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Pandya J, Puentedura EJ, Koppenhaver S, Cleland J. Dry Needling Versus Manual Therapy for Patients With Mechanical Neck Pain: A Randomized Controlled Trial. J Orthop Sports Phys Ther 2024; 54:1-12. [PMID: 38284367 DOI: 10.2519/jospt.2024.12091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
OBJECTIVE: To compare the short- and intermediate-term effects of dry needling to manual therapy on pain, disability, function, and patient-perceived improvement in patients with mechanical neck pain. DESIGN: A single (therapist) blinded randomized controlled trial. METHODS: Seventy-eight patients (mean ± SD age, 50.74 ± 13.81) were randomly assigned to one of the 2 groups: (1) dry needling and therapeutic exercises (DN + Exercises) and (2) manual therapy and therapeutic exercises (MT + Exercises). Both groups received 7 treatment sessions over a maximum of 6 weeks. Outcome measures, collected at baseline, 2 weeks, discharge (7th treatment session), and 3 months after discharge, were as follows: Neck Disability Index (NDI), numeric pain-rating scale (NPRS), Patient-Specific Functional Scale (PSFS), global rating of change (GROC), Fear-Avoidance Belief Questionnaire (FABQ), and Deep Neck Flexor Endurance Test (DNFET). Data were analyzed with mixed-model analysis of covariance (ANCOVA), using pretest scores as covariates, and a Mann-Whitney U test for GROC scores. RESULTS: The ANCOVA revealed significant group-by-time interaction for all variables. Significant between-group differences, favoring MT + Exercises, were observed at all 3 time points on the NDI (2 weeks: F1,446 = 172.68, P≤.001, [Formula: see text] = .27; discharge: F1,446 = 254.15, P≤.001, [Formula: see text] = .36; and 3 months: F1,446 = 339.40, P≤.001, [Formula: see text] = .43). Results for the MT + Exercises group exceeded recommended minimal clinically important difference for all variables, at all follow-up points. CONCLUSION: MT + Exercises was more effective, both in the short term and intermediate term, than DN + Exercises in reducing pain, disability, and improving function in patients with mechanical neck pain. J Orthop Sports Phys Ther 2024;54(4):1-12. Epub 29 January 2024. doi:10.2519/jospt.2024.12091.
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Kelly NF, Mansfield CJ, Schneider E, Moeller JC, Bleacher JS, Prakash RS, Briggs MS. Functional connectivity patterns are altered by low back pain and cause different responses to sham and real dry needling therapies: a systematic review of fMRI studies. Physiother Theory Pract 2024; 40:671-688. [PMID: 36484262 DOI: 10.1080/09593985.2022.2155094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 11/30/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is a relationship between low back pain (LBP) and central nervous system dysfunction. Needling therapies (e.g. acupuncture, dry needling) are proposed to impact the nervous system, however their specific influence is unclear. PURPOSE Determine how needling therapies alter functional connectivity and LBP as measured by functional magnetic resonance imaging (fMRI). METHODS Databases were searched following PRISMA guidelines. Studies using fMRI on individuals with LBP receiving dry needling or acupuncture compared to control or sham treatments were included. RESULTS Eight studies were included, all of which used acupuncture. The quality of studies ranged from good (n = 6) to excellent (n = 2). After acupuncture, individuals with LBP demonstrated significant functional connectivity changes across several networks, notably the salience, somatomotor, default mode network (DMN) and limbic networks. A meta-analysis demonstrated evidence of no effect to potential small effect of acupuncture in reducing LBP (SMD -0.28; 95% CI: -0.70, 0.13). CONCLUSION Needling therapies, like acupuncture, may have a central effect on patients beyond the local tissue effects, reducing patients' pain and disability due to alterations in neural processing, including the DMN, and potentially other central nervous system effects. The meta-analysis should be interpreted with caution due to the narrow focus and confined sample used.
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Affiliation(s)
- Nina F Kelly
- Cleveland Clinic Main Campus, Crile Building Sports Medicine Rehabilitation, Cleveland, OH, USA
- Orthopedic Manual Physical Therapy Fellowship, Sports Medicine Rehab, Ohio State University Wexner Medical Center, Columbus, OH, USA
- Gahanna Sports Medicine Rehabilitation, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Cody J Mansfield
- Orthopedic Manual Physical Therapy Fellowship, Sports Medicine Rehab, Ohio State University Wexner Medical Center, Columbus, OH, USA
- Gahanna Sports Medicine Rehabilitation, Ohio State University Wexner Medical Center, Columbus, OH, USA
- Sports Medicine Research Institute, Ohio State University Wexner Medical Center, Columbus, OH, USA
- Jameson Crane Sports Medicine Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- School of Health and Rehabilitation Sciences, College of Medicine, Ohio State University, Columbus, OH, USA
| | - Eric Schneider
- School of Health Sciences, Mount St. Joseph University, Cincinnati, OH, USA
| | - Josh C Moeller
- School of Health and Rehabilitation Sciences, College of Medicine, Ohio State University, Columbus, OH, USA
- Department of Psychology, Ohio State University 1825 Neil Avenue, Columbus, OH, USA
| | - Jerald S Bleacher
- Orthopedic Manual Physical Therapy Fellowship, Sports Medicine Rehab, Ohio State University Wexner Medical Center, Columbus, OH, USA
- Gahanna Sports Medicine Rehabilitation, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Ruchika S Prakash
- Center for Cognitive and Behavioral Brain Imaging, Ohio State University, Columbus, OH, USA
| | - Matthew S Briggs
- Sports Medicine Research Institute, Ohio State University Wexner Medical Center, Columbus, OH, USA
- Jameson Crane Sports Medicine Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- School of Health and Rehabilitation Sciences, College of Medicine, Ohio State University, Columbus, OH, USA
- Department of Orthopedics, Ohio State University Wexner Medical Center, Columbus, OH, USA
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Porter M, Griswold D, Gargano F, Ickert E, Learman K. Immediate effects of superficial dry needling of the trigeminal nerve innervation field for participants with cervicogenic headache. A randomized controlled trial. Physiother Theory Pract 2024; 40:253-261. [PMID: 36047014 DOI: 10.1080/09593985.2022.2118560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/23/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Cervicogenic headache (CGH) is a common condition with a neuroanatomical basis involving the trigeminal nerve. Dry needling (DN) is a safe and effective treatment for CGH but most studies involve deep DN to cervical musculature. OBJECTIVE The aim of this study was to investigate immediate effects of superficial DN of the trigeminal nerve innervation field on numeric pain rating scale (NPRS), flexion-rotation test (FRT), cervical range of motion (AROM), and pain-pressure threshold (PPT) of right (R) and left (L) supraorbital (SO), and right (R) and left (L) greater occipital (GO) nerves in participants with CGH. METHODS A parallel controlled randomized design involving 30 participants with CGH received either superficial DN (N = 17) or sham DN (N = 13). Participants and outcome assessors were blind to group assignment. Wilcoxon signed rank analyzed within-group effects and Mann-Whitney U analyzed between-group. RESULTS Statistically significant between-group differences were observed for NPRS (P < .001) and AROM (P < .006) favoring DN and were clinically meaningful. Right and left Flexion rotation tests (FRT) outcomes were non-significant (P = .137) but clinically meaningful. No differences were observed for PPT over: R SO (P = .187); L SO (P = .052); R GO (P = .187); or L GO (P = .052). Between-group effect sizes across variables were moderate to large (0.53-1.4) but confidence intervals were wide. CONCLUSION Superficial DN targeting the innervation field of the trigeminal nerve improves clinical outcomes in patients with CGH. Only the immediate effects were analyzed and the sample size was small. Larger, longer-term assessments are needed comparing superficial DN of the trigeminal innervation field and other conservative interventions for CGH.
