Myofascial Pain SyndromeINIT ARTNCT07395154
Comparison of Integrated Neuromuscular Inhibition Technique (INIT) and Active Release Technique (ART) in Patients With Upper Trapezius Trigger Points
A study testing Group A and Group B in people with Myofascial Pain Syndrome, run by Lahore University of Biological and Applied Sciences at 1 site in Pakistan.
Trial summary
The goal of this clinical trial is to determine whether two manual therapy techniques-Integrated Neuromuscular Inhibition Technique (INIT) and Active Release Technique (ART)-can reduce pain, improve neck range of motion, and decrease functional disability in adults with upper trapezius myofascial trigger points. Read more about this study
- Who is it for?
- Ages 20 to 40 years
- Conditions the study is for
- Myofascial Pain Syndrome
- What is being tested?
- Group A and Group B
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 64 participants
- Where
- 1 sitePakistan
- Study dates
- 15 Feb 2026to 30 Jun 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Presence of active trigger points in the upper trapezius muscle.
- Forward Head Posture (measured by craniovertebral angle).
- Pain duration less than 3 months.
Who cannot join
- History of trauma or surgery involving the cervical spine or shoulder
- Neurological disorders (e.g., cervical radiculopathy)
- Systemic conditions like diabetes or rheumatoid arthritis
- Use of corticosteroids
- Fibromyalgia, Thoracic Outlet Syndrome, Temporomandibular Joint Disorders
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
Lahore University of Biological and Applied Sciences
Lahore, Punjab Province, 54000
About this study
Official title: COMPARATIVE EFFECT OF INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUE AND ACTIVE RELEASE TECHNIQUE ON PAIN, RANGE OF MOTION AND FUNCTIONAL DISABILITY IN PATIENTS WITH UPPER TRAPEZIUS TRIGGER POINTS
The goal of this clinical trial is to determine whether two manual therapy techniques-Integrated Neuromuscular Inhibition Technique (INIT) and Active Release Technique (ART)-can reduce pain, improve neck range of motion, and decrease functional disability in adults with upper trapezius myofascial trigger points.
The main questions it aims to answer are:
Read more
Does INIT reduce pain, improve ROM, and reduce functional disability more effectively than ART?
Does ART provide similar or different treatment benefits compared to INIT?
Researchers will compare INIT with ART to see which technique produces greater improvements in pain, ROM, and functional disability.
Participants will:
Receive treatment sessions of either INIT or ART.
Undergo assessment of pain, cervical range of motion, and functional disability before and after the intervention.
Read the detailed description
Myofascial trigger points in the upper trapezius are a common cause of neck pain, restricted cervical mobility, and functional limitations. Manual therapy techniques are frequently used to deactivate trigger points and improve muscle function, but evidence comparing specific techniques remains limited.
This study investigates two commonly used interventions: the Integrated Neuromuscular Inhibition Technique (INIT), which combines sustained pressure, muscle energy technique, and stretching; and the Active Release Technique (ART), which involves movement-based soft tissue release. Both techniques target trigger point sensitivity and muscle tightness but use different mechanisms.
Participants with diagnosed upper trapezius trigger points will be randomly assigned to receive either INIT or ART. Each group will follow a structured treatment protocol over a defined period. Pain intensity, cervical range of motion, and functional disability will be measured at baseline and after the intervention using validated outcome tools.
The study aims to provide comparative evidence on which technique offers greater clinical effectiveness for reducing pain, improving cervical mobility, and enhancing function in individuals with upper trapezius trigger points. Results may assist clinicians in selecting more effective manual therapy strategies for managing myofascial pain.
- Conditions
- Myofascial Pain Syndrome
- Being tested
- Group A, Group B
- Keywords
- Integrated Neuromuscular Inhibition Technique, Active Release Technique, Muscle Energy Technique, Ischemic Compression
- Medical subject headings
- Myofascial Pain Syndromes
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Group AOther
Also called Integrated Neuromuscular Inhibition Technique
Participants will receive treatment three times per week for 6 weeks. Each session will begin with a moist hot pack for 10 minutes followed by TENS for 15 minutes to relax the muscles and reduce pain. After this preparation, participants will receive 15 minutes of Integrated Neuromuscular Inhibition Technique, including ischemic compression, strain-counterstrain, and muscle energy technique, applied to the identified myofascial trigger points.
Group BOther
Also called Active Release Technique
Participants will receive treatment three times per week for 6 weeks. Each session will begin with a moist hot pack for 10 minutes and TENS for 15 minutes to prepare the tissues. This will be followed by 15 minutes of Active Release Technique, including repeated active passes, targeted fiber release, and mild stretching, applied to the upper trapezius myofascial trigger points.
| Study group | Role | What they receive |
|---|---|---|
| Group A | Experimental | Integrated Neuromuscular Inhibition Technique Receives: Other: Group A |
| Group B | Experimental | Active Release Technique Receives: Other: Group B |
What is being measured
The primary outcome is the main question the study is designed to answer.
