{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T17:16:01Z","timestamp":1778087761430,"version":"3.51.4"},"reference-count":58,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T00:00:00Z","timestamp":1773446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T00:00:00Z","timestamp":1773446400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Chronic cervical pain is a common disorder and is difficult to manage. Therefore, this study was conducted to investigate the effects of nociceptor hypostimulation versus hyperstimulation on electromyographic (EMG) activity of cervical muscles, myofascial trigger point (MTP) sensitivity, pain intensity, and disability in patients with chronic cervical pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixty patients with chronic cervical pain were randomly assigned to hypostimulation, hyperstimulation, or control groups. The hypostimulation group received subthreshold stimulation, the hyperstimulation group received suprathreshold stimulation, and the control group received sham treatment. Stimulation was applied for 20\u00a0min, three times per week, for 8\u00a0weeks. Outcome measures included upper trapezius EMG activity (resting and maximal contraction), pain intensity, MTP pressure pain threshold, and cervical range of motion (flexion, lateral flexion, and rotation bilaterally). Outcomes were assessed at baseline, post\u2010treatment (8\u00a0weeks), and follow\u2010up (8\u00a0weeks).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, no significant differences were observed among groups for any outcome (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&gt;\u00a00.05). Post\u2010treatment, the hypostimulation group demonstrated significantly greater improvements than both the hyperstimulation and control groups across all outcomes (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). These improvements were maintained at follow\u2010up. Hyperstimulation resulted in short\u2010term improvements in pain and cervical range of motion but not in EMG activity; these effects were not sustained at follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Eight weeks of nociceptor hypostimulation produced significant and sustained improvements in cervical muscle EMG activity, MTP sensitivity, pain, and disability in adults aged 40\u201365\u00a0years with chronic cervical pain. Hypostimulation was superior to hyperstimulation for the long\u2010term management of chronic cervical pain involving upper trapezius MTPs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>NCT06559358.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pri.70192","type":"journal-article","created":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T16:29:51Z","timestamp":1773505791000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Nociceptors Hypostimulation Versus Nociceptors Hyperstimulation on Electromyography of Cervical Muscles, Myofascial Trigger Points Sensitivity, Pain, and Disability in Patients With Chronic Cervical Pain: A Randomized Double\u2010Blinded Controlled Trial"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5092-3549","authenticated-orcid":false,"given":"Ayman A.","family":"Mohamed","sequence":"first","affiliation":[{"name":"Basic Sciences Department Faculty of Physical Therapy Beni\u2010Suef University  Beni Suef Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rania Hakim","family":"Hamed","sequence":"additional","affiliation":[{"name":"Basic Sciences Department Faculty of Physical Therapy Al\u2010Salam University  Kafr El Zayat Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5787-5815","authenticated-orcid":false,"given":"Dina Al\u2010Amir","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Basic Sciences Department Faculty of Physical Therapy Beni\u2010Suef University  Beni Suef Egypt"},{"name":"Basic Sciences Department Faculty of Physical Therapy Nahda University  New Bani Suef Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omima Alaa\u2010Eldin","family":"Hussien","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Physical Therapy Nahda University  New Bani Suef Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2010.3180"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974\u20107788.59946"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MRR.0b013e3282fc0f93"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20070146"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12551\u2010017\u20100300\u20108"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2014.09.008"},{"key":"e_1_2_10_8_1","first-page":"371","volume-title":"CRAM\u2019S Introduction to Surface Electromyography","author":"Criswell E.","year":"2011"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.12780"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fncel.2015.00471"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.13.1444"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.37.4.378"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0268\u20100033(03)00095\u20100"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbmt.2010.04.003"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","unstructured":"Gerwin R. 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