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Affiliation(s)
- Megan Porter
- Department of Graduate Studies in Health and Rehabilitation Sciences, Youngstown State University, One University Plaza, Youngstown, OH, USA
| | - David Griswold
- Department of Graduate Studies in Health and Rehabilitation Sciences, Youngstown State University, One University Plaza, Youngstown, OH, USA
| | | | - Edmund Ickert
- Department of Graduate Studies in Health and Rehabilitation Sciences, Youngstown State University, One University Plaza, Youngstown, OH, USA
| | - Ken Learman
- Department of Graduate Studies in Health and Rehabilitation Sciences, Youngstown State University, One University Plaza, Youngstown, OH, USA
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Chmielewska D, Malá J, Opala-Berdzik A, Nocuń M, Dolibog P, Dolibog PT, Stania M, Kuszewski M, Kobesova A. Acupuncture and dry needling for physical therapy of scar: a systematic review. BMC Complement Med Ther 2024; 24:14. [PMID: 38167051 PMCID: PMC10759514 DOI: 10.1186/s12906-023-04301-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/10/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND There is a continuing interest in finding effective methods for scar treatment. Dry needling is gaining popularity in physiotherapy and is defined by Western medicine as a type of acupuncture. The terms acupuncture and dry needling have been used interchangeably so we have focused on the efficacy of dry needling or acupuncture in scar treatment. OBJECTIVE The aim of this systematic review was to determine the usefulness of dry needling or local acupuncture for scar treatment. In our search process, we used the terms 'acupuncture,' 'needling,' or 'dry needling' to identify all relevant scientific papers. We have focused on the practical aspects of local management of different scar types with dry needling or acupuncture. SEARCH STRATEGY The search strategy included different combinations of the following keywords: 'scar', 'keloid', 'dry needling', 'needling', 'acupuncture', 'treatment', 'physical therapy'. This systematic review was conducted in accordance with PRISMA guidelines. MEDLINE (PubMed, EBSCOHost and Ovid), EMBASE (Elsevier), and Web of Science databases were searched for relevant publications from inception through October 2023. INCLUSION CRITERIA The studies that investigated the effectiveness of dry needling or acupuncture for scar treatment were included. DATA EXTRACTION AND ANALYSIS The main extraction data items were: the needling technique; needle: diameter, length; needling locations; manual needling manipulation; number of sessions; settings; outcomes and results. RESULTS As a result of a comprehensive search, 11 manuscripts were included in the systematic review, of which eight were case reports, two were randomized trials and one study concerned case series. Two case reports scored 2-4 out of 8 points on the JBI checklist, five studies scored 5-7, and one study scored 8 points. The methodological quality of the two clinical trials was rated as good or fair on the PEDro scale. The case series study scored 7 of 10 points on the JBI checklist. A meta-analysis was not possible as only two randomized trials, eight case reports, and one case series were eligible for review; also, scar assessment scales and pain severity scales were highly heterogeneous. CONCLUSIONS The studies differed regarding the delivery of dry needling or local acupuncture for scar treatment. Differences included treatment frequency, duration, number of treatments, selection of needle insertion sites, number of needles used, angle of needle placement, and use of manual needling manipulation. SYSTEMATIC REVIEW REGISTRATION INPLASY no. 202310058.
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Affiliation(s)
- Daria Chmielewska
- Electromyography and Pelvic Floor Muscles Laboratory, Department of Physical Medicine, Institute of Physiotherapy and Health Sciences, Academy of Physical Education in Katowice, Mikołowska 72 street, Katowice, 40-065, Poland.
| | - Jitka Malá
- Physiotherapy Department, Faculty of Physical Education and Sport, Charles University in Prague, José Martího 31, Prague 6, 162 52, Czech Republic
| | - Agnieszka Opala-Berdzik
- Institute of Physiotherapy and Health Sciences, Department of Physiotherapy in Internal Diseases, Academy of Physical Education in Katowice, Mikołowska 72 street, Katowice, 40-065, Poland
| | - Magdalena Nocuń
- Students Scientific Association "IMPULSE" of the Institute of Electromyography and Pelvic Floor Muscles Laboratory, Department of Physical Medicine, Physiotherapy and Health Sciences, Academy of Physical Education in Katowice, Mikołowska 72 street, Katowice, 40-065, Poland
| | - Patrycja Dolibog
- Department of Medical Biophysics, Faculty of Medical Sciences, Medical University of Silesia, Medyków 18 street, 40-752, Katowice, Poland
| | - Paweł T Dolibog
- Department of Biophysics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19 street, Zabrze, 41-808, Poland
| | - Magdalena Stania
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Mikołowska 72 street, Katowice, 40-065, Poland
| | - Michał Kuszewski
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education in Katowice, Mikołowska 72 street, Katowice, 40-065, Poland
| | - Alena Kobesova
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University and University Hospital Motol in Prague, V Úvalu 84, Prague 5, 150 06, Czech Republic
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Yildizgoren MT, Bagcier F. YouTube as a source of information and education on ultrasound- guided dry needling. Med Ultrason 2023; 25:398-402. [PMID: 38150681 DOI: 10.11152/mu-4206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
AIM This study aims to evaluate the educational quality of videos related to ultrasound guided dry needling (USDN). Material and method: This study was designed as a cross-sectional study. A video-based search was performed on the YouTube online video sharing platform (https://www.youtube.com/) using the English keywords "ultrasound guided dry needling" on May 10, 2023. The first 60 videos were analysed. RESULT The first 60 videos were analyzed, and 32 videos that met the inclusion criteria were included in the study. The content of the videos mostly consisted of technical knowledge regarding Ultrasound Guided Dry Needling (USGDN) (56.3%) and information (43.84%). The total mean DISCERN score was 26.9 ± 12.0 (range 17 to 54). The total mean JAMA Score was 2.4 ± 0.7 (range 2 to 4). There was no significant differences between the groups, according to the DISCERN, and JAMAs scores (all p>0.05). The video with the highest DISCERN score belongedto The American Institute of Ultrasound in Medicine (AIUM) channel. CONCLUSION There is a significant amount of content available on YouTube regarding USDN; however, unfortunately, most of the existing content is of low quality and carries the risk of misinformation. Healthcare professionals should be aware of the importance of health-related information on YouTubeand strive to provide high-quality, accurate, and up-to-date content.
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Affiliation(s)
| | - Fatih Bagcier
- Basaksehir Cam and Sakura Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
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Alnwick GM, Clewley D, Beuning B, Koppenhaver S. Improvements after dry needling for craniofacial pain in a patient with chronic rhinosinusitis: a case report. Physiother Theory Pract 2023; 39:2740-2749. [PMID: 35659189 DOI: 10.1080/09593985.2022.2085218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 05/18/2022] [Accepted: 05/27/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Typically treated medically, chronic rhinosinusitis (CRS) is a prevalent condition characterized by multiple craniofacial symptoms, some of which may respond favorably to dry needling intervention. OBJECTIVE To describe the outcomes of a patient presenting with craniofacial pain and symptoms consistent with a diagnosis of CRS who was treated with dry needling. Case Description: A 41-year-old male, self-referred to physical therapy with a diagnosis of CRS, with a 20-year history of signs and symptoms associated with CRS, including craniofacial pain and headaches. The patient had been treated with multiple medication regimens over this time, including antihistamines, anti-inflammatories, decongestants, leukotriene inhibitors, and antibiotics; all of which provided only short-term relief. On initial examination, the patient was tender to palpation in multiple muscles of the head, neck, and face. Intervention consisted of dry needling to these muscular tender points once or twice weekly over 2 months. OUTCOMES After 2 months of dry needling, the patient demonstrated clinically meaningful improvements in pain and quality of life, which included a decrease in both medication usage and the frequency of sinus infections. CONCLUSION Although CRS is generally managed medically, we observed areas of muscular tenderness in this case, which were effectively managed with dry needling. Rehabilitative providers may consider screening CRS patients for muscular impairments that may be modifiable with dry needling. Further research should be performed to determine whether dry needling has a role in the management of CRS.