Goniometer (Range of Motion)
The Universal Goniometer (UG) will be used to assess Active Cervical Range of Motion (ACROM) in multiple planes. This reliable tool allows physical therapists to measure joint angles accurately, both with and without assistance. In this study, it will be employed to evaluate cervical spine movement as an objective outcome measure of participants' range of motion.
Measured: Assessment at baseline, after 3rd and 6th weeks.
Numeric Pain Rating Scale (NPRS)
The NPRS questionnaire is composed of an 11-point scale from 0 to 10. The patient chooses the most compatible value for the force of pain they have experienced in the last 24 h, with "0" meaning no pain and "10" meaning intense pain. The patient has to mark the score on the questionnaire according to the pain intensity he/she is experiencing.
Measured: Assessment at baseline, after 3rd and 6th weeks.
Neck Disability Index (NDI)
The Neck Disability Index (NDI) is a ten-item questionnaire that assesses disability associated with neck pain and whiplash. There are four items that relate to subjective symptomatology (pain intensity, headache, concentration, and sleeping) and six items that relate to activities of daily living (lifting, work, driving, recreation, personal care, and reading). The questionnaire requires only 5-10 minutes to complete and score, and requires no special training to administer.
Measured: Assessment at baseline, after 3rd and 6th weeks.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Feb 2026
- Study start15 Feb 2026
- Primary completion30 Jun 2026
- Study completion30 Jun 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Myofascial Pain SyndromeStudies of the same condition, open and under way.
- More trials run by Lahore University of Biological and Applied SciencesThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 64 participants (actual)
Sponsor and investigators
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07395154
- Sponsor's protocol ID
- UBAS/ERB/FoRS/25/023
- Acronym
- INIT ART
- Status last verified
- Sep 2026
- First submitted
- 1 Dec 2025
- Last updated
- 3 Sep 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Sadria G, Hosseini M, Rezasoltani A, Akbarzadeh Bagheban A, Davari A, Seifolahi A. A comparison of the effect of the active release and muscle energy techniques on the latent trigger points of the upper trapezius. J Bodyw Mov Ther. 2017 Oct;21(4):920-925. doi: 10.1016/j.jbmt.2016.10.005. Epub 2016 Oct 21.
PubMed 29037649Nayak PP. A Study to Find Out the Efficacy of Init (Integrated Neuromuscular Inhibition Technique) with Therapeutic Ultrasound Vs Init with Placebo Ultrasound in the Treatment of Acute Myofascial Trigger Point in Upper Trapezius: Rajiv Gandhi University of Health Sciences (India); 2013.
Study at a glance
From the registry record, last updated by the sponsor on 3 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- COMPARATIVE EFFECT OF INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUE AND ACTIVE RELEASE TECHNIQUE ON PAIN, RANGE OF MOTION AND FUNCTIONAL DISABILITY IN PATIENTS WITH UPPER TRAPEZIUS TRIGGER POINTS
- ClinicalTrials.gov ID
- NCT07395154
- Acronym / sponsor ID
- INIT ART / UBAS/ERB/FoRS/25/023
- Conditions
- Myofascial Pain Syndrome
- Keywords
- Integrated Neuromuscular Inhibition Technique, Active Release Technique, Muscle Energy Technique, Ischemic Compression
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 64 participants (actual)
- Lead sponsor
- Lahore University of Biological and Applied SciencesUniversity, hospital or other
- Study start
- 15 Feb 2026 (actual)
- Primary completion
- 30 Jun 2026 (actual)
- Study completion
- 30 Jun 2026 (actual)
- First posted
- 9 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to determine whether two manual therapy techniques-Integrated Neuromuscular Inhibition Technique (INIT) and Active Release Technique (ART)-can reduce pain, improve neck range of motion, and decrease functional disability in adults with upper trapezius myofascial trigger points.
The main questions it aims to answer are:
Does INIT reduce pain, improve ROM, and reduce functional disability more effectively than ART?
Does ART provide similar or different treatment benefits compared to INIT?
Researchers will compare INIT with ART to see which technique produces greater improvements in pain, ROM, and functional disability.
Participants will:
Receive treatment sessions of either INIT or ART.
Undergo assessment of pain, cervical range of motion, and functional disability before and after the intervention.
Detailed description
Myofascial trigger points in the upper trapezius are a common cause of neck pain, restricted cervical mobility, and functional limitations. Manual therapy techniques are frequently used to deactivate trigger points and improve muscle function, but evidence comparing specific techniques remains limited.
