Effect of Integrated Neuromuscular Inhibition Technique on Hand Grip Strength in Upper Trapezius Myofascial Trigger Points

Inclusion Criteria: * Subjects will be selected from out patient clinic of Delta University hospital, Dakahlia, Egypt. * Subjects aged between 18 and 55 years. * Their body mass index (BMI) were ranged from 18-30 kg/m2. * Subjects diagnosed as myofascial pain syndrome with a unilateral upper trapezius myofascial trigger point on the dominant side by a physician. * Subjects must have characteristics of trigger points: hardened, thickened taut bands in MPS patients. Contraction knots within taut muscle bands are pathognomonic features of MTrPs. Common features of the trigger point include the tender bands of muscles, taut band which could produce pain while pressing it directly or sometimes spontaneous, with this there was weak muscles, sensory motor dysfunctions, changes in motor control function and disruption of normal patterns of motor recruitments are seen. * Subjects from both genders. * The severity of pain on the visual analogue scale should be higher than two out of ten. * Patients will receive all standard medical treatment. Exclusion Criteria: * A history of any major neurological or musculoskeletal disorders, cardiovascular or respiratory diseases. * Neck pain due to cervical spine pathology. * Any history of cervical trauma, fractures or dislocations, carcinoma. * Uncooperative behavior, and unwillingness to participate. * Wrist problems (stiffness, fracture, operation or carpal tunnel syndrome).