Effects of Dry Needling on Pain in Patients with Knee Osteoarthritis: A Preliminary Study

Background

Osteoarthritis is one of the most common rheumatological diseases and is also considered as one of the causes of myofascial trigger points (MtrPs). Dry needling (DN) is one of the methods used for the treatment of the MtrPs. The aim of the current study was to investigate the effects of DN on pain in participants with knee osteoarthritis (KOA).

Materials and Methods

In this before and after preliminary clinical trial study, patients with mild to moderate KOA were enrolled. In one session, after determining the location of trigger points in quadriceps and gastrocnemius muscles, the patients underwent DN. The pain was evaluated at baseline, by passing 4 days and 1 month from the intervention using the Visual Analog Scale (VAS).

Results

Sixteen patients with a mean age of 56.5 (4.53) years old have completed the study and follow-up period. According to the ANOVA analysis, VAS values indicated a significant decrease in pain score at the 4^th and 1 month after the intervention compared to baseline (P < 0.001). There was no significant difference between VAS at the 4^th day of intervention and also 1 month later of intervention (P = 0.087).

Conclusion

The application of one session DN can lead to improvement in pain intensity in participants with mild to moderate KOA.

Uncontrolled manifold analysis of gait kinematic synergy during normal and narrow path walking in individuals with knee osteoarthritis compared to asymptomatic individuals

Knee osteoarthritis (KOA) is a common musculoskeletal disorder resulting in altered gait patterns. Uncontrolled manifold (UCM) analysis has been demonstrated as a useful approach for quantitative analysis of motor variability and synergies. The present study aimed to investigate the changes in the kinematic synergy, controlling the center of mass (COM) position while walking on normal and narrow paths in people with KOA compared to asymptomatic participants. In this cross-sectional study, twenty people with mild to moderate KOA and twenty asymptomatic individuals walked at their comfortable preferred speed across normal and narrow paths on a treadmill. The UCM analysis was performed separately using the lower limb segmental angles as elemental variables and the COM displacement as a performance variable during the stance phase of gait for the frontal and sagittal planes. The results revealed that KOA and asymptomatic individuals could exploit kinematic synergy to control the COM displacement regardless of walking conditions (p < 0.05). Furthermore, the variance within the UCM and synergy index were significantly higher on the narrow path than the normal walking in the mediolateral direction in the KOA group (p < 0.05). The findings of this study suggest that individuals with KOA modify their gait kinematic variability to ensure a stronger kinematic synergy when walking on a challenging narrow path.

The effects of challenging walking conditions on kinematic synergy and stability of gait in people with knee osteoarthritis: A study protocol

Background:

Knee osteoarthritis (KOA) may considerably change the gait parameters, including the gait variability patterns. Uncontrolled manifold (UCM) analysis has been used to evaluate the relationship between motor control and gait variability as a useful index for assessing the multi-segmental movements’ coordination during walking. To our knowledge, no research has evaluated the alterations in the gait kinematic parameters during normal and narrow path walking in individuals with KOA as compared to asymptomatic people.

Materials and Methods:

In this cross-sectional study, individuals diagnosed with mild to moderate medial KOA and asymptomatic people will walk at their comfortable preferred speed on a treadmill. A motion capture system will be used to record at least 50 successful gait cycles. The kinematic variability of joints during gait will be analyzed using UCM, with the center of mass (COM) displacement considered as the performance variable. The primary outcome measure will be the lower limb synergy index. Variability of the COM displacement and changes in angles and angular velocities of lower extremity joints will be assessed as the secondary outcomes.

Results:

The results of this protocol study provide information on the lower limb kinematic synergy during gait on normal and narrow paths for individuals with KOA and asymptomatic controls.

Conclusion:

This information will help the researchers and clinicians understand KOA patients’ gait variability characteristics more deeply. Moreover, it may lead to an enhanced evidence-based approach for clinical decision-making concerning improving gait stability and decreasing the falling risk in these people.

The Effectiveness of Sternocleidomastoid Muscle Dry Needling in Patients with Cervicogenic Headache

BACKGROUND

Cervicogenic headache (CGH) is a secondary headache with a cervical source that radiates pain to the head or face. Accordingly, one reason of CGH is myofascial trigger points. The purpose of this study was to investigate the effect of one session dry needling (DN) of myofascial trigger points of the sternocleidomastoid (SCM) muscle in patients with CGH.

MATERIALS AND METHODS

In this before-and-after clinical trial, 16 females aged 18-60 years with a clinical diagnosis of CGH were enrolled. All of the patients received one session DN into the myofascial trigger points of the SCM muscle. Headache index (HI), headache duration, headache frequency, and headache disability index (HDI) were assessed at 2 weeks before and 2 weeks after the intervention. This study was registered in Clinical Trials as IRCT20181109041599N1.

RESULTS

One session DN into myofascial trigger points of the SCM muscle showed a significant improvement in HI (P < 0.001). Duration and frequency of headache as well as HDI significantly reduced after intervention (P < 0.001).

CONCLUSION

One session DN into myofascial trigger points of the SCM muscle was effective on improvement of HI, headache duration, headache frequency, and HDI in patients with CGH.

Comparing the Effect of Kinesiology Taping on Dynamic Balance and Pain of Men and Women With Unilateral Patellofemoral Pain Syndrome

Objective: Patellofemoral Pain Syndrome (PFPS) is one of the most common disorders of the knee joint. It is characterized by pain, reduced proprioception, and altered pattern of vastus muscle activation, which effectively maintain the balance needed for performing daily living activities such as walking and running. One treatment method that can reduce pain and improve balance in people with PFPS is Kinesiology Taping (KT). Considering the physiological and anatomical differences in the knee structure of men and women and the importance of studying the effect of KT on the dynamic balance of men with PFPS, this study aims to compare the effect of KT on dynamic balance and pain of men and women with unilateral PFPS. Materials & Methods: This is a quasi-experimental and non-randomized clinical trial. The participants were 30 males and 31 females aged 18-40 years suffering from unilateral PFPS. They were recruited using a convenience sampling method. First, the subjects performed the Y-balance test three times in each of the anterior, posteromedial, and posterolateral directions. The maximum score obtained from the three repetitions in each direction was divided by the limb length and recorded in percentage as a dynamic balance score. After 5 minutes of rest and performing initial tests, the subjects performed the intervention. In this stage, KT with a tension equal to 50%-75% of its initial length was applied on the patella of the involved limb to cause medial glide. The effectiveness of KT was examined under a single-leg squat-test. For this purpose, all subjects performed unilateral squatting on their affected leg for 10 seconds with 45 degrees of knee flexion before and after KT, while their pain level was recorded using the visual analog scale. In case of a 50% reduction in pain, the subjects were allowed to enter the final stage (performing the Y-balance test); otherwise, patellar taping was repeated to obtain the appropriate pain reduction. Results: Within-group comparison of balance parameters before and after KT using the paired t-test showed an increase in the reach distance at three directions in the Y-balance test, revealing a significant improvement in the dynamic balance following KT (P<0.05). According to the independent t-test results, there was no significant difference in balance parameters between males and females before and after the intervention (P>0.05). Moreover, the pain was significantly reduced in both genders after KT (P<0.05), but its difference between men and women was not statistically significant (P>0.05). Conclusion: KT is an appropriate therapeutic intervention for improving dynamic balance and reducing pain in people with PFPS. It seems that KT has the same effect on dynamic balance and pain of women and men with PFPS.