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de Macedo CF, Sonza A, Puel AN, dos Santos AR. Trigger point dry needling increases masseter muscle oxygenation in patients with temporomandibular disorder. J Appl Oral Sci 2023; 31:e20230099. [PMID: 37646716 PMCID: PMC10501752 DOI: 10.1590/1678-7757-2023-0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/15/2023] [Accepted: 07/13/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Temporomandibular disorder (TMD) is an umbrella term encompassing various clinical complaints involving the temporomandibular joints, masticatory muscles, and/or associated orofacial structures. Myogenous TMDs are the most frequent cause of chronic orofacial pain. Musculoskeletal pain is commonly associated with myofascial trigger points (MTPs), for which dry needling (DN) is a routine treatment. OBJECTIVE To investigate muscle oxygenation and pain immediately after DN application on an MTP in the masseter muscle of patients with myogenous TMDs. METHODOLOGY Masseter muscle oxygen tissue saturation indices (TSI%) were assessed by near-infrared spectroscopy (NIRS) pre- and post-interventions by a randomized, controlled, double-blind, crossover DN/Sham clinical trial (primary outcome). Pain was investigated by the visual analog scale (VAS). In total, 32 individuals aged from 18 to 37 years who were diagnosed with myogenous TMD and myofascial trigger points in their masseter muscles participated in this study. Relative deltas for the studied variables were calculated. Data normality was tested using the Shapiro-Wilk test. According to their distribution, data were analyzed by two-way ANOVA and the Student's t-, and Mann-Whitney tests. Statistical analyses were performed using Prism® 5.0 (GraphPad, USA). RESULTS We found a significant difference (2,108% vs. 0,142%) between masseter muscle TSI% deltas after the DN and Sham interventions, respectively (n=24). We only evaluated women since men refused to follow NIRS procedures. Pain increased immediately after DN (n=32, 8 men), in comparison to Sham delta VAS. CONCLUSION These findings show an increase in tissue oxygen saturation in the evaluated sample immediately after the DN intervention on the MTP of patients' masseter muscle. Pain may have increased immediately after DN due to the needling procedure.
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Affiliation(s)
- Carolina Ferreira de Macedo
- Universidade Federal de Santa CatarinaCentro de Ciências BiológicasDepartamento de Ciências FisiológicasSanta CatarinaBrasilUniversidade Federal de Santa Catarina, Centro de Ciências Biológicas, Departamento de Ciências Fisiológicas, Programa de Pós-Graduação em Neurociências Florianópolis, Laboratório de Neurobiologia da Dor e Inflamação, Santa Catarina, Brasil.
| | - Anelise Sonza
- Universidade do Estado de Santa CatarinaPrograma de Pós-Graduação em FisioterapiaSanta CatarinaBrasilUniversidade do Estado de Santa Catarina (UDESC), Programa de Pós-Graduação em Fisioterapia, Florianópolis, Laboratório de Desenvolvimento e Controle Postural (LADESCOP), Santa Catarina, Brasil.
- Universidade do Estado de Santa CatarinaCentro de Ciências da Saúde e EsporteDepartamento de FisioterapiaSanta CatarinaBrasilUniversidade do Estado de Santa Catarina (UDESC), Centro de Ciências da Saúde e Esporte, Departamento de Fisioterapia, Programa de Pós-Graduação em Ciências do Movimento Humano, Santa Catarina, Brasil.
| | - Alexia Nadine Puel
- Universidade do Estado de Santa CatarinaPrograma de Pós-Graduação em FisioterapiaSanta CatarinaBrasilUniversidade do Estado de Santa Catarina (UDESC), Programa de Pós-Graduação em Fisioterapia, Florianópolis, Laboratório de Desenvolvimento e Controle Postural (LADESCOP), Santa Catarina, Brasil.
| | - Adair Roberto dos Santos
- Universidade Federal de Santa CatarinaCentro de Ciências BiológicasDepartamento de Ciências FisiológicasSanta CatarinaBrasilUniversidade Federal de Santa Catarina, Centro de Ciências Biológicas, Departamento de Ciências Fisiológicas, Programa de Pós-Graduação em Neurociências Florianópolis, Laboratório de Neurobiologia da Dor e Inflamação, Santa Catarina, Brasil.
