Evidence map›Paper›PMID 39802681›Full record

Trial reportJournal of multidisciplinary healthcare2025

Comparing the Therapeutic Impact of Strain-Counterstrain and Exercise on Low Back Myofascial Pain Syndrome: A Randomized Trial.

Ghada Mohamed Rashad Koura, Ahmed Mohamed Fathi Elshiwi, Mohamed Naeem Selim, Amani Abdu Mohammed Asiri, Reem Hadi Jowaied Alqahtani, Doaa Ayoub Elimy, Mohammed Abdullah Alshehri, Hani Hassan Alnakhli, Sultan Mofreh Assiri, Fuzail Ahmad and 1 more

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PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of multidisciplinary healthcare, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Ghada Mohamed Rashad KouraProgram of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia.
Ahmed Mohamed Fathi ElshiwiConsultant & Head of Physical Therapy Department, Saudi German Hospital, Aseer, Saudi Arabia.
Mohamed Naeem SelimBasic Sciences Department, Faculty of Physical Therapy, Beni Suef University, Beni Suef, Egypt.ORCID 0000-0001-9473-4715
Amani Abdu Mohammed AsiriPhysical Therapy Department, Saudi German Hospital, Aseer, Saudi Arabia.
Reem Hadi Jowaied AlqahtaniEradh Physical Therapy Center, Aseer, Saudi Arabia.
Doaa Ayoub ElimyBasic Sciences Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
Mohammed Abdullah AlshehriDepartment of Physiotherapy, Abha International Private Hospital, Abha, Saudi Arabia.
Hani Hassan AlnakhliProgram of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia.
Sultan Mofreh AssiriDepartment of Physical Therapy, Muhayel General Hospital, Asir Health Affairs, Ministry of Health, Abha, Saudi Arabia.
Fuzail AhmadRespiratory Care Department, College of Applied Sciences, Almaarefa University, Dirirya, Riyadh, Saudi Arabia.
Irshad AhmadProgram of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia.ORCID 0000-0002-6012-9207

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Background: Strain-Counterstrain (SCS) therapy is a manual therapeutic technique used to treat myofascial pain by addressing tender points through passive positioning. Despite anecdotal evidence, limited peer-reviewed research supports its efficacy in chronic low back pain (LBP). This study evaluates the effects of SCS combined with exercise on pain severity, lumbar range of motion (ROM), and functional disability in patients with chronic LBP. Methods: A randomized controlled trial was conducted with 30 participants aged 45-55 years, divided into Group A (SCS + Exercise) and Group B (Exercise Only). Outcome measures included pain intensity, lumbar ROM (flexion, extension, side bending), and functional disability (Oswestry Disability Index). Assessments were conducted at baseline and after four weeks of intervention. MANOVA was performed to evaluate group, time, and interaction effects, with detailed univariate follow-ups and effect sizes. Reliability of ROM measurements was ensured using intraclass correlation coefficients (ICC > 0.90). Results: MANOVA revealed statistically significant group, time, and interaction effects for all outcomes (Wilks' Lambda = 0.065, F (6, 51) = 91.34, p < 0.001). Pain severity decreased by 26.7% in Group A compared to 5.2% in Group B (F (1, 56) = 65.78, p < 0.001, partial η² = 0.77). Lumbar ROM improved significantly in Group A for flexion (10.9%), extension (20.3%), and right-side bending (17.7%) (p < 0.001, partial η² = 0.68-0.74), with no significant improvement in left-side bending. Functional disability scores reduced by 25.2% in Group A versus 2.3% in Group B (F (1, 56) = 53.45, p < 0.001, partial η² = 0.73). Conclusion: SCS therapy combined with exercise significantly reduces pain, improves lumbar ROM, and enhances functional capacity in patients with chronic LBP compared to exercise alone. These findings highlight SCS as a promising adjunctive treatment for managing chronic musculoskeletal pain. Future studies should investigate long-term outcomes and further refine treatment protocols.

Indexed as

low back painmyofascial pain syndromemyofascial trigger pointsstrain-counter-strain

Identifiers

PMID39802681
PMCPMC11721143

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.