Scapulocostal SyndromeNCT07403227

Comparative Effects of Muscle Energy Technique and Modified Active Release Technique in Scapulocostal Syndrome.

A study testing Muscle Energy Technique, Modified Active Release Technique and Conventional Physical Therapy in people with Scapulocostal Syndrome, run by Riphah International University at 1 site in Pakistan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record

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Trial summary

The study was conducted to determine the comparative effects of Muscle Energy Technique and Modified Active Release Technique on Pain, Chest expansion and Functional disability in patients with Scapulocostal Syndrome. Read more about this study

Who is it for?: Ages 18 to 40 years
Conditions the study is for: Scapulocostal Syndrome
What is being tested?: Muscle Energy Technique, Modified Active Release Technique and Conventional Physical Therapy
Could I receive a placebo?: No, everyone receives an active treatment
How many people: 46 participants
Where: 1 sitePakistan
Study dates: 10 Jan 2025to 30 Oct 2025
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 18 to 40 years
All sexes
No healthy volunteers
Adult

Who may be able to join

Age between 18-40 yrs.
Both male and females with shoulder-neck pain.
NPRS value> than 3.
Chest expansion value < than 3cm are included.
Subjects with Upper Trapezius, Levator Scapulae and Rhomboid muscles tenderness.
Pain duration should be present for at least for 3 months before inclusion in the study.
Presence of 1 to 3 trigger points in upper trapezius, levator scapulae, and rhombhoids (MTrP) causing referred pain pattern with palpable taut band of muscle.

Who cannot join

Thoracic outlet syndrome.
Brachial neuralgia.
Local neck and shoulder disorder.
Adhesive Capsulitis.
Cervical Radiculopathy.
Trauma or Injury around Scapular area.

Show all 9Show fewer

Past Surgical Area.
Any cardiovascular or Respiratory pathology.
People with psychiatric illness such as depression.

Trial locations and contacts

1 site in 1 country.

Pakistan1 site

AAHAD Hospital Sialkot.
Sialkot, Punjab Province, 51310

Other trials in Pakistan

About this study

Official title: Comparative Effects of Muscle Energy Technique and Modified Active Release Technique in Patients With Scapulocostal Syndrome.

Conditions: Scapulocostal Syndrome
Being tested: Muscle Energy Technique, Modified Active Release Technique, Conventional Physical Therapy
Keywords: Chronic Neck Pain, Muscle Energy Technique, Myofascial Release Therapy, Neck Ache, Neck Disability, Manual Therapy
Medical subject headings: Neck Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Muscle Energy TechniqueOther
Also called MET
Muscle Energy Technique (PIR) began by putting the muscles in stretched position. An isometric contraction was exerted against minimum resistance. Followed by Relaxation, then gentle stretch followed as the muscle releases. Tight, tender muscles commonly suffering with pain undergoes such techniques. All the contraction were hold for 10 seconds for each muscle i.e. 10 repetitions followed with 20 seconds rest time.
1. MET for upper Trapezius Muscle.
2. MET for Levator scapulae Muscle
3. MET for Rhomboid muscle
Modified Active Release TechniqueOther
Also called mART
Modified Active Release Technique combined the active movement by patients with the passive movements done by the therapist. During this, participants were instructed to hold every movement for 6seconds with 10 repetitions. Pin and stretch type of modified active release technique was used in the study.
1. Modified Active Release Technique for Upper trapezius:
2. Modified Active Release Technique for Levator Scapulae:
3. Modified Active Release Technique for Rhombhoids.
Conventional Physical TherapyOther
Also called Baseline Treatment
- Hot pack for 10 minutes.
- Transcutaneous electrical nerve stimulation (TENS) (frequency: 2Hz and pulse duration 200 μs, 10 minutes

Study groups in NCT07403227
Study group	Role	What they receive
Muscle Energy Technique	Experimental	Not described Receives: Other: Muscle Energy Technique; Other: Conventional Physical Therapy
Modified Active Release Technique	Active comparator	Not described Receives: Other: Modified Active Release Technique; Other: Conventional Physical Therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