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Affiliation(s)
| | - Derek Clewley
- Doctor of Physical Therapy Division, Department of Orthopaedic Surgery Duke University School of Medicine, Durham, NC, USA
| | - Brett Beuning
- Physical Therapy Department, Robbins College of Health and Human Services, Baylor University, Waco, TX, USA
| | - Shane Koppenhaver
- Physical Therapy Department, Robbins College of Health and Human Services, Baylor University, Waco, TX, USA
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Dach F, Ferreira KS. Treating myofascial pain with dry needling: a systematic review for the best evidence-based practices in low back pain. Arq Neuropsiquiatr 2023; 81:1169-1178. [PMID: 38157883 PMCID: PMC10756779 DOI: 10.1055/s-0043-1777731] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/28/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Myofascial pain syndrome (MPS) is a common source of pain in primary care or pain clinics. There are many different ways to manage and treat MPS, such as physical exercise, trigger points massage, and dry needling. OBJECTIVE The objective of this overview is to highlight and discuss the evidence-based treatment of myofascial pain by dry needling in patients with low back pain. METHODS A systematic review was made based on meta-analysis (MA) and randomized controlled trials (RCTs) related to dry needling treatment for myofascial pain in patients with lumbar pain, published from 2000 to 2023. RESULTS A total of 509 records were identified at first. Seventy were published before 2000, so they were excluded. From the remaining 439 studies, ninety-two were RCTs or MA, of which 86 additional studies were excluded for the following reasons: not related to dry needling treatment (n = 79), not published in English (n = 4), duplicated (n = 1), project protocol (n = 1), and not related to myofascial pain (n = 1). So, this review was based on 4 RCTs and two MA. These studies compared dry needling efficacy to other treatments, such as acupuncture, sham dry needling, laser therapy, physical therapy, local anesthetic injection, ischemic compression, and neuroscience education. Despite outcomes and follow-up period varied between them, they showed that dry needling can decrease post-intervention pain intensity and pain disability. CONCLUSION Dry needling is an effective procedure for the treatment of myofascial pain in patients with acute and chronic low back pain. Further high-quality studies are needed to clarify the long-term outcomes.
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Affiliation(s)
- Fabíola Dach
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto SP, Brazil.
| | - Karen S. Ferreira
- Suroit Hospital, Department of Neurology, Salaberry-de-Valleyfield, Quebec, Canada
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Menéndez-Torre Á, Pintado-Zugasti AM, Zaldivar JNC, García-Bermejo P, Gómez-Costa D, Molina-Álvarez M, Arribas-Romano A, Fernández-Carnero J. Effectiveness of deep dry needling versus manual therapy in the treatment of myofascial temporomandibular disorders: a systematic review and network meta-analysis. Chiropr Man Therap 2023; 31:46. [PMID: 37924127 PMCID: PMC10625247 DOI: 10.1186/s12998-023-00489-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/01/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Temporomandibular disorders (TMDs) are the most common cause of orofacial pain of non-dental origin, with approximately 42% of diagnoses corresponding to myofascial pain. Manual therapy and dry needling are commonly used interventions for the treatment of myofascial temporomandibular disorders. However, it is unclear whether one of them could be superior to the other. OBJECTIVES The aim of the present systematic review and network meta-analysis was to compare the effectiveness of manual therapy and dry needling in patients with myofascial TMD. METHODS This is a systematic review and network meta-analysis. Randomized clinical trials were searched in the databases of Pubmed, PEDro, CINAHL, Web of Science, Scopus, Cochrane, Google Academic and EMBASE. The methodological quality of studies included in this review was judged using the Physiotherapy Evidence Database (PEDro) scale. A frequentist network meta-analysis was carried out, assuming random effects, to estimate the effects of interventions for temporomandibular joint pain measured on a 10-point visual analogue scale. RESULTS Out of 3190 records identified, 17 met the inclusion criteria for qualitative analysis and eight were included in the network meta-analysis. Indirect comparisons between dry needling and manual therapy showed no significant differences in their effects on pain reduction (Odds Ratio [95%CI]; - 0.263 [- 1.517, 0.992]). The ranking of treatments shows that manual therapy (SUCRA = 0.932) followed by deep dry needling (SUCRA = 0.775) present the highest values of estimation and can be considered the most likely to reduce pain. CONCLUSIONS The results of the network meta-analysis should be considered with caution due to the low quality of the evidence available and the high variability of the study protocols in terms of the method of application of dry needling and manual therapy interventions. PROSPERO under identifier: (CRD42020186470).
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Affiliation(s)
- Ángela Menéndez-Torre
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28933, Alcorcón, Spain
- Servicio de Fisioterapia, Centro Médico Gava, 28600, Navalcarnero, Madrid, Spain
| | - Aitor Martín Pintado-Zugasti
- Departamento de Fisioterapia, Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, 28008, Madrid, Spain
| | - Juan Nicolás Cuenca Zaldivar
- Rehabilitation Service, Guadarrama Hospital, Madrid, Spain.
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute - Segovia de Arana (IDIPHISA), Madrid, Spain.
| | - Paula García-Bermejo
- DINAMIA Clinic. Alfonso VI, 28806, Alcalá de Henares, Madrid, Spain
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain
| | - Diego Gómez-Costa
- Department of Nursing and Estomatology, Faculty of Health Sciences, Rey Juan Carlos University, Avenida de Atemas s/n, Alcorcón, 28922, Madrid, Spain
| | - Miguel Molina-Álvarez
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, Madrid, Spain
| | - Alberto Arribas-Romano
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28933, Alcorcón, Spain
- Department of Physical and Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922, Madrid, Spain
| | - Josué Fernández-Carnero
- Department of Physical and Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922, Madrid, Spain
- La Paz Hospital Institute for Health Research, IdiPAZ, 28046, Madrid, Spain
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora, Universidad Rey Juan Carlos-Banco de Santander, 28922, Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023, Madrid, Spain
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Lara-Palomo IC, Gil-Martínez E, López-Fernández MD, González González LM, Querol-Zaldívar MDLÁ, Castro-Sánchez AM. Efficacy of Dry Needling for Chronic Low Back Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Altern Ther Health Med 2023; 29:110-120. [PMID: 36399082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective To evaluate the current evidence of the effectiveness of dry needling in patients with chronic low back pain (LBP). Methods PubMed, Medline, ScienceDirect, Web of Science, CINAHL and PEDro databases were searched until 2020. Study selection Randomised controlled trials (RCTs) that used dry needling as the main treatment and which included participants diagnosed with chronic LBP. Data extraction Two reviewers independently screened articles, scored methodologic quality, and extracted data. The primary outcomes were pain intensity and functional disability at post-intervention and follow-up. Results A total of 8 RCTs involving 414 patients were included in the meta-analysis. All trials examined the efficacy of DN in patients with chronic LBP. Results suggested that compared with other treatments, dry needling combined was more effective in alleviating the pain intensity of LBP post-intervention (standardised mean difference [SMD], -0.42; 95% confidence interval [CI], -0.79 to -0.05; P = .03) and at short- term (SMD -0.99, 95% CI -1.61 to -0.37, P = .002). Conclusion Current evidence showed that dry needling, especially if associated with other therapies, could be recommended to relieve the pain intensity of LBP at post-intervention and at short-term follow up. There is no evidence that dry needling alone or in combination improves disability at post-immediate or at short-term follow up. Registration This review was registered on PROSPERO (PROSPERO CRD42020215781) and was aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting systematic reviews that evaluate healthcare interventions.
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Zarrin M, Nakhostin Ansari N, Naghdi S, Hasson S, Forogh B, Rezaee M. Dry Needling for Arthrogenic Muscle Inhibition of Quadriceps Femoris in Patients after Reconstruction of Anterior Cruciate Ligament: a Protocol for a Randomized Controlled Trial. J Acupunct Meridian Stud 2023; 16:193-202. [PMID: 37885255 DOI: 10.51507/j.jams.2023.16.5.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/23/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
Background : Dry needling (DN) is recommended as a therapeutic modality for various neuromusculoskeletal disorders. No study has been performed on the impact of DN on arthrogenic muscle inhibition (AMI) after anterior cruciate ligament reconstruction (ACLR). This study protocol is aimed to investigate the impacts of DN on AMI of quadriceps femoris, corticomotor, and spinal reflex excitability in patients with ACLR. Methods : A double-blind, between-subject, randomized, controlled trial will be conducted to measure changes in AMI after DN. Twenty-four subjects with ACLR will be recruited to receive a DN or a sham DN, providing that they met the inclusion criteria. Three sessions of DN on the quadriceps femoris will be applied during a one-week period. The primary outcome measures are the active motor threshold, motor evoked potential, and Hmax - Mmax ratio. The secondary outcomes are the International Knee Documentation Committee subjective knee form questionnaire score and maximum quadriceps isometric torque. Data will be collected at baseline, immediately after the first session, after the third session, and at the one-month follow-up visit. Discussion : The results of this study will provide preliminary evidence regarding the effects of DN on AMI of quadriceps femoris in patients with ACLR.
