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Comparison of effectiveness of myofascial trigger point release with manual therapy and myofascial release in combination with self stretching in upper cross syndrome

Background: Upper cross syndrome is a common postural dysfunctional pattern that describes the dysfunctional tone of the musculature of shoulder girdle/cervicothoracic region of the body. In upper cross syndrome cervical flexors and rhomboid and lower trapezius become weak and pectorals and upper trapezius/elevator and sub occipital become tight. Overuse and tightness of these muscles results in trigger point (hyperirritable points/knots) formation in the belly of the muscles. 
Objective: To compare the effectiveness of myofascial trigger point release in upper cross syndrome versus myofascial trigger point release in combination with self-stretching treatment. 
Methodology: A total of 40 patients with upper cross syndrome were selected for study on the basis of inclusion criteria, randomly allocated in to two groups (each n=20). Group A was treated with myofascial trigger point release alone once a week and followed for 6 weeks, while group B was given the same treatment along with self-stretching home plan. Self-stretching include (chest stretch in sitting, upper trapezius stretch and sub occipital self-stretch include hold for 10-15 sec and release of 5-10 seconds). The pain, disability and Cervical ROM were assessed before and after treatment through Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI) and Goniometry respectively. Data was analyzed on SPSS 20. 
Results: The results shows that patients in Group B improve pain (mean NPRS from 5.40±0.50 to 2.50±0.52) and disability (mean NDI from 36.00±4.47 to 22.20±4.67) more than Group A with pain (mean NPRS from5.45±0.75 to 4.00±0.32) and disability (mean NDI from 31.25±6.85 to 23.20±7.40).Statistically significant results were found between the groups regarding NPRS, NDI and cervical ROM as p value was