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Intelangelo L, Mendoza C, Lassaga I, Barbosa AC, Biurrun Manresa J, Mista C. No Evidence of Short-term Changes in Muscle Activity Elicited by Dry Needling in Chronic Unilateral Shoulder Pain Patients. Clin J Pain 2023; 39:595-603. [PMID: 37440340 DOI: 10.1097/ajp.0000000000001151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/30/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE The aim of the study was to assess short-term changes in shoulder muscle activity elicited by dry needling in chronic unilateral shoulder pain (USP) patients. METHODS A randomized, double-blind, placebo-controlled clinical trial was conducted, in which 30 volunteers with USP were recruited and randomly assigned to either real or sham dry needling conditions. Pain intensity scores, pressure pain threshold, glenohumeral internal rotation angles, and electromyographic activity during isotonic shoulder tasks (shoulder flexion and extension) were assessed before, immediately, and 72 hours after the intervention in the infraspinatus and deltoid muscles. RESULTS A single application of real dry needling resulted in lower pain intensity scores and a larger range in glenohumeral internal rotation 72 hours after the intervention in comparison with sham dry needling. No differences in pressure pain threshold or muscle activity were observed due to the intervention. DISCUSSION A single application of real dry needling resulted in clinically significant changes in the short term. No differences were detected in muscle activation in the infraspinatus or deltoid muscles. Complementary interventions and longer follow-up times may be required to observe changes in muscle activity.
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Affiliation(s)
- Leonardo Intelangelo
- Musculoskeletal Research Unit-UIM, University Center for Assistance, Teaching, and Research-CUADI, University of Gran Rosario-UGR, Rosario, Santa Fe
| | - Cristian Mendoza
- Musculoskeletal Research Unit-UIM, University Center for Assistance, Teaching, and Research-CUADI, University of Gran Rosario-UGR, Rosario, Santa Fe
| | - Ignacio Lassaga
- Musculoskeletal Research Unit-UIM, University Center for Assistance, Teaching, and Research-CUADI, University of Gran Rosario-UGR, Rosario, Santa Fe
| | - Alexandre C Barbosa
- Department of Physical Therapy, Musculoskeletal Research Group-NIME, Federal University of Juiz de Fora, São Pedro, Governador Valadares, Brazil
| | - José Biurrun Manresa
- Institute for Research and Development on Bioengineering and Bioinformatics (IBB), CONICET-UNER
- Centre for Rehabilitation Engineering and Neuromuscular and Sensory Research (CIRINS), Faculty of Engineering, National University of Entre Ríos, Oro Verde, Entre Ríos, Argentina
| | - Christian Mista
- Institute for Research and Development on Bioengineering and Bioinformatics (IBB), CONICET-UNER
- Centre for Rehabilitation Engineering and Neuromuscular and Sensory Research (CIRINS), Faculty of Engineering, National University of Entre Ríos, Oro Verde, Entre Ríos, Argentina
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Martínez‐Jiménez EM, Losa‐Iglesias ME, Mazoteras‐Pardo V, López‐López D, Pereiro‐Buceta H, Calvo‐Lobo C, Rodríguez‐Sanz D, Becerro‐de‐Bengoa‐Vallejo R, Navarro‐Flores E. Dry needling of the flexor digitorum brevis muscle reduces postural control in standing: A pre-post stabilometric study. J Anat 2023; 243:545-554. [PMID: 36924312 PMCID: PMC10439377 DOI: 10.1111/joa.13862] [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: 10/14/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
There are studies that show the better balance after dry needling in lumbar pain. However, the postural control effects after foot dry needling are unknown. Our objective was to check if dry needling reduces postural control. Eighteen subjects with flexor digitorum brevis (FDB) muscle Myofascial trigger point were evaluated pre- and post-deep dry needling. We measured stabilometric variables in a pre-post study. We have found significant differences in three stabilometric variables: surface with eyes closed (29.36-53.21 mm2 ) (p = 0.000), medium speed of the laterolateral displacement with eyes closed (1.42-1.64 mm/s) (p = 0.004), and medium speed of the anteroposterior displacement with eyes closed (1.30-1.53 mm/s) (p = 0.025). Dry needling therapy application in FDB muscle reduces standing postural control with eyes closed.