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Affiliation(s)
- Milad Zarrin
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Tehran University of Medical Sciences, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Soofia Naghdi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Scott Hasson
- Department of Physical Therapy, Augusta University, Augusta, GA, USA
| | - Bijan Forogh
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Rezaee
- Department of Orthopedics, School of Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
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11
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Yildizgoren MT, Bagcier F. Obtaining local twitch response with ultrasound-guided dry needling. Med Ultrason 2023; 25:362-363. [PMID: 37778026 DOI: 10.11152/mu-4199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Affiliation(s)
| | - Fatih Bagcier
- Basaksehir Cam and Sakura Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Türkiye
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12
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Hernández-Secorún M, Abenia-Benedí H, Borrella-Andrés S, Marqués-García I, Lucha-López MO, Herrero P, Iguacel I, Tricás-Moreno JM, Hidalgo-García C. Effectiveness of Dry Needling in Improving Pain and Function in Comparison with Other Techniques in Patients with Chronic Neck Pain: A Systematic Review and Meta-Analysis. Pain Res Manag 2023; 2023:1523834. [PMID: 37664417 PMCID: PMC10469395 DOI: 10.1155/2023/1523834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/16/2022] [Accepted: 04/12/2023] [Indexed: 09/05/2023]
Abstract
The purpose of this systematic review and meta-analysis was to assess the short-, mid-, and long-term effectiveness of dry needling in improving pain and functional capacity of patients with chronic neck pain. Search strategy was performed on PubMed, Web of Science, Scopus, PEDro, and Cochrane Library Plus biomedical databases. The risk of bias was assessed using the RoB2 tool. Randomised controlled clinical trials in which at least 1 of the groups received dry needling were included. 662 studies were found; 14 clinical trials were selected for qualitative analysis and 13 for quantitative analysis. The quality of most of the studies included was "high." All the studies reported improvements in cervical pain and/or disability, regardless of the protocol followed and the muscles targeted. No serious adverse effects were reported. Dry needling showed to be more effective when compared with other therapies in both women and men, without differences by sex. When the analysis was carried out by age, patients over 40 years old benefitted more than those below 40 years old. Our meta-analysis supports the use of dry needling to improve pain and functional capacity in patients with chronic neck pain at short- and mid-term intervals.
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Affiliation(s)
- Mar Hernández-Secorún
- Department of Physiatry and Nursing, Faculty of Sciences, University of Zaragoza, Zaragoza, Spain
- Physiotherapy Research Unit, University of Zaragoza, Zaragoza 50009, Spain
| | - Hugo Abenia-Benedí
- Department of Physiatry and Nursing, Faculty of Sciences, University of Zaragoza, Zaragoza, Spain
- Physiotherapy Research Unit, University of Zaragoza, Zaragoza 50009, Spain
| | - Sergio Borrella-Andrés
- Department of Physiatry and Nursing, Faculty of Sciences, University of Zaragoza, Zaragoza, Spain
- Corpore 360°, Zaragoza 50008, Spain
| | | | - María Orosia Lucha-López
- Department of Physiatry and Nursing, Faculty of Sciences, University of Zaragoza, Zaragoza, Spain
- Physiotherapy Research Unit, University of Zaragoza, Zaragoza 50009, Spain
| | - Pablo Herrero
- Department of Physiatry and Nursing, Faculty of Sciences, University of Zaragoza, Zaragoza, Spain
- iHealthy Research Group, ISS Aragón, University de Zaragoza, Zaragoza 50009, Spain
| | - Isabel Iguacel
- Department of Physiatry and Nursing, Faculty of Sciences, University of Zaragoza, Zaragoza, Spain
| | - José Miguel Tricás-Moreno
- Department of Physiatry and Nursing, Faculty of Sciences, University of Zaragoza, Zaragoza, Spain
- Physiotherapy Research Unit, University of Zaragoza, Zaragoza 50009, Spain
| | - César Hidalgo-García
- Department of Physiatry and Nursing, Faculty of Sciences, University of Zaragoza, Zaragoza, Spain
- Physiotherapy Research Unit, University of Zaragoza, Zaragoza 50009, Spain
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Ickert EC, Griswold D, Learman K, Cook C. Creation of a risk of harms informed consent form for dry needling: A nominal group technique. Musculoskelet Sci Pract 2023; 66:102778. [PMID: 37290346 DOI: 10.1016/j.msksp.2023.102778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND When consenting patients to dry needling treatment, it is necessary to inform patients of potential risks of harms. OBJECTIVES The aim of this study was to identify elements and framework for an Informed Consent (IC) risk of harm statement to improve patient decision-making. DESIGN A virtual Nominal Group Technique (vNGT) methodology was used to achieve consensus among participants to identify what needs to be on a consent form, how it should be framed, and what it should state so patients understand the true risks. METHODS Eligible participants were identified as one of four groups: legal expert, policy expert, dry needling expert, or patient. The vNGT session consisted of 5 rounds of idea generation and final consensus voting which lasted for 2 h. RESULTS Five individuals consented to participate. Of the 27 original ideas, 22 reached consensus including ones specifically related to a risk of harms statement: identifying risks and discomforts, identify different sensations, and using a classification to order risks by severity. Consensus was achieved with percent agreement of ≥ 80%. The constructed risk of harm statement had a reading level of grade 7 and provided a list of stratified risks associated with dry needling. CONCLUSION The generated risk of harm statement can be incorporated on IC forms that require disclosure of risks in both the clinical and research setting. Additionally, further elements were identified by panel participants about defining the framework for an IC form outside of the risk of harm statement. CLINICALTRIALS GOV REGISTRATION NCT05560100 (29/09/22).
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Affiliation(s)
- Edmund C Ickert
- Department of Physical Therapy, Youngstown State University, 1 University Plaza, Youngstown, OH, 44555, USA.
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15
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Abbasi L, Panahi F, Zarei-Kurdshooli Z, Yazdi Yahya-Abadi F. The effect of perturbation training with and without applying the dry needling on leg muscles in patients with chronic ankle sprain. J Bodyw Mov Ther 2023; 35:233-237. [PMID: 37330775 DOI: 10.1016/j.jbmt.2023.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/30/2023] [Accepted: 04/12/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Ankle sprain is a common musculoskeletal injury that leads to recurrent instability. Repeated ankle sprain can be a mechanism for creating trigger point. Proper treatment of trigger points, in addition to preventing recurrence of sprains, may reduce pain and improve muscle function. This improvement can be the result of preserving the surrounding tissues from excessive pressure. OBJECTIVE Investigate the added value of dry needling into perturbation training protocol for chronic ankle sprain. DESIGN Randomized clinical trial; assessor-blind; before and after comparison. SETTING Treatment of patients referred to the institutional rehabilitation clinics. MAIN OUTCOME MEASURE(S) Functional assessment with FAAM questionnaire score, Pain with NPRS scale, ankle instability severity with Cumberland tool. METHODS Twenty-four patients with chronic ankle instability participated in this clinical trial and were randomly divided into two groups. Intervention was 12 sessions in which one group received only perturbation training and the other group received perturbation training along with dry needling. Repeated measures ANOVA was used to investigate the effect of treatment. RESULTS Data Analysis showed significant difference in NPRS and FAAM and Cumberland score before and after treatment in each group (P < 0.001). Comparison of the results between the groups did not show any significant difference (P > 0.05). CONCLUSION The findings showed that adding dry needling technique to the perturbation training does not have greater effects on the pain and function of patients with chronic ankle instability.