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Ellwood J, Carnes D. An international profile of the practice of osteopaths: A systematic review of surveys. INT J OSTEOPATH MED 2021. [DOI: 10.1016/j.ijosm.2021.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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The effect of dry needling & muscle energy technique separately and in combination in patients suffering shoulder impingement syndrome and active trigger points of infraspinatus. J Bodyw Mov Ther 2020; 26:94-100. [PMID: 33992303 DOI: 10.1016/j.jbmt.2020.12.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 09/09/2020] [Accepted: 12/19/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of a combination of dry needling (DN) and muscle energy technique (MET) on pain intensity (PI), pressure pain threshold (PPT) and shoulder active range of motion (ROM) in patients with shoulder impingement syndrome and active trigger points in the infraspinatus muscle. METHODS 39 patients, aged 20-50 participated in this study. All the cases were randomly assigned into three groups: group 1 (n = 13) received DN, group 2 (n = 13) received MET, and group 3 (n = 13) received DN & MET. The patients were treated for three sessions in a one-week period with at least a two-day break between sessions. RESULTS The results showed a significant improvement in visual analog scale (VAS), PPT and shoulder ROM over time (P < 0.001) in all three groups. There were no significant differences BETWEEN VAS (P = 0.406) PPT (P = 0.293), external rotation(EXT.ROT) (0.476), internal rotation (INT.ROT)(P = 0.476) and extension(EXT) (P = 0.574) ROMs in the three groups; however, DN group was significantly more effective on abduction(ABD) (P = 0.003) and flexion(FLEX) (0.012) ROM compared with other two groups. CONCLUSION In line with previous studies, the present study found that the application of DN, MET and combined of these treatment on active trigger points in the infraspinatus muscle of patients with shoulder impingement syndrome helps reduce pain, increase PPT and enhance the shoulder ROM. Both techniques are effective in the treatment of trigger points. Nevertheless, DN is more effective in enhancing the ROM of flexion & abduction.
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Hakim IK, Takamjani IE, Sarrafzadeh J, Ezzati K, Bagheri R. The effect of dry needling on the active trigger point of upper trapezius muscle: Eliciting local twitch response on long-term clinical outcomes. J Back Musculoskelet Rehabil 2020; 32:717-724. [PMID: 30636729 DOI: 10.3233/bmr-181286] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Pain from myofascial trigger points is often treated by dry needling (DN). Empirical evidence suggests eliciting a local twitch response (LTR) during needling is essential. Muscle damage after eliciting LTR can increase the risk of tissue fibrosis in some cases. OBJECTIVE This study aimed to compare two methods of DN including with and without LTR on clinical parameters. METHODS Twenty-six participants suffering from chronic non-specific neck pain with an active trigger point (TrP) in their upper trapezius muscles were recruited via the convenience sampling method. Participants were randomly assigned in DN with LTR (control group) and without eliciting LTR or "de qi" (experimental group). Then, they received 3 sessions of dry needling, 3 days apart. We evaluated pain, pain pressure threshold, active cervical lateral flexion range of motion, and Neck Disability Index before the intervention and 4 weeks after the treatment. RESULTS After the treatment, significant higher changes were seen in the experimental group compared to the control group (p< 0.05) regarding pain, pain pressure threshold, and active cervical lateral flexion. However, there was no significant difference between groups according to the disability (p> 0.05). CONCLUSION DN without eliciting LTR has superiority over the DN along with eliciting LTR while the treatment aimed to receive long-term effects.
