الفهرس 
Title: Effect of high power-pain threshold ultrasound versus extracorporeal shock wave on myoelectric activity of upper trapezius myofascial trigger points
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Abstract
Background: Myofascial pain syndrome can be significant source of pain and it’s characterized by the presence of one or more trigger points. Extracorporeal shock wave therapy is considered an effective treatment for myofascial pain syndrome High power pain threshold ultrasound efficient method for relieving pain and disability and increasing range of motion Objective: To investigate the effect of high power-pain threshold versus extracorporeal shock wave on myoelectric activity of upper trapezius myofascial trigger points. Methods: sixty participants (34 female, 26 male) with active MTrPs on the dominant upper fiber of trapezius was enrolled in this study. There were randomly divided into three equal groups (study group (A), study group (B) and control group (C)). group (A) (Extracorporeal shock wave group) (n=20) received radial extracorporeal shock wave will be applied as low energy and neck strengthening, stretching exercise and ischemic compression two sessions per week for two weeks 4 shock/session . group B (n=20) received high power -pain threshold ultrasound and neck strengthening, stretching exercise and ischemic compression twice/week for two weeks 4 U. S/session . group C (n=20) control group received conventional physical therapy treatment strengthening, stretching exercise and ischemic compression for twice/week for two weeks four treatment sessions. The outcome measure was neck function which by Arabic neck disability index, pain threshold which was assessed by digital pressure algometer, muscle amplitude which was measured by surface electromyography. They were assessed before treatment and at the end of the treatment period. Results: The differences within and between groups were measured using mixed design MANOVA. Within group analysis revealed that there was improvement in both Extracorporeal shock wave and high power pain threshold ultrasound post treatment compared to pretreatment, also between group analysis revealed there was significant improvement in neck disability index, Pressure pain threshold and Root mean square in favor of extracorporeal shock wave group