Numeric Pain Rating Scale
Patient's pain level was accessed using NPRS. It is a tool used to check the severity of pain, on a scale of 0 to 10, 0 indicates no pain, 1-3 means mild pain,4to 6 indicates moderate pain, and 7 to 10 value shows severe pain. Patient rates their level of pain at that time and the less and severe pain level in previous 24 hours, Then the average is taken by using 3 values. Validity of NPRS is 0.86 and reliability 0.96.
Measured: From enrollment to the end of treament at 6 weeks.
Neck Disability Index.
Neck Disability index is a tool to check the neck complaints. Developed from Oswestry Index of neck pain and neck disability index. It is based on activites of daily life and provide a good functional value. This scale consists of 10 sections, each section contains 5 further questions of daily life activities affected, each section scored 0 to 5. The subject was asked to answer these questions. By dividing the total scores over number of questions answered and multiply by 100, the index was calculated. The validity and realibility of NDI is good
Measured: From enrollment to the end of treatment at 6 weeks
Measuring Inches Tape
Measuring Tape is used to measure Chest expansion. It is a reliable, non-invasive and simple method. Chest Expansion is measured by thoracic girth difference, after maximal inspiration, and at maximal expiration end point. There are several anatomical landmarks to measures upper and lower chest expansion. Anatomical landmarks are 4th intercostal space, axillary lines, and thoracic vertebrae (3rd ,5th .12th) and 10th thoracic vertebrae and xiphoid process. 4th Intercostal space and axillary lines were used to measure chest expansion in this study at both levels. The 2-instruction evaluated were, "breathe in maximally, breathe out maximally". And value were recorded at end of Maximal inhalation and maximal exhalation. A difference in these values were then calculated. An acceptable Reliability by ICC was determined. Value > 0.85 and SEMs < 5%.
Measured: From enrollment to the end of study at 6 weeks

Secondary outcomes (4)

ROM Cervical Spine (Flexion)
Changes in cervical spine flexion ROM at baseline and at 6th week of intervention was measured using Goniometer.
Measured: from enrollment to the end at 6th week of treatment.
ROM Cervical Spine (Extension)
Changes in cervical spine extension ROM at baseline and at 6th week of intervention was measured using Goniometer.
Measured: from enrollments to the end of treatment at 6 weeks.
ROM Cervical Spine (Left Lateral Flexion).
Changes in cervical spine left lateral flexion ROM at baseline and at 6th week of intervention was measured using Goniometer.
Measured: From Enrollment to the end of treatment at 6 weeks
ROM Cervical Spine (Right Lateral Flexion)
Changes in cervical spine right lateral flexion flexion ROM at baseline and at 6th week of intervention was measured using Goniometer.
Measured: From enrollment to the end of treatment at 6 weeks.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

10 Jan 202530 Oct 2025

First posted11 Feb 2026
Study start10 Jan 2025
Primary completion28 Jul 2025
Study completion30 Oct 2025

Resources

Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
Publications (14)Papers the sponsor has linked to this study.
Other trials for Scapulocostal SyndromeStudies of the same condition, open and under way.
More trials run by Riphah International UniversityThe 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: 46 participants (actual)

IDs, dates and publications

ClinicalTrials.gov ID: NCT07403227
Sponsor's protocol ID: REC/RCR & AHS/24/01105
Status last verified: Feb 2026
First submitted: 4 Feb 2026
Last updated: 11 Feb 2026
Results posted: No
Data monitoring committee: No
FDA-regulated drug: No
FDA-regulated device: No
Individual data sharing: No

