The effect of adding Transfer Energy Capacitive and Resistive therapy (TECAR) to dry needling on pain, pressure pain threshold, functinal disability and neck range of motion (ROM) in people with active trigger points in upper trapezius muscle

To determine effects of adding tecar therapy to dry needling on pain intensity, pressure pain threshold, neck disability and active cervical range of motion in patients with active upper trapezius myofascial trigger points

This study is a randomized, assessor-blinded clinical trial with two groups (control and intervention groups) using a parallel-group design, conducted on 44 patients

Eligible participants attending the Rehabilitation Faculty Clinic of Shahid Beheshti University of Medical Sciences will be randomly allocated to either the intervention or control group. The interventions will be delivered by the principal investigator in four sessions over two weeks. Outcome assessment, data collection, and statistical analysis will be performed by an independent assessor.

Participants will be adults aged 20–50 years with active myofascial trigger points in the upper trapezius muscle who have experienced pain with an intensity greater than 3 for more than 30 days. Individuals with a fear of needles, a history of cardiovascular disease, or a history of cervical surgery will be excluded from participation.

In the control group, dry needling of the upper trapezius muscle is performed over 4 sessions (2 sessions per week). The intervention group receives, in addition to dry needling, 20 minutes of TECAR therapy (New Age, Italy), including 10 minutes of capacitive and 10 minutes of resistive therapy at an intensity of 20% to 50%. Pain intensity, cervical range of motion, pressure pain threshold, and functional disability are assessed at three time points: before the intervention, 48 hours after the last session, and 3 months after treatment.

Pain intensity, pressure pain threshold, functional disability, cervical active range of motion

Participants will be randomly allocated into two groups. Group 1 (control group) will receive dry needling alone, while group 2 (intervention group) will receive tecar therapy combined with dry needling. Randomization will be performed using the sealed opaque envelope method. Based on the total sample size of 44 participants, 44 opaque sealed envelopes will be prepared. Twenty-two envelopes will contain the allocation for Group 1 (dry needling) and the remaining twenty-two envelopes will contain the allocation for Group 2 (tecar therapy plus dry needling). After enrollment, each participant will be asked to randomly select one envelope, which will determine their treatment assignment.

The principal investigator is blinded to the participant selection and randomization process. However, the interventions for both the intervention and control groups are administered by the principal investigator. Participants are assessed at three time points: before the intervention, 48 hours after the final treatment session, and 4 weeks after the final treatment session (follow-up). All assessments are conducted by a physiotherapist who is blinded to the participants' group allocation. Thus, the outcome assessor remains blinded throughout the baseline, post-intervention, and follow-up assessments. Statistical analysis of the data will be performed after completion of data collection by the study's statistical consultant, who is also blinded to the participants' group allocation.

All de-identified participant data will be made available to other researchers. Additional study documents, including data analyses and the study protocol, will also be published.

Data access will begin in 2028.

Researchers affiliated with academic institutions and medical students

Other researchers, as well as healthcare professionals and rehabilitation therapists, will be able to use the data and findings for patient management and the development of future research projects.

For further information or access requests, researchers may contact the study team via email at Alishirani1380127@gmail.com or visit the Rehabilitation Faculty of Shahid Beheshti University of Medical Sciences.

For further information or access requests, researchers may contact the study team via email at Alishirani1380127@gmail.com or visit the Rehabilitation Faculty of Shahid Beheshti University of Medical Sciences.