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Abstract
Objective: To investigate the combined effect of the Extracorporeal Shockwave Therapy (ESWT) and Integrated Neuromuscular Inhibition (INI) on Myofascial Trigger Points of the Upper Trapezius. Methods: Sixty subjects aged 18-24 years old with active myofascial trigger point in upper trapezius. Participants were assigned randomly to either; group A, received ESWT one session/week, group B, received INI three sessions/week, and group C, received ESWT in addition to INI. All groups completed four weeks of intervention. Main outcome measures: At baseline and after four weeks of intervention, pain intensity, functional disability, pressure pain threshold (PPT), sympathetic skin response (SSR), and neuromuscular junction response (NMJR) were evaluated. Results: The within-group analysis revealed a significant decline in Visual analogue scale (VAS), Arabic neck disability index (ANDI), and NMJR and incline in PPT and SSR latency post-intervention where (P < 0.001). Multiple comparison analysis showed a substantial difference between groups, while the major changes favored group C, where (P < 0.05)