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Affiliation(s)
| | - Marta Elena Losa‐Iglesias
- Nursing and Stomatology Department, Faculty of Health SciencesUniversidad Rey Juan CarlosMadridSpain
| | - Victoria Mazoteras‐Pardo
- Grupo de Investigación ENDOCU, Departamento Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Fisioterapia y Enfermería de ToledoUniversidad de Castilla‐La ManchaCiudad RealSpain
| | - Daniel López‐López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and PodiatryUniversidade da CoruñaIndustrial Campus of FerrolFerrol, Spain
| | - Héctor Pereiro‐Buceta
- Departamento de Enfermería y Fisioterapia, Facultad de Ciencias de la SaludUniversidad de LeónPonferradaSpain
| | - César Calvo‐Lobo
- Facultad de enfermería Fisioterapia y PodologíaUniversidad Complutense de MadridMadridSpain
| | - David Rodríguez‐Sanz
- Facultad de enfermería Fisioterapia y PodologíaUniversidad Complutense de MadridMadridSpain
| | | | - Emmanuel Navarro‐Flores
- Frailty Research Organized Group (FROG), Department of Nursing, Faculty of Nursing and PodiatryUniversity of ValenciaValenciaSpain
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Para-García G, García-Muñoz AM, López-Gil JF, Ruiz-Cárdenas JD, García-Guillén AI, López-Román FJ, Pérez-Piñero S, Abellán-Ruiz MS, Cánovas F, Victoria-Montesinos D. Dry Needling Alone or in Combination with Exercise Therapy versus Other Interventions for Reducing Pain and Disability in Subacromial Pain Syndrome: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10961. [PMID: 36078676 PMCID: PMC9518516 DOI: 10.3390/ijerph191710961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
This systematic review and meta-analysis examined the effects of dry needling alone or in combination with exercise therapy for reducing pain and disability in people with subacromial pain syndrome. Systematic searches of randomized clinical trials (RCTs) were performed in five different databases. A meta-analysis was carried out with the data obtained, and the risk of bias and quality of the studies was assessed using the Cochrane ROB 2.0 and GRADE tools. Finally, five RCTs (n = 315) were included in the meta-analysis and qualitative analysis. Our results determine that dry needling alone or combined with exercise therapy showed improvements in pain in the short-term (5RCTs: SMD: -0.27; [-0.49, -0.05]; low-quality) and mid-term (4RCTs: SMD: -0.27; [-0.51, -0.04]; low-quality) compared to a range of interventions. However, no differences were shown for disability at short-term (3 RCTs: SMD: -0.97; [-2.04, 0.11]; very-low quality) and mid-term (3 RCTs: SMD: -0.85; [-1.74, 0.04]; very-low quality). Dry needling alone or in combination with exercise therapy may result in a slight reduction in pain in the short-term and mid-term. However, the evidence about the effect of this therapy on disability in the short- or mid-term is very uncertain compared to the range of interventions analyzed in this systematic review (Registration: INPLASY202260112).