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Affiliation(s)
- Leila Abbasi
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Panahi
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Student research committee, Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zahra Zarei-Kurdshooli
- Student research committee, Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Yazdi Yahya-Abadi
- Student research committee, Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Kaur S, Maurya UK, Shenoy S. Recovery of two elite footballers from adductor strain with dry needling and eccentric strengthening: Two case studies. J Bodyw Mov Ther 2023; 35:332-336. [PMID: 37330790 DOI: 10.1016/j.jbmt.2023.04.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/10/2023] [Accepted: 04/11/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Groin injuries are common in sports, almost 68% adductor strain among them, which generally more prone in football, soccer, hockey, and other games. The available literature well describes the rehabilitation phase of adductor strain but an application of dry needling on adductor injuries are not yet established. CASE DESCRIPTION Two national-level younger football players were clinically diagnosed with the adductor strain. They had severe pain on medial aspect of the thigh, aggravated with kicking and functional activity (VAS- 8/10, LEFS 58/80, 69/80). The therapist assessed the patients and designed their rehabilitation protocol as per their findings of the examination. OUTCOME The lower extremity functional scale (LEFS), global rating scale, and VAS were used as outcome variables. The total intervention was given for 10-12 weeks, follow up had been taken for 4 months. DISCUSSION The application of dry needling reduced the pain, improved and relieved the symptoms. The eccentric strengthening of the adductors and core stability improved the strength as well as functional activity of the lower limb. The case study is not generalized the effect of treatment. Thus, a randomized control trial is suggested for further study.
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Affiliation(s)
- Sharnpreet Kaur
- MYAS-GNDU, Department of Sports Sciences and Medicine, GNDU, Amritsar, Punjab, India.
| | - Umesh Kumar Maurya
- MYAS-GNDU, Department of Sports Sciences and Medicine, GNDU, Amritsar, Punjab, India
| | - Shweta Shenoy
- MYAS-GNDU, Department of Sports Sciences and Medicine, GNDU, Amritsar, Punjab, India
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Byrne A, Lodge C, Wallace J. Design and testing the validity of an inexpensive and accessible sham dry needling protocol. J Bodyw Mov Ther 2023; 35:169-174. [PMID: 37330765 DOI: 10.1016/j.jbmt.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/12/2022] [Accepted: 04/11/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE To use a simple method of needle blunting to produce a placebo dry needling protocol which is indistinguishable from the sensations felt during therapeutic dry needling. METHODS A randomised cross-over design was used to compare the perception of needle skin penetration, pain experienced and types of sensations experienced following a single placebo dry needling and a single therapeutic dry needling application. RESULTS There were no significant differences in the proportions of patients reported ability to perceive needle penetration (p = 0.646), description of needling sensations (p = 0.3) or pain rating (p = 0.405) when comparing placebo needling to therapeutic dry needling. CONCLUSION Needle tip bending creates a simple, cost-effective and effective placebo needle for use in comparisons with therapeutic dry needling. This offers researchers a viable alternative to expensive and inappropriate acupuncture sham devices when conducting dry needling trials.
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Affiliation(s)
- A Byrne
- Department of Health and Sport Sciences, South East Technological University, Carlow, Ireland.
| | - C Lodge
- Department of Health and Sport Sciences, South East Technological University, Carlow, Ireland.
| | - J Wallace
- Department of Health and Sport Sciences, South East Technological University, Carlow, Ireland
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18
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Boz M, Sahin AA. Comparing the effectiveness of prolotherapy and percutaneous dry needling in the treatment of lateral epicondylitis: a retrospective cohort study. Eur Rev Med Pharmacol Sci 2023; 27:5596-5603. [PMID: 37401297 DOI: 10.26355/eurrev_202306_32798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
OBJECTIVE Lateral epicondylitis (LE) can result in a functional loss in patients because of pain and has recently become more prevalent. This study compared the effects of minimally invasive prolotherapy (PRO) and percutaneous dry needling (PDN) on LE treatment. PATIENTS AND METHODS Patients were divided into three groups; Group 1 included patients undergoing PDN, Group 2 included those undergoing PRO, and Group 3 included those undergoing PDN+PRO. All these treatments were administered three times and at a 3-week interval in each patient. Data on the visual analog scale (VAS) and patient-rated tennis elbow evaluation (PRTEE) scale scores of the patients were collected at weeks 0, 3, and 6 and month 6 and retrospectively analyzed. RESULTS The VAS and PRTEE scores decreased in all groups. The decrease in Group 3 was higher than that in the other groups (p<0.001). Upon evaluating within-group differences in VAS and PRTEE scores, the scores at week 3, week 6, and month 6 gradually decreased compared with the baseline in all groups (p<0.001). CONCLUSIONS PDN and PRO are minimally invasive and can successfully treat LE. A combination of PDN+PRO provides better results than PDN or PRO alone. As the materials we used in these treatments are relatively inexpensive and readily available, we believe our study will help reduce the national healthcare costs allocated for the treatment of LE.
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Affiliation(s)
- M Boz
- Department of Orthopaedic and Traumatology, Turgut Ozal University Malatya Training and Research Hospital, Malatya, Turkey.
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Becerra-Yañez P, Núñez-Cortés R, López R, Ortiz M, Pérez M, Cruz-Montecinos C. Treadmill exercise post dry needling improves heel rise in patients recovering from surgical ankle fracture: A randomised controlled trial. J Bodyw Mov Ther 2023; 34:60-65. [PMID: 37301559 DOI: 10.1016/j.jbmt.2023.04.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 01/10/2023] [Accepted: 04/12/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Little is known about the effectiveness of the dry needling technique (DNT) plus exercise on motor function in musculoskeletal diseases. OBJECTIVE To evaluate the effects of treadmill exercise immediately after DNT on pain, range of motion (ROM) and bilateral heel rise test in patients recovering from surgical ankle fracture. METHOD A randomised, parallel-group, controlled trial was conducted on patients recovering from surgical ankle fracture. Patients received the DNT intervention for the triceps surae muscle. Then, participants were randomly assigned to the experimental (DNT plus incline treadmill for 20 min) or control group (DNT plus rest for 20 min). Baseline and immediate post-intervention assessments included: visual analogue scale (VAS), maximal ankle dorsiflexion ROM and bilateral heel rise test. RESULTS A total of 20 patients recovering from surgical ankle fracture were included. Eleven patients were assigned to the experimental group (mean age 46 ± 12.6 years, 2/9 men/women) and nine to the control group (mean age 52 ± 13.4 years, 2/7 men/women). Two-way ANOVA showed a significant time × group interaction for bilateral heel rise test (F = 5.514, p = 0.030, ηp2 = 0.235). Both groups increased the number of repetitions (p < 0.001), however, the experimental group showed a significant difference compared to control group (mean difference: 2.73 repetitions; p = 0.030). There was no time × group interaction in VAS and ROM (p > 0.05). CONCLUSION Our results indicate that treadmill exercise after dry needling improves plantar flexors motor function more than rest after dry needling in patients with surgical ankle fracture.
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Affiliation(s)
- Pablo Becerra-Yañez
- Division of Research, Devolvement and Innovation in Kinesiology, Kinesiology Unit, San José Hospital, Santiago, Chile
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Ricardo López
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Morín Ortiz
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Martín Pérez
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Carlos Cruz-Montecinos
- Division of Research, Devolvement and Innovation in Kinesiology, Kinesiology Unit, San José Hospital, Santiago, Chile; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.
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20
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Temel MH, Özyiğit E. Flexor hallucis brevis' trigger point and dry needling treatment: a myofascial pain syndrome perspective on big toe pain. Med Ultrason 2023; 25:116-117. [PMID: 36996399 DOI: 10.11152/mu-3987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Affiliation(s)
| | - Elif Özyiğit
- Kanuni Sultan Süleyman Training and Research Hospital.
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21
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Shrestha D, Sharma S. Letter to the editor on, "Comparison of the effectiveness of dry needling and high-intensity laser therapy in the treatment of myofascial pain syndrome: a randomized single-blind controlled study". Lasers Med Sci 2023; 38:88. [PMID: 36935434 DOI: 10.1007/s10103-023-03752-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 03/10/2023] [Indexed: 03/21/2023]
Affiliation(s)
- Diggaj Shrestha
- Department of Musculoskeletal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, 133207, Haryana, India
| | - Sunita Sharma
- Department of Musculoskeletal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, 133207, Haryana, India.
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Swarbrigg C, Dalton B, Sheehy M, Glynn S. Dry Needling - the Life-Threatening Risk of Iatrogenic Pneumothorax. Ir Med J 2023; 116:735. [PMID: 37555791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
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Portilla G, Montero de Espinosa F. Device for Dual Ultrasound and Dry Needling Trigger Points Treatment. Sensors (Basel) 2023; 23:580. [PMID: 36679375 PMCID: PMC9865287 DOI: 10.3390/s23020580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/21/2022] [Accepted: 12/29/2022] [Indexed: 06/17/2023]
Abstract
Ultrasound is a well-known tool to produce thermal and non-thermal effects on cells and tissues. These effects require an appropriate application of ultrasound in terms of localization and acoustic energy delivered. This article describes a new device that combines ultrasound and dry needling treatments. The non-thermal effects of ultrasound should locally amplify the needle's effects. The ultrasound transducer can mechanically rotate in 3D space to align itself in the direction of the needle. The transducer electronically focuses the acoustic pressure automatically on the needle tip and its surroundings. A computer, using graphical interface software, controls the angulation of the array and the focus position.