Publications

Chatchawan U. Comparative study of the immediate therapeutic effects between modified active release technique and traditional Thai massage on pain alteration in patient with scapulocostal syndrome. DOAJ (DOAJ: Directory of Open Access Journals). 2017.
Ali S, Ahmad S, Jalal Y, Shah B. Effectiveness of Stretching Exercises Versus Muscle Energy Techniques in the Management of Upper Cross Syndrome: JRCRS. 2017; 5 (1): 12-16. Journal Riphah College of Rehabilitation Sciences. 2017;5(1):12-6.
Mishra D, Prakash RH, Mehta J, Dhaduk A. Comparative study of active release technique and myofascial release technique in treatment of patients with upper trapezius spasm. Journal of Clinical and Diagnostic Research. 2018;12(11):17-20.
Ganesh B, Patil P, Rodrigues A. Effect of Muscle Energy Technique on Strength and Range of Motion in Young Swimmers with Sick Scapula Syndrome: A Pre-Post Clinical Trial. Indian Journal of Physiotherapy & Occupational Therapy Print-(ISSN 0973-5666) and Electronic-(ISSN 0973-5674). 2020;14(2):45-9.
Allison GT, Nagy BM, Hall T. A randomized clinical trial of manual therapy for cervico-brachial pain syndrome -- a pilot study. Man Ther. 2002 May;7(2):95-102. doi: 10.1054/math.2002.0453.
PubMed 12151246
Risalda P, Phansopkar P, Naqvi WM. Effectiveness of active release technique verses conventional physiotherapy in management of upper cross syndrome. Indian Journal of Forensic Medicine & Toxicology. 2021;15(1):246-50.
Seo J, Song C, Shin D. A Single-Center Study Comparing the Effects of Thoracic Spine Manipulation vs Mobility Exercises in 26 Office Workers with Chronic Neck Pain: A Randomized Controlled Clinical Study. Med Sci Monit. 2022 Jul 8;28:e937316. doi: 10.12659/MSM.937316.
PubMed 35799408
Abbas AH, Javaid M, Ali A, Ali Z, Mehmood S, Manzoor S. Comparative Efficacy of Muscle Energy Technique and Myofascial Release Technique in Reducing Pain in Upper Cross Syndrome: A Randomised Clinical Trial. The Healer Journal of Physiotherapy and Rehabilitation Sciences. 2025;5(2):228-34.
Mohan V, Dzulkifli NH, Justine M, Haron R, Rathinam C. Intrarater reliability of chest expansion using cloth tape measure technique. Bangladesh journal of medical science. 2012;11(4):307-11.
Narulkar R, Welling A, Gurudut P, Kage V. Comparing the efficacy of 3-dimensional release technique and modified active release therapy on pain, scapular position and Craniovertebral angle in IT workers with scapulocostal syndrome: A Randomised Clinical Trial. J Bodyw Mov Ther. 2025 Oct;44:80-90. doi: 10.1016/j.jbmt.2025.05.033. Epub 2025 May 23.
PubMed 40954664
Kanhachon W, Boonprakob Y. Modified-Active Release Therapy in Patients with Scapulocostal Syndrome and Masticatory Myofascial Pain: A Stratified-Randomized Controlled Trial. Int J Environ Res Public Health. 2021 Aug 12;18(16):8533. doi: 10.3390/ijerph18168533.
PubMed 34444281
Zahid A, Gull S, Athar M, Khan IU, Maqbool S, Zahid H. Comparative Effectiveness of Scapular Stabilization Exercises with and Without Deep Breathing on Pain and Chest Expansion in Patients with Scapulocostal Syndrome: Scapular Stabilization with Deep Breathing in SCS. Journal of Health and Rehabilitation Research. 2024;4(3).
Deka D, Yaduvanshi P, Mozhi A. EFFECT OF MUSCLE ENERGY TECHNIQUE AND MYOFASCIAL RELEASE IN SCAPULOCOSTAL SYNDROME IN COLLEGIATE YOUNG ADULTS.
Buttagat V, Taepa N, Suwannived N, Rattanachan N. Effects of scapular stabilization exercise on pain related parameters in patients with scapulocostal syndrome: A randomized controlled trial. J Bodyw Mov Ther. 2016 Jan;20(1):115-122. doi: 10.1016/j.jbmt.2015.07.036. Epub 2015 Jul 26.
PubMed 26891646

Study at a glance

From the registry record, last updated by the sponsor on 11 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.

Official title: Comparative Effects of Muscle Energy Technique and Modified Active Release Technique in Patients With Scapulocostal Syndrome.
ClinicalTrials.gov ID: NCT07403227
Acronym / sponsor ID: REC/RCR & AHS/24/01105
Conditions: Scapulocostal Syndrome
Keywords: Chronic Neck Pain, Muscle Energy Technique, Myofascial Release Therapy, Neck Ache, Neck Disability, Manual Therapy
Study type: Interventional
Recruitment status: Completed
Enrolment: 46 participants (actual)
Lead sponsor: Riphah International UniversityUniversity, hospital or other
Study start: 10 Jan 2025 (actual)
Primary completion: 28 Jul 2025 (actual)
Study completion: 30 Oct 2025 (actual)
First posted: 11 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.