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Affiliation(s)
- Gonzalo Para-García
- Physiotherapy Department, Faculty of Health Sciences, Universidad Católica de Murcia, 30107 Murcia, Spain
| | - Ana María García-Muñoz
- Health Sciences Department, Campus de los Jerónimos, Universidad Católica San Antonio de Murcia (UCAM), Carretera de Guadalupe s/n, 30107 Murcia, Spain
| | - José Francisco López-Gil
- Health and Social Research Center, Universidad de Castilla-La Mancha (UCLM), 16002 Cuenca, Spain
| | - Juan Diego Ruiz-Cárdenas
- ECOFISTEM Research Group, Faculty of Health Sciences, Catholic University of Murcia, 30107 Murcia, Spain
| | - Ana Isabel García-Guillén
- Health Sciences Department, Campus de los Jerónimos, Universidad Católica San Antonio de Murcia (UCAM), Carretera de Guadalupe s/n, 30107 Murcia, Spain
| | - Francisco Javier López-Román
- Health Sciences Department, Campus de los Jerónimos, Universidad Católica San Antonio de Murcia (UCAM), Carretera de Guadalupe s/n, 30107 Murcia, Spain
- Primary Care Research Group, Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain
| | - Silvia Pérez-Piñero
- Health Sciences Department, Campus de los Jerónimos, Universidad Católica San Antonio de Murcia (UCAM), Carretera de Guadalupe s/n, 30107 Murcia, Spain
| | - María Salud Abellán-Ruiz
- Health Sciences Department, Campus de los Jerónimos, Universidad Católica San Antonio de Murcia (UCAM), Carretera de Guadalupe s/n, 30107 Murcia, Spain
| | - Fernando Cánovas
- Health Sciences Department, Campus de los Jerónimos, Universidad Católica San Antonio de Murcia (UCAM), Carretera de Guadalupe s/n, 30107 Murcia, Spain
| | - Desirée Victoria-Montesinos
- Health Sciences Department, Campus de los Jerónimos, Universidad Católica San Antonio de Murcia (UCAM), Carretera de Guadalupe s/n, 30107 Murcia, Spain
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Blanco-Díaz M, Ruiz-Redondo R, Escobio-Prieto I, De la Fuente-Costa M, Albornoz-Cabello M, Casaña J. A Systematic Review of the Effectiveness of Dry Needling in Subacromial Syndrome. BIOLOGY 2022; 11:biology11020243. [PMID: 35205109 PMCID: PMC8869493 DOI: 10.3390/biology11020243] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/28/2022] [Accepted: 02/01/2022] [Indexed: 11/16/2022]
Abstract
Simple Summary Dry needling, used by physical therapists, is a treatment modality used for the management of musculoskeletal pain. It is a technique in which a fine needle is used to penetrate the skin, subcutaneous tissues and muscles, with the aim of mechanically disrupting the inner tissues. This technique is called dry needling as the procedure does not involve the injection of any substance. Subacromial syndrome is defined as any kind of non-traumatic, usually unilateral, shoulder problem that causes pain around the acromion, that usually gets worse during or after lifting the arm. It should not be treated with surgical methods as the first option, but with different physiotherapy techniques. In this review, an overview of the effects of dry needling combined with conventional physiotherapy in patients with subacromial syndrome is presented. One of the key focal points is that dry needling combined with physiotherapy is effective and safe in reducing the pain and disability caused by this pathology. Abstract Our aim was to evaluate the effectiveness of dry needling (DN) combined with conventional physiotherapy in the recovery of patients with subacromial syndrome (SAS). A search was made of the main open access health science databases. The publication date was not limited for systematic reviews but was for randomized clinical trials (RCTs), which were limited to the last five years (from 2016) in English or in Spanish. Ninety-four studies were selected. In order to assess the quality of the studies, the JADAD scale or Oxford quality scoring system was used. A total of 402 patients were analyzed in all the studies in which the application of conventional physiotherapy was compared to the DN, either in a combination or in isolation. Improvements were obtained in pain intensity (Visual Analogic Scale—VAS), Range of Movement (ROM), Pressure Pain Threshold (PPT), functionality with Disabilities of the Arm, Shoulder and Hand (DASH) and the Shoulder Pain and Disability Index (SPADI), and in the cost–benefit ratio. DN is effective and safe in reducing the pain and disability produced by SAS, with the best combination of treatment turning out to be conventional physiotherapy together with DN, obtaining more stable and longer-lasting benefits than merely applying the techniques in isolation.
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Affiliation(s)
- María Blanco-Díaz
- Faculty of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Asturias, Spain; (M.B.-D.); (R.R.-R.); (M.D.l.F.-C.)
| | - Rubén Ruiz-Redondo
- Faculty of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Asturias, Spain; (M.B.-D.); (R.R.-R.); (M.D.l.F.-C.)
| | - Isabel Escobio-Prieto
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain;
- Correspondence:
| | - Marta De la Fuente-Costa
- Faculty of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Asturias, Spain; (M.B.-D.); (R.R.-R.); (M.D.l.F.-C.)
| | - Manuel Albornoz-Cabello
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain;
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain;
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