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Fakontis C, Iakovidis P, Lytras D, Kasimis K, Koutras G, Ntinou SR, Kottaras A, Chatziprodromidou IP, Chatzikonstantinou P, Apostolou T. Efficacy of percutaneous needle electrolysis versus dry needling in musculoskeletal pain: A systematic review and meta-analysis. J Back Musculoskelet Rehabil 2023; 36:1033-1046. [PMID: 37458028 DOI: 10.3233/bmr-220408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Physical therapists use dry needling (DN) and percutaneous needle electrolysis (PNE) to treat musculoskeletal pain. OBJECTIVE To investigate the efficacy of PNE vs. DN in the treatment of musculoskeletal pain. METHODS This systematic review and meta-analysis was based on the PICOS and PRISMA protocols. The PubMed, PEDro, Cochrane Library, SCOPUS, and Google Scholar databases were searched for randomized clinical trials measuring pain intensity in various musculoskeletal syndromes using PNE and DN. Pain outcome measures were the visual analog scale or the numerical pain rating scale. Risk of bias was assessed according to Cochrane guidelines and quality of evidence was reported using the Grading of Recommendations Assessment, Development, and Evaluation approach (GRADE). Standardized mean differences were calculated using random effects models. RESULTS The meta-analysis of the six included studies showed that the overall effect of PNE vs. DN for pain reduction was statistically significant at -0.74 (95% confidence interval [CI], -1.34 to -0.14) with a large effect size (SMD =-0.41; 95% CI, -0.75 to -0.08), albeit clinically insignificant in the short, medium, and long term. Risk of bias was generally low with moderate-level evidence due to the overall effect heterogeneity and the small sample. CONCLUSIONS Moderate-quality evidence showed that PNE is slightly more effective than DN in reducing pain. However, because the results were not clinically significant, we cannot recommend the application of PNE over DN. More high-quality studies comparing the two interventions are needed to draw firm conclusions.
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Ahi ED, Sirzai H. Comparison of the effectiveness of dry needling and high-intensity laser therapy in the treatment of myofascial pain syndrome: a randomized single-blind controlled study. Lasers Med Sci 2022; 38:3. [PMID: 36538189 DOI: 10.1007/s10103-022-03687-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/12/2022] [Indexed: 12/24/2022]
Abstract
Myofascial pain syndrome (MPS) is a very common disease in the population that seriously affects quality of life. Although many treatment modalities are used, there is still no common protocol. The aim of this study was to compare the effectiveness of high-intensity laser therapy (HILT) and dry needling options. This prospective study included 108 patients with neck and/or upper back pain, diagnosed with MPS, who were randomly separated into 3 groups: the exercise group, the exercise + HILT group (HILT group), and the exercise + dry needling group (needling group). The visual analog scale (VAS), neck disability index (NDI), short form-36 (SF-36) scores, and neck range of motion (ROM) values of the patients before and after treatment were recorded and compared between the groups. In all 3 groups, the VAS and NDI scores decreased and ROM levels increased after treatment. The results in the HILT and needling groups were statistically significantly better than those of the exercise group (p < 0.05).The addition of HILT and dry needling to exercises is seen as a more successful treatment option to reduce pain in MPS. Clinical trial registration number: NCT05078333.
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Affiliation(s)
- Emine Dundar Ahi
- Faculty of Health Sciences, Physiotherapy and Rehabilitation, Kocaeli Health and Technology University, Private Medar Hospital, Yeniköy Mahallesi Ilıca Caddesi No:29, Başiskele, Kocaeli, Turkey.
| | - Hulya Sirzai
- Private Romatem Hospital Physical Medicine and Rehabilitation Department, Fulya, Hakkı Yeten Cd. No:9 Kat:1, 34365, Şişli, Istanbul, Turkey
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Khanittanuphong P, Saesim A. Comparison of the effectiveness between dry needling with and without needle retention in myofascial trigger points in upper trapezius muscle: A randomized comparative trial. J Back Musculoskelet Rehabil 2022; 35:1247-1255. [PMID: 35570477 DOI: 10.3233/bmr-210177] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Dry needling (DN) is commonly used to treat myofascial trigger points (MTrPs). OBJECTIVE To compare the effect between DN with and without needle retention in the treatment of MTrPs in the upper trapezius muscle. METHODS Fifty-four patients who had active MTrPs in the upper trapezius muscle were randomly allocated into the DN group or the DN with retention group. The DN group received DN only, while the DN with retention group received DN with needle retention for 30 minutes. The visual analogue scale (VAS) and pressure pain threshold (PPT) were recorded both before and after 7 and 14 days of the treatment sessions. RESULTS Both groups showed a significant decrease of the VAS at 7 and 14 days (mean difference DN group -53.0, DN with retention group -57.0, p< 0.001). The PPT was also significantly improved in both groups (mean difference DN group 109.8 kPa, DN with retention group 132.3 kPa, p< 0.001). However, there were no significant differences in the VAS or PPT between the groups. CONCLUSIONS Both DN and DN with retention had significant improvement of pain intensity in the treatment of MTrPs in the upper trapezius muscle at 14 days. However, pain reduction was not significantly different between the interventions.
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Khalifeloo M, Naghdi S, Ansari NN, Dommerholt J, Sahraian MA. Dry needling for the treatment of muscle spasticity in a patient with multiple sclerosis: a case report. Physiother Theory Pract 2022; 38:3248-3254. [PMID: 34546842 DOI: 10.1080/09593985.2021.1978118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Spasticity is a common cause of disability in multiple sclerosis (MS), which can negatively affect the patient's walking and balance. OBJECTIVE To evaluate the immediate effect of dry needling (DN) on spasticity and mobility in a female with MS. CASE DESCRIPTION In this case, a 38-year-old female with a 4-year history of MS was treated. The hamstring muscles (biceps femoris and semitendinosus) were needled for 1 minute in a single session. The main outcome measures were the Modified Modified Ashworth Scale (MMAS) to evaluate spasticity, the Timed 25-Foot Walk (T25FW) for the assessment of mobility and leg function performance, and stiffness as a biomechanical index of spasticity measured by a dynamometer. The assessments were done before and immediately after DN. OUTCOMES The MMAS scores decreased in the hamstrings (1 to 0) and quadriceps (2 to 1). The mobility improved as the time for T25FW decreased from 16.30 to 9.29 seconds. The stiffness of hamstring decreased after treatment (0.451 to 0.312). CONCLUSION One session of DN for the hamstring muscle decreased spasticity and improved mobility in this patient with MS. Further studies are suggested.
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Affiliation(s)
- Maede Khalifeloo
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Soofia Naghdi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Ali Sahraian
- Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran, Iran
- Sina Ms Research Center, Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Tang L, Liu S, Gan L, Ding H, Huang QM, Gao F, Li Y. Effects of dry needling intervention on lower limb dysfunction after stroke: study protocol for a randomised controlled trial. BMJ Open 2022; 12:e062494. [PMID: 36288843 PMCID: PMC9615970 DOI: 10.1136/bmjopen-2022-062494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Lower limb dysfunction is among the common sequelae of patients who had a poststroke and often results in the reduction of the quality of life. This study aims to assess the short and interim-term efficacy of dry needling (DN) intervention on lower extremity function, balance and gait in lower limb dysfunction after stroke. METHODS AND ANALYSIS This protocol entails an assessor and statistician-blinded, single-centre study with a randomised controlled trial. Forty-four patients who had a poststroke will be randomly allocated (1:1) to either the conventional treatment group (n=22) or the DN group (n=22). The conventional treatment group will receive conventional rehabilitation treatment once a day for 40 min each time. The treatment will be performed five times a week for 2 weeks. In the DN group, participants will be treated with DN on the basis of the conventional treatment. The intervention will be performed thrice a week for 2 weeks. The primary outcome that determines the efficacy of lower limb dysfunction will be the change in the Fugl-Meyer Assessment of Lower Extremity scale. The secondary indicators include the range of motion of knee and ankle joints, limits of stability, modified Clinical Test of Sensory Interaction on Balance, Timed Up and Go test, Modified Ashworth Scale and Barthel Index. Results will be evaluated at baseline, at 24 hours after intervention, at 2 weeks after intervention and at 3-month follow-up. Data will be released after the completion of the study. Adverse events will be reported. ETHICS AND DISSEMINATION The experiment was approved by the Ethical Committee of Shanghai Tong Ren Hospital in October 2021 (approval number: 202105702). The results of this study will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ChiCTR2000040754.