Study design

Primary purpose: Treatment
Allocation: Randomised
Intervention model: Parallel groups
Masking: Single blind (outcomes assessor)
Number of arms: 2

Arm	Type	Receives
Muscle Energy Technique	Experimental	Other: Muscle Energy Technique, Other: Conventional Physical Therapy
Modified Active Release Technique	Active comparator	Other: Modified Active Release Technique, Other: Conventional Physical Therapy

Who may qualify

Ages: 18 to 40 years
Sex: All
Healthy volunteers: Not accepted
Age groups: Adult

Key inclusion criteria (7 listed)

Age between 18-40 yrs.
Both male and females with shoulder-neck pain.
NPRS value> than 3.
Chest expansion value < than 3cm are included.
Subjects with Upper Trapezius, Levator Scapulae and Rhomboid muscles tenderness.

Key exclusion criteria (9 listed)

Thoracic outlet syndrome.
Brachial neuralgia.
Local neck and shoulder disorder.
Adhesive Capsulitis.
Cervical Radiculopathy.

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
Muscle Energy TechniqueAlso: METMuscle Energy Technique (PIR) began by putting the muscles in stretched position. An isometric contraction was exerted against minimum resistance. Followed by Relaxation, then gentle stretch followed as the muscle releases. Tight, tender muscles commonly suffering with pain undergoes such techniques. All the contraction were hold for 10 seconds for each muscle i.e. 10 repetitions followed with 20 seconds rest time. 1. MET for upper Trapezius Muscle. 2. MET for Levator scapulae Muscle 3. MET for Rhomboid muscle	Other	Muscle Energy Technique
Modified Active Release TechniqueAlso: mARTModified Active Release Technique combined the active movement by patients with the passive movements done by the therapist. During this, participants were instructed to hold every movement for 6seconds with 10 repetitions. Pin and stretch type of modified active release technique was used in the study. 1. Modified Active Release Technique for Upper trapezius: 2. Modified Active Release Technique for Levator Scapulae: 3. Modified Active Release Technique for Rhombhoids.	Other	Modified Active Release Technique
Conventional Physical TherapyAlso: Baseline Treatment* Hot pack for 10 minutes. * Transcutaneous electrical nerve stimulation (TENS) (frequency: 2Hz and pulse duration 200 μs, 10 minutes	Other	Modified Active Release Technique, Muscle Energy Technique

Primary outcome

Numeric Pain Rating Scale
Time frame: From enrollment to the end of treament at 6 weeks.
Patient's pain level was accessed using NPRS. It is a tool used to check the severity of pain, on a scale of 0 to 10, 0 indicates no pain, 1-3 means mild pain,4to 6 indicates moderate pain, and 7 to 10 value shows severe pain. Patient rates their level of pain at that time and the less and severe pain level in previous 24 hours, Then the average is taken by using 3 values. Validity of NPRS is 0.86 and reliability 0.96.
Neck Disability Index.
Time frame: From enrollment to the end of treatment at 6 weeks
Neck Disability index is a tool to check the neck complaints. Developed from Oswestry Index of neck pain and neck disability index. It is based on activites of daily life and provide a good functional value. This scale consists of 10 sections, each section contains 5 further questions of daily life activities affected, each section scored 0 to 5. The subject was asked to answer these questions. By dividing the total scores over number of questions answered and multiply by 100, the index was calculated. The validity and realibility of NDI is good
Measuring Inches Tape
Time frame: From enrollment to the end of study at 6 weeks
Measuring Tape is used to measure Chest expansion. It is a reliable, non-invasive and simple method. Chest Expansion is measured by thoracic girth difference, after maximal inspiration, and at maximal expiration end point. There are several anatomical landmarks to measures upper and lower chest expansion. Anatomical landmarks are 4th intercostal space, axillary lines, and thoracic vertebrae (3rd ,5th .12th) and 10th thoracic vertebrae and xiphoid process. 4th Intercostal space and axillary lines were used to measure chest expansion in this study at both levels. The 2-instruction evaluated were, "breathe in maximally, breathe out maximally". And value were recorded at end of Maximal inhalation and maximal exhalation. A difference in these values were then calculated. An acceptable Reliability by ICC was determined. Value > 0.85 and SEMs < 5%.

4 secondary outcomes

ROM Cervical Spine (Flexion)
Time frame: from enrollment to the end at 6th week of treatment.
ROM Cervical Spine (Extension)
Time frame: from enrollments to the end of treatment at 6 weeks.
ROM Cervical Spine (Left Lateral Flexion).
Time frame: From Enrollment to the end of treatment at 6 weeks
ROM Cervical Spine (Right Lateral Flexion)
Time frame: From enrollment to the end of treatment at 6 weeks.

