Hanten W, Olson S, Black B, Do S, Grisel J; Texas Woman’s University, Houston, Texas, USA. whanten@twu.edu.

PURPOSE: to determine the effectiveness of active head retraction with retraction/ extension exercises in a home program for the treatment of cervical and scapular trigger points (TPs). SUBJECTS: thirty-nine subjects (11 males, 28 females) between the ages of 19 and 60 years old ([GRAPHIC]=28.8, SD=9.9) with complaints of pain in the cervical and/or scapular regions, and who met the inclusion criteria of having at least one active TP, participated in this study. METHODS: in a double-blind study, subjects were randomly assigned to either Group 1 or 2, receiving a 5 day home exercise program. Treatment Group 1 received active head retraction with retraction/ extension exercises performed every other hour, where as control Group 2 received active neck range of motion exercises performed twice a day. The TP with the lowest pressure pain threshold (PPT) was found via physical examination and marked with a semi-permanent marker to last for the duration of the subjects’ participation in the study. Measurements were obtained previous to instruction of the treatment and on the third day after they stopped treatment. A pressure algometer was used to measure the PPT of the primary TP. Two visual analog scales (VASs) were marked to measure average pain affect (VASA) and average pain intensity (VASI) over the previous 24 hours. ANALYSES: pre-test and post-test means and standard deviations of the VASI, the VASA, and the PPT scores were calculated. In order to determine if there were significant differences (p<0.01) between the two groups on the post-test scores, three analyses of covariance (ANCOVAs) were performed, with the pre-test scores as the covariates. RESULTS: the analyses performed for VASI, VASA, and PPT revealed that there were no significant differences between the group means on any of the dependent variables. CONCLUSION: a home program of active head retraction with retraction/ extension was not found to be effective in relieving TP sensitivitiy, pain affect, or pain intensity. A study using subjects reporting higher levels of pain may be necessary to verify that head retraction with retraction/ extension exercises are not effective in the treatment of cervical and scapular TPs. FUNDING SOURCE: none.

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