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Affiliation(s)
- Iman Kamali Hakim
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Ismail Ebrahimi Takamjani
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Javad Sarrafzadeh
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Kamran Ezzati
- Neuroscience Research Center, Poorsina Hospital, Guilan University of Medical and Health Services, Rasht, Iran
| | - Rasool Bagheri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
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Ziaeifar M, Arab AM, Mosallanezhad Z, Nourbakhsh MR. Dry needling versus trigger point compression of the upper trapezius: a randomized clinical trial with two-week and three-month follow-up. J Man Manip Ther 2018; 27:152-161. [PMID: 30935341 DOI: 10.1080/10669817.2018.1530421] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objectives: The purpose of this randomized controlled trial was to investigate the long-term clinical effect of dry needling with two-week and three-month follow up, on individuals with myofascial trigger points in the upper trapezius muscle. Methods: A sample of convenience (33 individuals) with a trigger point in the upper trapezius muscle, participated in this study. The individuals were randomly assigned to two groups: trigger point compression (N = 17) or dry needling (N = 16). Pain intensity, neck disability, and disability of the arm, hand, and shoulder (DASH) were assessed before treatment, after treatment sessions, and at two-week and three-month follow ups. Results: The result of repeated measures ANOVA showed significant group-measurement interaction effect for VAS (p = .02). No significant interaction was found for NPQ and DASH (p > .05). The main effect of measurements for VAS, NPQ, and DASH were statistically significant (p < .0001). The results showed a significant change in pain intensity, neck disability, and DASH after treatment sessions, after two weeks and three months when compared with before treatment scores in both groups. There was no significant difference in the tested variables after two-week or three-month as compared to after treatment sessions between the two groups. However, pain intensity after treatment sessions was significantly different between the two groups (p = .02). Discussion: Dry needling and trigger point compression in individuals with myofascial trigger point in the upper trapezius muscle can lead to three-month improvement in pain intensity and disability.
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Affiliation(s)
- Maryam Ziaeifar
- a Department of Physical Therapy , Iran University of Medical Sciences , Tehran , Iran
| | - Amir Massoud Arab
- b Department of Physical Therapy , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | - Zahra Mosallanezhad
- b Department of Physical Therapy , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | - Mohammad Reza Nourbakhsh
- c Department of Physical Therapy , North Georgia College and State University , Dahlonega , GA , USA
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The effect of upper trapezius muscle dry needling treatment on sleep quality: A case report. J Bodyw Mov Ther 2018; 22:333-336. [DOI: 10.1016/j.jbmt.2017.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 05/23/2017] [Accepted: 05/27/2017] [Indexed: 11/24/2022]
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Espejo-Antúnez L, Tejeda JFH, Albornoz-Cabello M, Rodríguez-Mansilla J, de la Cruz-Torres B, Ribeiro F, Silva AG. Dry needling in the management of myofascial trigger points: A systematic review of randomized controlled trials. Complement Ther Med 2017; 33:46-57. [DOI: 10.1016/j.ctim.2017.06.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 01/04/2017] [Accepted: 06/06/2017] [Indexed: 01/28/2023] Open
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Clinical Effectiveness of Dry Needling Immediately After Application on Myofascial Trigger Point in Upper Trapezius Muscle. J Chiropr Med 2016; 15:252-258. [PMID: 27857633 DOI: 10.1016/j.jcm.2016.08.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 08/15/2016] [Accepted: 08/25/2016] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the effect of dry needling (DN) on pain intensity and pressure pain threshold (PPT) compared with ischemic compression (IC) immediately and 48 hours after each treatment session in individuals with myofascial trigger points in the upper trapezius muscle. METHODS Thirty-one patients with myofascial trigger points in the upper trapezius muscle participated in this study. Patients were randomly assigned to a standard (N = 17) or experimental group (N = 14). The treatment protocol for the standard group consisted of IC, whereas the patients in the experimental group received DN. RESULTS The results indicated that the effect size of the DN methods for pain intensity and PPT was considerably greater after 2 days compared with immediately after the treatment session. In contrast, the effect of the IC for PPT was greater immediately after treatment compared with the measures after 2 days. There was also no noticeable difference in the effect size for IC on pain intensity between the scores obtained immediately and 2 days after treatment. However, our data also revealed a greater effect size for DN on PPT after 2 days compared with the IC technique. CONCLUSIONS In this study, DN improved the pain intensity and PPT after 2 days. However, it had no clinical improvement immediately after application because of muscle soreness. Thus, assessment of the effect of DN immediately after application can be criticized, and the results should be interpreted with caution.