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 11 Feb 2026.
BackgroundChatchawan U. Comparative study of the immediate therapeutic effects between modified active release technique and traditional Thai massage on pain alteration in patient with scapulocostal syndrome. DOAJ (DOAJ: Directory of Open Access Journals). 2017.
BackgroundAli S, Ahmad S, Jalal Y, Shah B. Effectiveness of Stretching Exercises Versus Muscle Energy Techniques in the Management of Upper Cross Syndrome: JRCRS. 2017; 5 (1): 12-16. Journal Riphah College of Rehabilitation Sciences. 2017;5(1):12-6.
BackgroundMishra D, Prakash RH, Mehta J, Dhaduk A. Comparative study of active release technique and myofascial release technique in treatment of patients with upper trapezius spasm. Journal of Clinical and Diagnostic Research. 2018;12(11):17-20.
BackgroundGanesh B, Patil P, Rodrigues A. Effect of Muscle Energy Technique on Strength and Range of Motion in Young Swimmers with Sick Scapula Syndrome: A Pre-Post Clinical Trial. Indian Journal of Physiotherapy & Occupational Therapy Print-(ISSN 0973-5666) and Electronic-(ISSN 0973-5674). 2020;14(2):45-9.
Background: PubMed 12151246Allison GT, Nagy BM, Hall T. A randomized clinical trial of manual therapy for cervico-brachial pain syndrome -- a pilot study. Man Ther. 2002 May;7(2):95-102. doi: 10.1054/math.2002.0453.
BackgroundRisalda P, Phansopkar P, Naqvi WM. Effectiveness of active release technique verses conventional physiotherapy in management of upper cross syndrome. Indian Journal of Forensic Medicine & Toxicology. 2021;15(1):246-50.
Background: PubMed 35799408Seo J, Song C, Shin D. A Single-Center Study Comparing the Effects of Thoracic Spine Manipulation vs Mobility Exercises in 26 Office Workers with Chronic Neck Pain: A Randomized Controlled Clinical Study. Med Sci Monit. 2022 Jul 8;28:e937316. doi: 10.12659/MSM.937316.
BackgroundAbbas AH, Javaid M, Ali A, Ali Z, Mehmood S, Manzoor S. Comparative Efficacy of Muscle Energy Technique and Myofascial Release Technique in Reducing Pain in Upper Cross Syndrome: A Randomised Clinical Trial. The Healer Journal of Physiotherapy and Rehabilitation Sciences. 2025;5(2):228-34.
BackgroundMohan V, Dzulkifli NH, Justine M, Haron R, Rathinam C. Intrarater reliability of chest expansion using cloth tape measure technique. Bangladesh journal of medical science. 2012;11(4):307-11.
Background: PubMed 40954664Narulkar R, Welling A, Gurudut P, Kage V. Comparing the efficacy of 3-dimensional release technique and modified active release therapy on pain, scapular position and Craniovertebral angle in IT workers with scapulocostal syndrome: A Randomised Clinical Trial. J Bodyw Mov Ther. 2025 Oct;44:80-90. doi: 10.1016/j.jbmt.2025.05.033. Epub 2025 May 23.
Background: PubMed 34444281Kanhachon W, Boonprakob Y. Modified-Active Release Therapy in Patients with Scapulocostal Syndrome and Masticatory Myofascial Pain: A Stratified-Randomized Controlled Trial. Int J Environ Res Public Health. 2021 Aug 12;18(16):8533. doi: 10.3390/ijerph18168533.
BackgroundZahid A, Gull S, Athar M, Khan IU, Maqbool S, Zahid H. Comparative Effectiveness of Scapular Stabilization Exercises with and Without Deep Breathing on Pain and Chest Expansion in Patients with Scapulocostal Syndrome: Scapular Stabilization with Deep Breathing in SCS. Journal of Health and Rehabilitation Research. 2024;4(3).
Individual participant dataSharing planned: No

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.

Rafia Mannan, MS-SPT principal investigator

Riphah International University

1 site in 1 country: see every site and its status.

Questions about this trial

What is this clinical trial studying?

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 7 inclusion and 9 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 11 Feb 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?

Numeric Pain Rating Scale (time frame: From enrollment to the end of treament at 6 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 NCT07403227, which also lists 14 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 11 Feb 2026.