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Ferreira CCQ, Lima KR, Dias-Peixoto MF, Orlando DR, Castelo PM, Pereira LJ, Francelino Andrade E. Manual therapy and dry needling improve mobility, pain and reduce fear of COVID-19 in temporomandibular disorder patients: Randomized controlled trial. J Bodyw Mov Ther 2024; 40:620-626. [PMID: 39593654 DOI: 10.1016/j.jbmt.2024.05.015] [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: 03/15/2024] [Revised: 04/29/2024] [Accepted: 05/25/2024] [Indexed: 11/28/2024]
Abstract
BACKGROUND AND PURPOSE The COVID-19 pandemic exacerbated pain and joint mobility outcomes in patients with temporomandibular disorders (TMD), being that effective treatments are of clinical interest. We aimed to evaluate the effects of manual therapy (MT) and dry needling (DN), compared to cognitive-behavioral therapy/control (CO), on pain, articular mobility, and fear of COVID-19 in patients with TMD. MATERIALS AND METHODS Sixty participants with myofascial TMD were randomly assigned to three groups: MT, DN, and CO. Participants received four weeks of treatment (30 min per week). The participants completed the Fear of COVID- 19 Scale, the Visual Analog Scale, and mandibular mobility was assessed. Data were collected before the intervention (T1), after the last treatment session (T2), and 30 days after the end of treatment (T3). The data were analyzed using two-way Mixed-Design ANOVA, considering the group effect (DN x MT x CO), time (T1, T2, and T3), and the interaction time × group in the observed variance of outcomes. RESULTS We observed an interaction effect of time × group for maximum mouth opening, protrusion, and pain. The maximum mouth opening increased in the DN and MT groups (p = 0.005), while protrusion increased in the DN group (p = 0.007; test power = 97%, large effect size). A decrease in pain scores over time was observed in the DN and MT groups (p < 0.001; test power>99%, large effect size). The fear of COVID-19 score decreased in the DN and MT groups after 30 days (p = 0.033). CONCLUSION DN and MT improve pain, joint mobility, and fear of COVID-19 in patients with TMD.
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Affiliation(s)
| | - Karen Rodrigues Lima
- Health Sciences Department, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | - Marco Fabrício Dias-Peixoto
- Health Sciences Program, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Débora Ribeiro Orlando
- Health Sciences Department, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | - Paula Midori Castelo
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), Diadema, Brazil
| | - Luciano José Pereira
- Health Sciences Department, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | - Eric Francelino Andrade
- Health Sciences Department, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil.
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Medrano-de-la-Fuente R, Hernando-Garijo I, Mingo-Gómez MT, Jiménez-Del-Barrio S, Hernández-Lázaro H, Ceballos-Laita L. Is adding dry needling to a standard care protocol beneficial in patients with chronic neck pain? A randomized placebo-controlled trial. Complement Ther Clin Pract 2024; 55:101842. [PMID: 38364664 DOI: 10.1016/j.ctcp.2024.101842] [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: 11/03/2023] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 02/18/2024]
Abstract
PURPOSE To evaluate the short-term effects of adding a dry needling therapy to a standard care protocol based on education, exercise and electrotherapy, compared to a sham procedure and to a standard care protocol in isolation in patients with chronic neck pain. MATERIAL AND METHODS A randomized placebo-controlled trial was performed. The participants in the dry needling group received a standard care protocol based on patient education, therapeutic exercise and electrotherapy, as well as two sessions of dry needling in the upper trapezius, levator scapulae, and/or sternocleidomastoid muscles. The participants in the sham dry needling group received the same standard care protocol and two sessions of sham dry needling. The participants in the control group received the same standard care protocol. The outcomes measured were pain intensity, pressure pain threshold, neck disability, range of movement, activation of deep cervical flexor muscles, kinesiophobia, pain catastrophizing, anxiety, and depression. RESULTS No significant group by time interactions were found for any of the outcome variables except for lower cervical spine range of movement (F = 3.79; p = 0.030). CONCLUSION The addition of two sessions of dry needling in the superficial neck muscles to a standard protocol did not yield superior results compared to either the standard care alone or the standard care plus sham dry needling in patients with chronic neck pain in any outcome except for cervical range of movement.
