Table 1 Summary of the included article

Turkey

Ömer GEZGİNASLAN2020 [7]

N = 94

(F = 78

M = 16)

19–74

① high-energy ESWT and stretching exercises

② TENS, US, hot pack and stretching exercises

① 0.26mj/mm²,

2500 pulses per trigger point

② US:1 MHz, 1.5 w/cm²

TENS: unknown

hot pack: unknown

① 7 sessions

② 10 sessions

trapezius muscles

VAS, NDI, SF36, BDI, PSQI, FACIT

Changes in the ESWT group were statistically significantly greater in these six areas. Improvement in area SF-36 was more than twice that of the control group

Germany

Márta Király2018 [15]

N = 61

 > 18

① LLLT

② ESWT

①3 j/cm² for 2 min;5000 Hz (2000 mW), 9 j/cm², for 2 min

② 1000 pulses, 1.5 bar, 10 Hz, 0.25 mj/mm², 15 mm treating head diamete

15 sessions

trapezius muscles

PPT, SF-36,4-grade Likert scale, NFI

Significant improvements in four areas in the two groups. ESWT group showed more obvious improvement especially in all areas of SF-36

Korea

Ki Deok Park2018 [16]

N = 30

(F = 27 M = 3)

19–70

① high-energy ESWT

② low-energy ESWT

① 0.210 mj/mm², 1500 pulses

② 0.068 mj/mm², 1500 pulses

2 sessions

upper trapezius

VAS, PPT, neck ROM, NDI

Significant improvements in four areas in the two groups. No statistically significant differences between groups in VAS and PPT

Significant improvements in neck flexion and extension were

observed only in the high-energy group

China

Shuo Luan2019 [17]

N = 62

16–60

①ESWT

②dry needling

① 0.1mj/mm²

②30–50 mm deep

3 weeks

upper trapezius

VAS, PPT, NDI

Significant improvements in three areas in the two groups, but no significant differences between groups at various time points in these three areas.每组人数31

Iran

Mohammad Rahbar2020 [13]

N = 72

18–55

①radial ESWT and exercises

②US and exercises

③ exercises

① 2000 pulses, 60mj/m²,5 Hz

② 1.25 -1.5w/cm²

③ unknown

① 4 sessions

② 12 sessions

③ 4 weeks

neck and upper back

VAS, PPT, NDI

Significant improvements in three areas in the first two groups than control group. ESWT group had more improvement in VAS and PPT, less improvement in NDI than US group

Turkey

Ümit Yalçın2020 [3]

N = 262

(F = 167 M = 95

)

20–75

①ESWT and exercises

②KT and exercises

③ exercises

① 0.056 mj/mm², 1500 pulses per week

② X-shaped KT: 2 bands of 7.5 cm

③ exercises

① 3 sessions, 3 months

② 3 times, 3 months

③ months

unilateral trapeze muscle

VAS, neck ROM, NDI

Significant improvements in three areas in the first two groups than control group. ESWT group is superior to KT group in pain severity and functional recovery

KT group has more significant improvement in contralateral flexion

Turkey

Ahmet Sumen2015 [6]

N = 45

(F = 32

M = 13)

18–65

① stretching exercises and LLLT

②stretching exercises and intramuscular electrical stimulation therapy

③ stretching exercises

① 10 Hz, 670 nm, 4 j/cm², 10 min

② 80 Hz, 20 min

③ unknown, 2 times per day

① 10 sessions

② 10 days

③ 6 weeks

upper trapezius

VAS, PPT, neck ROM,

NDI

Significant improvements in four areas in the first two groups than control group.LLLT group is superior to the second group only in ROM

Turkey

Umit Dundar2015 [29]

N = 75

(F = 75)

20–60

① high-intensity laser therapy and exercises

②placebo high-intensity laser therapy and exercises

① First phase:three subphases of 360 mj/cm² (166.7 j), 410 mj/cm² (166.8 j), and 510 mj/cm² (166.5 j);

Second phase: 610 mj/cm²;

Third phase:three subphases of 360 mj/cm² (166.7 j), 410 mj/cm² (166.8 j), and 510 mj/cm² (166.5 j) .15 min

②Sham-high intensity laser therapy. 15 min

15 sessions

trapezius muscles

VAS, neck ROM, NDI, SF-36

Both groups have improved in four areas.High- intensity laser group has improved more obviously in VAS, NDI and SF-36.No significant differences in neck ROM

China

Wei-Han Chang2020 [30]

N = 100

(F = 88

M = 12)