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Affiliation(s)
- Li Tang
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shanshan Liu
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Gan
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hao Ding
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiang-Min Huang
- Department of Sport Rehabilitation, School of kinesiology, Shanghai University of Sport, Shanghai, China
| | - Fang Gao
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Li
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Valera-Calero JA, Varol U, Plaza-Manzano G, Fernández-de-las-Peñas C, Agudo-Aguado A. Regression Model Decreasing the Risk of Femoral Neurovascular Bundle Accidental Puncture. Tomography 2022; 8:2498-2507. [PMID: 36287807 PMCID: PMC9611046 DOI: 10.3390/tomography8050208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022] Open
Abstract
Although most of the adverse events derived from dry needling are minor, avoiding potential hazards for patients including accidental invasion of vessels, ganglia, and nerves is essential to ensure patients’ safety. We aimed to investigate the contribution of predictors explaining the variance of sartorius muscle depth limit at proximal third and middle thigh as these locations lead to an augmented risk of neurovascular bundle invasion during dry needling application. A diagnostic study was conducted on 84 subjects to calculate the accuracy of a prediction model for sartorius depth, as assessed with ultrasound imaging, based on sex, age, height, weight, body mass index (BMI), thigh perimeter, and length. After calculating a correlation matrix, a multiple linear regression analysis was performed to detect those variables contributing to the sartorius deep limit in both locations. Although males showed greater thigh perimeter than women (p < 0.001), the deep limit of the sartorius muscle was significantly more superficial for both the proximal third (p = 0.003) and the mid-third (p = 0.004) points. No side-to-side anthropometric differences were found (p > 0.05). In addition, we found sartorius muscle depth to be associated with the proximal and mid-third girth, gender, height, and BMI (all, p < 0.01). Gender, proximal-third girth, and BMI explained 51.1% and 42.6% of the variance for the sartorius deep limit at the proximal and the mid-third, respectively. This study analyzed whether anthropometric features could predict sartorius muscle depth in healthy participants for assisting clinicians in choosing the optimal needle length to avoid accidental femoral bundle puncture.
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Affiliation(s)
- Juan Antonio Valera-Calero
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, 28692 Madrid, Spain
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, 28692 Madrid, Spain
| | - Umut Varol
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, 28692 Madrid, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-913-941-545
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Adolfo Agudo-Aguado
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, 28692 Madrid, Spain
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Pang JCY, Fu ASN, Lam SKH, Peng B, Fu ACL. Ultrasound-guided dry needling versus traditional dry needling for patients with knee osteoarthritis: A double-blind randomized controlled trial. PLoS One 2022; 17:e0274990. [PMID: 36178946 PMCID: PMC9524650 DOI: 10.1371/journal.pone.0274990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/15/2022] [Indexed: 12/05/2022] Open
Abstract
Objective To compare the effect of ultrasound (US)-guided dry needling (DN) with traditional DN in the treatment of pain and dysfunction for patients with knee osteoarthritis (KOA). Design A double-blind, randomized controlled trial. Methods Patients (25 male and 65 female), age 50–80 years diagnosed with KOA were recruited and randomly assigned to one of three groups in a 1:1:1 ratio for intervention: real US-guided DN with exercise therapy (G1), placebo US-guided DN with exercise therapy (G2), and exercise therapy solely (G3). G1 and G2 were blinded to the application of real or placebo US guidance by turning the monitor of US imaging out-of-view from participants’ vantage points. The effectiveness of blinding was evaluated by asking the participants whether they had received real-US guided DN. The responses were assessed by Chi-square test. Visual Analogue Scale (VAS), Knee injury, and Osteoarthritis Outcome Score (KOOS) subscales (KOOS-pain, KOOS-symptoms, KOOS-quality-of-life (QoL)) were collected at baseline, 4 weeks, and 8 weeks by a blinded assessor. Data were analyzed by mixed model analysis of variance (ANOVA) with Bonferroni correction. Results Eighty-four participants (61.26±5.57 years) completed the study. G1 achieved significant improvement in VAS at 8 weeks compared to G2 and G3 (G1 vs. G2: MD = -15.61, 95% CI [-25.49, -5.51], p = 0.001; G1 vs. G3: MD = -19.90, 95% CI [-29.71, -10.08], p< 0.001). G1 achieved significant improvement in KOOS-pain at 8 weeks compared to G2 and G3 (G1 vs. G2: MD = 9.76, 95% CI [2.38, 17.14], p = 0.006; G1 vs. G3: MD = 9.48, 95% CI [2.31, 16.66], p = 0.010). KOOS-symptoms and KOOS-QoL were not statistically significant between groups. G2 had no significant difference of the perceptions as G1 with p = 0.128. G2 were successfully blinded to placebo US-guided DN. Conclusion US-guided DN with exercise therapy may be more effective than traditional DN with exercise therapy or exercise therapy alone in reduce pain of KOA.
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Affiliation(s)
- Johnson C. Y. Pang
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong, China
- * E-mail:
| | - Amy S. N. Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Stanley K. H. Lam
- The Hong Kong Institute of Musculoskeletal Medicine, Hong Kong, China
- Department of Family Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Department of Family Medicine, The University of Hong Kong, Hong Kong, China
| | - B. Peng
- Department of Rehabilitation Medicine, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Allan C. L. Fu
- Discipline of Physiotherapy, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
- Musculoskeletal Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, Australia
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Álvarez SD, Velázquez Saornil J, Sánchez Milá Z, Jaén Crespo G, Campón Chekroun A, Barragán Casas JM, Frutos Llanes R, Rodríguez Sanz D. Effectiveness of Dry Needling and Ischemic Trigger Point Compression in the Gluteus Medius in Patients with Non-Specific Low Back Pain: A Randomized Short-Term Clinical Trial. Int J Environ Res Public Health 2022; 19:12468. [PMID: 36231767 PMCID: PMC9564974 DOI: 10.3390/ijerph191912468] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The presence of latent myofascial trigger points (MTrPs) in the gluteus medius is one of the possible causes of non-specific low back pain. Dry needling (DN) and ischemic compression (IC) techniques may be useful for the treatment of these MTrPs. METHODS For this study, 80 participants were randomly divided into two groups: the dry needling group, who received a single session of DN to the gluteus medius muscle plus hyperalgesia (n = 40), and the IC group, who received a single session of IC to the gluteus medius muscle plus hyperalgesia (n = 40). Pain intensity, the pressure pain threshold (PPT), range of motion (ROM), and quality of life were assessed at baseline, immediately after treatment, after 48 h, and one week after treatment. RESULTS Statistically significant differences were shown between the two groups immediately after the intervention, showing a decrease in PPT (p < 0.05) in the DN group and an increase in PPT in the IC group. These values increased more and were better maintained at 48 h and after one week of treatment in the DN group than in the IC group. Quality of life improved in both groups, with greater improvement in the DN group than in the IC group. CONCLUSIONS IC could be more advisable than DN with respect to UDP and pain intensity in the most hyperalgesic latent MTrPs of the gluteus medius muscle in subjects with non-specific low back pain, immediately after treatment. DN may be more effective than IC in terms of PPT, pain intensity, and quality of life in treating latent plus hyperalgesic gluteus medius muscle MTrPs in subjects with non-specific low back pain after 48 h and after one week of treatment.