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Affiliation(s)
- Ricardo Medrano-de-la-Fuente
- Faculty of Health Sciences, University of Valladolid, C/ Universidad, 42004, Soria, Spain; Clinical Research in Health Sciences Group, University of Valladolid, C/ Universidad, 42004, Soria, Spain
| | - Ignacio Hernando-Garijo
- Faculty of Health Sciences, University of Valladolid, C/ Universidad, 42004, Soria, Spain; Clinical Research in Health Sciences Group, University of Valladolid, C/ Universidad, 42004, Soria, Spain
| | - María Teresa Mingo-Gómez
- Faculty of Health Sciences, University of Valladolid, C/ Universidad, 42004, Soria, Spain; Clinical Research in Health Sciences Group, University of Valladolid, C/ Universidad, 42004, Soria, Spain
| | - Sandra Jiménez-Del-Barrio
- Faculty of Health Sciences, University of Valladolid, C/ Universidad, 42004, Soria, Spain; Clinical Research in Health Sciences Group, University of Valladolid, C/ Universidad, 42004, Soria, Spain.
| | - Héctor Hernández-Lázaro
- Faculty of Health Sciences, University of Valladolid, C/ Universidad, 42004, Soria, Spain; Clinical Research in Health Sciences Group, University of Valladolid, C/ Universidad, 42004, Soria, Spain
| | - Luis Ceballos-Laita
- Faculty of Health Sciences, University of Valladolid, C/ Universidad, 42004, Soria, Spain; Clinical Research in Health Sciences Group, University of Valladolid, C/ Universidad, 42004, Soria, Spain
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Mengi A, Bulut GT. The effect of combining physiotherapy with dry needling in patients with cervical spondylosis: A randomized controlled trial. J Back Musculoskelet Rehabil 2024; 37:1213-1221. [PMID: 38943380 DOI: 10.3233/bmr-230287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
BACKGROUND There are no data on the additional contribution of dry needling (DN) for trigger points (TPs) accompanying patients with cervical spondylosis (CS). OBJECTIVE To analyse the contribution of DN applied to concomitant active TPs in the upper trapezius muscle on the treatment outcomes of physiotherapy in CS. METHODS In this prospective randomized controlled study, 70 patients with CS and active TPs in the upper trapezius muscle were included. The first group received physiotherapy for 5 days per week for 3 weeks. The second group received DN with the same program. All participants were evaluated before treatment (day 0) and at the end of treatment (day 21) in terms of pain, functional status, quality of life, anxiety/depression scores, and number of TPs. RESULTS 33 patients in the first group and 32 patients in the second group completed the study. While the change over time was found significant in all variables, the change was not different between groups. The group-time interaction effect was not found to be statistically significant in any variable. Percentage changes of all variables were similar between the groups. CONCLUSION DN treatment added to the physiotherapy did not contribute to recovery in patients with CS.
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Affiliation(s)
- Alper Mengi
- Department of Pain Management, Edirne Sultan 1. Murat State Hospital, Edirne, Turkey
| | - Gül Tugba Bulut
- Department of Physical Medicine and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey
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Ramirez MM, Shepherd MH, Melnick SJ, Hanebuth C, Bazemore C, Couce L, Hendren S, Horn ME. Patient-reported outcome measures in physical therapy practice for neck pain: an overview of reviews. J Patient Rep Outcomes 2023; 7:97. [PMID: 37782344 PMCID: PMC10545655 DOI: 10.1186/s41687-023-00637-0] [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: 05/21/2023] [Accepted: 09/13/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Understanding which patient-reported outcome measures are being collected and utilized in clinical practice and research for patients with neck pain will help to inform recommendations for a core set of measures that provide value to patients and clinicians during diagnosis, clinical decision-making, goal setting and evaluation of responsiveness to treatment. Therefore, the aim of this study was to conduct a review of systematic reviews using a qualitative synthesis on the use of patient-reported outcome measures (PROMs) for patients presenting with neck pain to physical therapy. METHODS An electronic search of systematic reviews and guideline publications was performed using MEDLINE (OVID), Embase (Elsevier), CINAHL Complete (EBSCOhost), and Web of Science (Clarivate) databases to identify reviews that evaluated physical therapy interventions or interventions commonly performed by a physical therapist for individuals with neck pain and included at least one patient-reported outcome measure. The frequency and variability in which the outcome measures were reported among the studies in the review and the constructs for which they measured were evaluated. The evaluation of a core set of outcome measures was assessed. Risk of bias and quality assessment was performed using A Measurement Tool to Assess systematic Reviews 2. RESULTS Of the initial 7,003 articles, a total of 37 studies were included in the final review. Thirty-one PROMs were represented within the 37 reviews with eleven patient-reported outcome measures in three or more reviews. The eleven PROMs assessed the constructs of disability, pain intensity, psychosocial factors and quality of life. The greatest variability was found amongst individual measures assessing psychosocial factors. Assessment of psychosocial factors was the least represented construct in the included studies. Overall, the most frequently utilized patient reported outcome measures were the Neck Disability Index, Visual Analog Scale, and Numeric Pain Rating Scale. The most frequently used measures evaluating the constructs of disability, pain intensity, quality of life and psychosocial functioning included the Neck Disability Index, Visual Analog Scale, Short-Form-36 health survey and Fear Avoidance Belief Questionnaire respectively. Overall risk of bias and quality assessment confidence levels ranged from critically low (2 studies), low (12 studies), moderate (8 studies), and high (15 studies). CONCLUSION This study identified a core set of patient-reported outcome measures that represented the constructs of disability, pain intensity and quality of life. This review recommends the collection and use of the Neck Disability Index and the Numeric Pain Rating Scale or Visual Analog Scale. Recommendation for a QoL measure needs to be considered in the context of available resources and administrative burden. Further research is needed to confidently recommend a QoL and psychosocial measure for patients presenting with neck pain. Other measures that were not included in this review but should be further evaluated for patients with neck pain are the Patient Reported Outcomes Measurement Information System (PROMIS) Physical function, PROMIS Pain Interference and the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) tool.