20–65

① acupoint LLLT

② acupoint control group

③ trigger point LLLT

④ trigger point control group

① 810 nm, 553 Hz in Shousanli,791 Hz in Houxi and 731 Hz in Waiguan

② Sham-laser therapy

③ 810 nm,583 Hz

④ Sham-laser therapy

① each acupoint 40 s

② each acupoint 40 s

③ 160 s

④ 160 s

posterior-neck and upper-back

VAS, PPT, neck ROM

Significant differences between group 3 and 4,only former had improved ipsilateral bending

Significant differences between group 2 and 3, latter was possible superior for improving ipsilateral rotation. No significant difference in VAS between group 1 and 3.No significant difference in PPT among the four groups

Italy

A. Manca2014 [18]

N = 60 (M = 32 F = 28)

20–30

① active US

② placebo US

③ active LLLT

④ placebo LLLT

⑤ no treatment

① US: 3 MHz,1.5 W/ cm²

② sham-US

③ laser wave-length 904 nm; pulse duration200ns; pulse frequency 1953 Hz; peak power 90mW; average output 30 mW; power density 22.5 mW cm2;treatment time 600 s;

④ sham-laser

⑤ no therapy

10 sessions

upper trapezius

PPT, neck ROM, NRS

Control group scored significantly less than other four groups in PPT

Notably LtA scored significantly better than UsA, UsP and Control, but not than LtP in NRS

No significant differences between active and placebo groups,

controls scored significantly less than actives. but not than placebos in contralateral-flexion

Sri Lanka

Thusharika Dilrukshi Dissanayaka2016 [20]

N = 105

(F = 58

M = 47)

18–65

① TENS and standard care

② IFT and standard care

③ standard care

① 100 Hz,250 µs, 20 min

② 4000 Hz/4100HZ,20 min

③ no stimulation

8 sessions

upper trapezius

VAS, neck ROM

Improvements in the TENS group was 1.5 times that in the IFT group in VAS and neck ROM

It was also larger in both TENS and IFT groups compared with control group

Turkey

Gokmen Azatcam2017 [21]

N = 69

(F = 48

M = 21)

18–65

① TENS and trapezius stretching exercises

② KT and trapezius stretching exercises

③ trapezius stretching exercises

① 100 ms, 60 Hz,

intensity according to the paresthesia perception of the patient, 20 min

② 20 cm

③ unknown

① 10 sessions

② 4 sessions

③ 2 weeks

upper trapezius

VAS, PPT, neck ROM, NDI

TENS and KT group improved more significantly than control group in VAS.No significant difference between the groups in other areas

More pronounced improvement in KT group compared to TENS group in the early period in VAS

Iran

Safoora Ebadi2021 [19]

N = 60

(F = 47

M = 13)

18–65

①conventional TENS

②acupuncture-like TENS

③ sham TENS

① 120 Hz, 80 µs, 30 min

② 5 Hz, 200–250 µs, 15 min

③ sham-TENS

5 sessions

upper trapezius

VAS, PPT, neck ROM,DASH

Significant improvements in VAS and DASH in favor of first two groups. Neck total lateral bending in favor of acupuncture-like TENS group compared other two groups

Significant immediate improvement in all outcomes was observed only with acupuncture-like TENS

Egypt

Mary Kamal Nassif Takla2018 [22]

N = 70

(F = 40

M = 30)

25–45

① burst‐TENS‐combined therapy

②AMF‐combined therapy

③ sham‐combined therapy

① 100 pulses per second,2 burst per second, 43 mA, 10 min

② carrier frequency of 4,000 Hz, sweep beat frequency of 100–150 Hz, 12 mA, 10 min

③ sham‐Combined therapy, 10 min

12 sessions

upper trapezius

PPT, neck ROM

Group 1 yields a greater increase than group 2 in two areas

Improvements of group 1 in PPT is about twice and in neck ROM is approximately 1.4 times that of group 2

Egypt

Mary Kamal Nassif Takla2017 [2]

N = 100

(F = 54

M = 46)

30–60

① PH-CT

② PH

③ US

④ sham-US

①TENS:120–200 Hz, 200 µs, US: 1 MHz continuous mode, 1.5 W/cm²,diclofenac sodium 10 mg gel, 10 min

② 1 MHz continuous mode, 1.5 W/cm²,

diclofenac sodium 10 mg gel, 10 min

③ 1 MHz continuous mode, 1.5 W/cm²,coupling gel, 10 min

④ sham-US,coupling gel, 10 min

1 session

upper trapezius

PPT, neck ROM

Diclofenac PH-CT, PH, and US were all effective in PPT and neck ROM.PH-CT was shown to be superior over PH, and PH was superior over US in PPT.No significant difference between all the four groups in neck ROM

Turkey

Gülis Kavadar2015 [23]