This study investigates two commonly used interventions: the Integrated Neuromuscular Inhibition Technique (INIT), which combines sustained pressure, muscle energy technique, and stretching; and the Active Release Technique (ART), which involves movement-based soft tissue release. Both techniques target trigger point sensitivity and muscle tightness but use different mechanisms.
Participants with diagnosed upper trapezius trigger points will be randomly assigned to receive either INIT or ART. Each group will follow a structured treatment protocol over a defined period. Pain intensity, cervical range of motion, and functional disability will be measured at baseline and after the intervention using validated outcome tools.
The study aims to provide comparative evidence on which technique offers greater clinical effectiveness for reducing pain, improving cervical mobility, and enhancing function in individuals with upper trapezius trigger points. Results may assist clinicians in selecting more effective manual therapy strategies for managing myofascial pain.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group A | Experimental | Other: Group AIntegrated Neuromuscular Inhibition Technique |
| Group B | Experimental | Other: Group BActive Release Technique |
Who may qualify
- Ages
- 20 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Presence of active trigger points in the upper trapezius muscle.
- Forward Head Posture (measured by craniovertebral angle).
- Pain duration less than 3 months.
Key exclusion criteria (5 listed)
- History of trauma or surgery involving the cervical spine or shoulder
- Neurological disorders (e.g., cervical radiculopathy)
- Systemic conditions like diabetes or rheumatoid arthritis
- Use of corticosteroids
- Fibromyalgia, Thoracic Outlet Syndrome, Temporomandibular Joint Disorders
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Group AAlso: Integrated Neuromuscular Inhibition TechniqueParticipants will receive treatment three times per week for 6 weeks. Each session will begin with a moist hot pack for 10 minutes followed by TENS for 15 minutes to relax the muscles and reduce pain. After this preparation, participants will receive 15 minutes of Integrated Neuromuscular Inhibition Technique, including ischemic compression, strain-counterstrain, and muscle energy technique, applied to the identified myofascial trigger points. | Other | Group A |
| Group BAlso: Active Release TechniqueParticipants will receive treatment three times per week for 6 weeks. Each session will begin with a moist hot pack for 10 minutes and TENS for 15 minutes to prepare the tissues. This will be followed by 15 minutes of Active Release Technique, including repeated active passes, targeted fiber release, and mild stretching, applied to the upper trapezius myofascial trigger points. | Other | Group B |
Primary outcome
Goniometer (Range of Motion)
Time frame: Assessment at baseline, after 3rd and 6th weeks.
The Universal Goniometer (UG) will be used to assess Active Cervical Range of Motion (ACROM) in multiple planes. This reliable tool allows physical therapists to measure joint angles accurately, both with and without assistance. In this study, it will be employed to evaluate cervical spine movement as an objective outcome measure of participants' range of motion.
Numeric Pain Rating Scale (NPRS)
Time frame: Assessment at baseline, after 3rd and 6th weeks.
The NPRS questionnaire is composed of an 11-point scale from 0 to 10. The patient chooses the most compatible value for the force of pain they have experienced in the last 24 h, with "0" meaning no pain and "10" meaning intense pain. The patient has to mark the score on the questionnaire according to the pain intensity he/she is experiencing.
Neck Disability Index (NDI)
Time frame: Assessment at baseline, after 3rd and 6th weeks.
The Neck Disability Index (NDI) is a ten-item questionnaire that assesses disability associated with neck pain and whiplash. There are four items that relate to subjective symptomatology (pain intensity, headache, concentration, and sleeping) and six items that relate to activities of daily living (lifting, work, driving, recreation, personal care, and reading). The questionnaire requires only 5-10 minutes to complete and score, and requires no special training to administer.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Sep 2026.
- Background: PubMed 29037649Sadria G, Hosseini M, Rezasoltani A, Akbarzadeh Bagheban A, Davari A, Seifolahi A. A comparison of the effect of the active release and muscle energy techniques on the latent trigger points of the upper trapezius. J Bodyw Mov Ther. 2017 Oct;21(4):920-925. doi: 10.1016/j.jbmt.2016.10.005. Epub 2016 Oct 21.
- BackgroundNayak PP. A Study to Find Out the Efficacy of Init (Integrated Neuromuscular Inhibition Technique) with Therapeutic Ultrasound Vs Init with Placebo Ultrasound in the Treatment of Acute Myofascial Trigger Point in Upper Trapezius: Rajiv Gandhi University of Health Sciences (India); 2013.
- Related InfoLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Group A and Group B in people with Myofascial Pain Syndrome, run by Lahore University of Biological and Applied Sciences at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 3 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Goniometer (Range of Motion) (time frame: Assessment at baseline, after 3rd and 6th weeks.). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07395154, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Sep 2026.