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Affiliation(s)
- Michelle M Ramirez
- Department of Population Health Sciences, Department of Orthopaedic Surgery, Duke University School of Medicine, 215 Morris Street, Suite 200, Durham, NC, 27708, USA.
| | - Mark H Shepherd
- Department of Physical Therapy, Bellin College, 3201 Eaton Rd, Greenbay, WI, 54311, USA
| | - S Jacob Melnick
- Doctor of Physical Therapy Program, Hawai'i Pacific University, 500 Ala Moana Blvd, Honolulu, HI, 96813, USA
| | - Cannon Hanebuth
- Division of Physical Therapy, Duke University School of Medicine, DUMC Box 104002, Durham, NC, 27710, USA
| | - Caroline Bazemore
- Division of Physical Therapy, Duke University School of Medicine, DUMC Box 104002, Durham, NC, 27710, USA
| | - Logan Couce
- Sugar House Health Center, University of Utah, 1280 E. Stringham Ave, Salt Lake City, UT, 84106, USA
| | - Steph Hendren
- Research & Education Librarian, Duke University Medical Center Library & Archives, Seeley G. Mudd Bldg., 103, Durham, NC, 27710, USA
| | - Maggie E Horn
- Department of Orthopaedic Surgery, Division of Physical Therapy, Department of Population Health Sciences, Duke University School of Medicine, DUMC Box 104002, Durham, NC, 27710, USA
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Chys M, De Meulemeester K, De Greef I, Murillo C, Kindt W, Kouzouz Y, Lescroart B, Cagnie B. Clinical Effectiveness of Dry Needling in Patients with Musculoskeletal Pain-An Umbrella Review. J Clin Med 2023; 12:jcm12031205. [PMID: 36769852 PMCID: PMC9917679 DOI: 10.3390/jcm12031205] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 02/05/2023] Open
Abstract
The number of systematic reviews (SR) summarizing the literature regarding the clinical effects of Dry Needling (DN) has increased rapidly. Yet, rigorous evidence about the clinical effectiveness of this technique is still lacking. The aim of this umbrella review is to summarize the evidence about the clinical effects of trigger point DN on musculoskeletal disorders across all body regions. PubMed, Web of Science and Embase were searched to identify SRs examining the effect of DN (as a stand-alone intervention or combined with another treatment modality) compared to sham/no intervention or a physical therapy (PT) intervention with at least one clinical outcome in the domain of pain or physical functioning. Risk of bias (RoB) was assessed with the AMSTAR-2 tool. Quantification of the overlap in primary studies was calculated using the corrected covered area (CCA). The electronic search yielded 2286 results, of which 36 SRs were included in this review. Overall, DN is superior to sham/no intervention and equally effective to other interventions for pain reduction at short-term regardless of the body region. Some SRs favored wet needling (WN) over DN for short-term pain reductions. Results on physical functioning outcomes were contradictory across body regions. Limited data is available for mid- and long-term effects. DN has a short-term analgesic effect in all body regions and may be of additional value to the interventions that are used to date in clinical practice. Several studies have shown an additional treatment effect when combining DN to physiotherapeutic interventions compared to these interventions in isolation. There is a substantial need for the standardization of DN protocols to address the problem of heterogeneity and to strengthen the current evidence.
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Affiliation(s)
- Marjolein Chys
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
- Correspondence:
| | | | - Indra De Greef
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
| | - Carlos Murillo
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
- Pain in Motion International Research Group, 1000 Brussels, Belgium
| | - Wouter Kindt
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
| | - Yassir Kouzouz
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
| | - Bavo Lescroart
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
| | - Barbara Cagnie
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
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