N = 59 (F = 49 M = 10)

 < 50

① conventiona-l US therapy

② placebo US therapy

① 1.5 W/cm², 1 MHz

② sham-US

15 sessions

trapezius muscle

VAS, PPT, BDQ, SPMS

Significant improvements in four areas in group 1 than group 2

Turkey

Leman Ilter2013 [24]

N = 77 (M = 25 F = 52)

18–60

① continuous US

② pulsed US

③ sham US

① 3 MHz, 1 W/cm²

② 3 MHz, 1 W/cm²

③ sham-US

10 sessions

trapezius muscle

VAS, BDI, NHP, SPMS, NPDS

Significant improvements in all 5 areas in three groups. Significantly greater improvements in pain at rest in continuous US group. No statistically significant differences in the other areas

US/Thailand

Piyaraid Sakrajai2013 [36]

N = 31

18–65

① standard treatment and anodal tDCS;

② standard treatment and sham tDCS

① 1 mA, 20 min

② sham-tDCS, 20 min

5 days

Shoulder girdle muscles

VAS, neck ROM

Significant improvement in VAS and PPT in two groups. Significant improvement in shoulder adduction passive ROM at 1-week follow-up in group 1 than group 2

Korea

Yoon-Hee Choi2014 [37]

N = 21 (F = 12

M = 9)

 > 18

① tDCS over M1 and trigger-point injection

② tDCS over Dorso-lateral prefrontal cortex and Trigger-point injection

③ sham tDCS and trigger-point injection

① 2 mA, 20 min

② 2 mA, 20 min

③ Sham-tDCS, 20 min

5 days

Shoulder girdle muscle

VAS, PPT, SF-MPQ

Mean VAS values were decreased in all three groups, significant change only in group 2.No significant differences among the three groups in PPT and SF-MPQ

China

Jingyun Xu2021 [38]

N = 68

(F = 68)

18–70

① biofeedback and electrical stimulation, self-myofascial release

② self-myofascial release

① first program:50–280 Hz,50 µs

second program: 1–10 Hz, 200 µs

third program:1–2 Hz, 300 µs

② no stimulation

14 sessions

pelvic muscles

NRS, PGI-I, sEMG, Degree of activation of MTrPs

Improvements in four areas in two groups. Greater change in group 1 in NRS and degree of activation of MTrPs, sEMG levels of pretest resting baseline and posttest resting baseline. No between-group differences in sEMG levels of quick flicks and endurance contraction

Group 1 improved PGI-I at 4-week post-intervention but not at 12-week post-intervention

Iran

Fariba Eslamian2020 [8]

N = 50

(F = 39

M = 11)

25–55

①acupuncture and concomitant electrical stimulation

②biofeedback

① ES:200 µs,100 Hz,10 -45 mA, 30 min

② Parameters were unknown, 30 min

6 sessions

neck and upper back

VAS, PPT, neck ROM, NDI

Significant improvements in two groups, intergroup differences showed priority of acupuncture in all four areas. Change in group 1 was almost 3 times that in group 2 in NDI

United Arab Emirates

Ibrahim M. Moustafa2018 [39]

N = 120

(F = 44

M = 76)

Unknown

① denneroll cervical traction

② placebo treatment

unknown

30 sessions

scapular retractors, deep cervical flexors, and neck extensors

PPT, neck ROM, NDI, NRS

Equal improvements for both groups in NDI and NRS. Significant differences between groups favoring group 1 for PPT, sagittal alignment variables and all measures of neck ROM at 10 weeks. Significantly difference between groups favoring group 1 at 1-year follow up all variables

China

Yen-Ting Lai2017 [40]

N = 117

(F = 78

M = 39)

 > 18

① FIR patch

② placebo treatment

① 0.038 w/cm²,24 h

② no stimulation

1 session

trapezius muscle

VAS, PPT, MPT

Significant improvement in VAS in two groups. Only FIR group had change in PPT and MPT

Spain

Mireia Yeste-Fabregat2021 [41]

N = 32

16–39

① TT

② sham-TT

① 500 MHz,

40% of the maximum intensity, 25 min

② sham-TT, 25 min

1 session

gastrocnemius muscle

VAS, lunge test, absolute temperature

Greater increase in absolute temperature in group 1 than group 2

No difference between the groups in lunge test

Korea

Sang Hee Im2013 [9]

N = 41 (F = 13 M = 28)

Unknown

① whirlpool bath

② conventional hydrocollator pack

① 32—36℃, 30 min

② 74.5℃, 30 min

6 sessions

upper trapezius

VAS, BDI, QOL

Greater improvements in VAS and BDI of group 1 than that of group 2

No significant difference between two groups in QOL