A pragmatic clinical investigation of the comparative effectiveness of ischaemic compression and cryo-ischaemic compression in the treatment of rhomboid myofascial pain syndrome

Abstract

The purpose of this study was to determine the comparative effectiveness of cryo-ischaemic compression, using the Cold Tennis-ball Technique, and ischaemic compression, using normal tennis balls, in the treatment of Myofascial Pain Syndrome The study was a randomised, controlled, comparative clinical trial. The samlpe population comprised of sixty patients between the ages of 18-35 years. Patients were screened according to the inclusion and exclusion criteria, were selected and randomly divided into two groups. One group, of thirty patients, received ischaemic compression using normal tennis balls, whilst the second group, of thirty patients, received ischaemic compression using the Cold Tennis-ball Technique. Patients received four treatments over a period of two weeks. Data was obtained from each patient prior to and immediately after each treatment. Objective data was obtained from pressure threshold algometry and the Myofascial Diagnostic Scale. Subjective data was obtained from the Numerical Pain Rating Scale (NRS) and patients were required to give a sensory description of their pain at two-minute intervals during the course of the treatment. Statistical analysis of the data was performed using the SPSS version 11.5 and Stata version 9.0 software. Treatment effects for quantitative outcomes were analysed using repeated measures ANOVA. Profile plots were examined in order to assess in which direction the significance lay. Ordinal outcomes were examined for a treatment effect using ordinal logistic regression modelling. These models also examined a time by group interaction. Nonparametric Spearman’s correlation coefficients were used to examine intra-group relationships.