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Law D, McDonough S, Bleakley C, Baxter GD, Tumilty S. Laser acupuncture for treating musculoskeletal pain: a systematic review with meta-analysis. J Acupunct Meridian Stud 2014; 8:2-16. [PMID: 25660439 DOI: 10.1016/j.jams.2014.06.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 06/18/2014] [Accepted: 06/25/2014] [Indexed: 11/28/2022] Open
Abstract
Laser acupuncture has been studied extensively over several decades to establish evidence-based clinical practice. This systematic review aims to evaluate the effects of laser acupuncture on pain and functional outcomes when it is used to treat musculoskeletal disorders and to update existing evidence with data from recent randomized controlled trials (RCTs). A computer-based literature search of the databases MEDLINE, AMED, EMBASE, CINAHL, SPORTSDiscus, Cochrane Library, PubMed, Current Contents Connect, Web of Science, and SCOPUS was used to identify RCTs comparing between laser acupuncture and control interventions. A meta-analysis was performed by calculating the standardized mean differences and 95% confidence intervals, to evaluate the effect of laser acupuncture on pain and functional outcomes. Included studies were assessed in terms of their methodological quality and appropriateness of laser parameters. Forty-nine RCTs met the inclusion criteria. Two-thirds (31/49) of these studies reported positive effects, were of high methodological quality, and reported the dosage adequately. Negative or inconclusive studies commonly failed to demonstrate these features. For all diagnostic subgroups, positive effects for both pain and functional outcomes were more consistently seen at long-term follow-up rather than immediately after treatment. Moderate-quality evidence supports the effectiveness of laser acupuncture in managing musculoskeletal pain when applied in an appropriate treatment dosage; however, the positive effects are seen only at long-term follow-up and not immediately after the cessation of treatment.
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Affiliation(s)
- Dina Law
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
| | - Suzanne McDonough
- Centre for Health, Activity and Rehabilitation Technologies, University of Ulster, Londonderry, UK
| | - Chris Bleakley
- Centre for Health, Activity and Rehabilitation Technologies, University of Ulster, Londonderry, UK
| | - George David Baxter
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Steve Tumilty
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Ziaeifar M, Arab AM, Karimi N, Nourbakhsh MR. The effect of dry needling on pain, pressure pain threshold and disability in patients with a myofascial trigger point in the upper trapezius muscle. J Bodyw Mov Ther 2013; 18:298-305. [PMID: 24725800 DOI: 10.1016/j.jbmt.2013.11.004] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 10/15/2013] [Accepted: 10/30/2013] [Indexed: 10/26/2022]
Abstract
Dry needling (DN) has been used recently by physical therapists as a therapy of choice for patients with myofascial trigger points (TrP). The purpose of this randomized controlled trial was to investigate the effect of DN in the treatment of TrPs in the upper trapezius (UT) muscle. A sample of convenience of 33 patients with TrP in the UT muscle participated in this study. Patients were randomly assigned to a standard (N = 17) or experimental group (N = 16). The treatment protocol for the standard group consisted of trigger point compression technique (TCT) on MTP, while the patients in the experimental group received DN. Pain intensity and pressure pain thresholds were assessed for both groups before and after the treatment sessions. In addition, the Disability of Arm, Hand, and Shoulder (DASH) was administered. Statistical analysis (paired t-test) revealed a significant improvement in pain, PPT and DASH scores after treatment in the experimental (DN) and standard (TCT) group compared with before treatment (P < 0.05). The ANCOVA revealed significant differences between the DN and TCT groups on the post-measurement VAS score (P = 0.01). There was, however, no significant difference between the two groups on the post-measurement score of the PPT (P = 0.08) and DASH (P = 0.34). DN produces an improvement in pain intensity, PPT and DASH and may be prescribed for subjects with TrP in UT muscles especially when pain relief is the goal of the treatment.
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Affiliation(s)
- Maryam Ziaeifar
- University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Amir Massoud Arab
- Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Evin, Koodakyar Ave., P.O. Box 1985713834, Tehran, Iran.
| | - Noureddin Karimi
- Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Evin, Koodakyar Ave., P.O. Box 1985713834, Tehran, Iran
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