain.

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