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Affiliation(s)
| | | | | | - Gonzalo Jaén Crespo
- Department of Physiotherapy, Universidad Europea de Madrid, 28670 Madrid, Spain
| | | | | | - Raúl Frutos Llanes
- Department of Physiotherapy, Universidad Católica de Ávila, 05005 Ávila, Spain
| | - David Rodríguez Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Sánchez Milá Z, Velázquez Saornil J, Campón Chekroun A, Barragán Casas JM, Frutos Llanes R, Castrillo Calvillo A, López Pascua C, Rodríguez Sanz D. Effect of Dry Needling Treatment on Tibial Musculature in Combination with Neurorehabilitation Treatment in Stroke Patients: Randomized Clinical Study. Int J Environ Res Public Health 2022; 19:12302. [PMID: 36231604 PMCID: PMC9564520 DOI: 10.3390/ijerph191912302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Introducing ultrasound-guided dry needling to neurorehabilitation treatments increases the beneficial effects of therapy. The aim of this study was to compare the effects of including an ultrasound-guided dry needling session in neurorehabilitation treatment on spasticity and gait-balance quality versus neurorehabilitation treatment in subjects who had suffered a stroke. (2) Methods: A single-blind, randomized clinical trial was conducted. Thirty-six patients who had suffered a stroke in the right middle cerebral artery signed the informed consent for participation in the study. Twenty patients finally participated and were randomly assigned to the control group (neurorehabilitation treatment) or experimental group (neurorehabilitation treatment plus ultrasound-guided dry needling). Pre-treatment and post-treatment data were collected on the same day. The experimental group (n = 10) first underwent an ultrasound-guided dry needling intervention on the tibialis anterior and tibialis posterior musculature, followed by neurorehabilitation treatment; the control group (n = 10) underwent their corresponding neurorehabilitation without the invasive technique. Pre-treatment and post-treatment measurements were taken on the same day, assessing the quality of balance-gait using the "Up and Go" test and the degree of spasticity using the Modified Modified Ashworth Scale. (3) Results: The patients who received neurorehabilitation treatment plus ultrasound-guided dry needling showed a greater decrease in spasticity in the tibial musculature after the neurorehabilitation treatment session (p < 0.001), improving balance and gait (p < 0.001). (4) Conclusions: An ultrasound-guided dry needling session combined with neurorehabilitation treatment reduced spasticity and improved balance and gait in stroke patients.
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Affiliation(s)
| | | | | | | | | | | | | | - David Rodríguez Sanz
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
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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. Int J Environ Res 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Saornil JV, Sánchez Milá Z, Campón Chekroun AM, Baraja Vegas L, Vicente Mampel J, Frutos Llanes R, Barragán Casas JM, Rodríguez-Sanz D. Comparative Study of the Efficacy of Hyaluronic Acid, Dry Needling and Combined Treatment in Patellar Osteoarthritis-Single-Blind Randomized Clinical Trial. Int J Environ Res Public Health 2022; 19:10912. [PMID: 36078628 PMCID: PMC9517789 DOI: 10.3390/ijerph191710912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/21/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Background: Osteoarthritis of the knee is one of the most common ailments worldwide, and pain management of this condition is critical. Methods: A multicentre randomized controlled trial RCT with three months of follow-up, conducted in parallel groups: hyaluronic acid (HA), dry needling (DN) and ultrasound (US) and isometrics of quadriceps. 60 participants took part in the RCT who were diagnosed with osteoarthritis (Grade 3) of the knee by MRI and active adults (age: 23.41 ± 1.68 years; height: 1.79 ± 0.08 m; body mass: 78.33 ± 9.03 kg; body mass index (BMI): 24.14 ± 1.45 kg/m2). After the assigned intervention, VAS, WOMAC, IPAQ and the Star Excursion Balance test were measured at baseline. At 24 h, 15 days, 30 days, 90 days and 180 days follow-up, all variables were measured again. Results: Comparing statistically significant differences between groups, VAS scores were significant at post-test measurement (HA vs. US + isometric and DN vs. US + isometric) at 24 h (HA vs. DN), at 15 days (HA vs. US + isometric and DN vs. US + isometric) and at 1 month (US + isometric vs. HA and US + isometric vs. DN). Conclusions: There is an improvement in pain intensity in knee osteoarthritis in the short term in patients undergoing DN and conventional US + isometric treatment, but in the long term the HA group shows an improvement in pain intensity. There is also a significant difference in the improvement of knee function at different phases of the study in the various intervention groups. The combination of DN and HA in clinical practice is the best option for the treatment of osteoarthritis.
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Affiliation(s)
- Jorge Velázquez Saornil
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, C/Canteros s/n, 05005 Ávila, Spain
| | - Zacarías Sánchez Milá
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, C/Canteros s/n, 05005 Ávila, Spain
| | | | - Luis Baraja Vegas
- Departamento de Fisioterapia, Facultad de Medicina y Ciencias de la Salud, Universidad Católica de Valencia, C/Quevedo, 2, 46001 Valencia, Spain
| | - Juan Vicente Mampel
- Departamento de Fisioterapia, Facultad de Medicina y Ciencias de la Salud, Universidad Católica de Valencia, C/Quevedo, 2, 46001 Valencia, Spain
| | - Raúl Frutos Llanes
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, C/Canteros s/n, 05005 Ávila, Spain
| | - José Manuel Barragán Casas
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, C/Canteros s/n, 05005 Ávila, Spain
| | - David Rodríguez-Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Avenida Séneca, 2, 28040 Madrid, Spain
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Valera-Calero JA, Fernández-de-las-Peñas C, Navarro-Santana MJ, Plaza-Manzano G. Efficacy of Dry Needling and Acupuncture in Patients with Fibromyalgia: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2022; 19:ijerph19169904. [PMID: 36011540 PMCID: PMC9408486 DOI: 10.3390/ijerph19169904] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/20/2022] [Accepted: 07/25/2022] [Indexed: 06/01/2023]
Abstract
Fibromyalgia (FM) is a syndrome that involves chronic pain, fatigue, sleep disturbance and impaired quality of life and daily functioning. In addition to medical and psychological therapies, other therapies including acupuncture and dry needling aim to reduce pain and disability in patients with FM. The aim of this study was to investigate the efficacy of dry needling and acupuncture in patients with FM regarding pain, function and disability in both the short and the long term. MEDLINE, PubMed, SCOPUS and Web of Science databases were systematically searched for randomized controlled trial studies evaluating efficacy data of dry needling or/and acupuncture treatments to improve pain, fatigue, sleep disturbance and impaired quality of life and/or daily function. A qualitative analysis including the methodological quality and a systematic data synthesis was performed. A total of 25 studies addressed the selection criteria. Most studies had an acceptable methodological quality. Four studies assessed the effect of dry needling, and twenty-one studies assessed the effect of acupuncture. In general, both interventions improved pain, anxiety, depression, fatigue, stiffness, quality of sleep and quality of life. However, both techniques were not compared in any study. Acupuncture and dry needling therapies seems to be effective in patients with FM, since both reduced pain pressure thresholds, anxiety, depression, fatigue, sleep disturbances and disability in the short term. It is still required to compare both techniques and their application in the long term.
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Affiliation(s)
- Juan Antonio Valera-Calero
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, 28692 Villanueva de la Cañada, Spain
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28933 Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28933 Alcorcón, Spain
| | | | - Gustavo Plaza-Manzano
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Vázquez-Justes D, Yarzábal-Rodríguez R, Doménech-García V, Herrero P, Bellosta-López P. Effectiveness of dry needling for headache: A systematic review. Neurologia (Engl Ed) 2022; 37:806-815. [PMID: 35659858 DOI: 10.1016/j.nrleng.2019.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/16/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Non-pharmacological treatment of patients with headache, such as dry needling (DN), is associated with less morbidity and mortality and lower costs than pharmacological treatment. Some of these techniques are useful in clinical practice. The aim of this study was to review the level of evidence for DN in patients with headache. METHODS We performed a systematic review of randomised clinical trials on headache and DN on the PubMed, Web of Science, Scopus, and PEDro databases. Methodological quality was evaluated with the Spanish version of the PEDro scale by 2 independent reviewers. RESULTS Of a total of 136 studies, we selected 8 randomised clinical trials published between 1994 and 2019, including a total of 577 patients. Two studies evaluated patients with cervicogenic headache, 2 evaluated patients with tension-type headache, one study assessed patients with migraine, and the remaining 3 evaluated patients with mixed-type headache (tension-type headache/migraine). Quality ratings ranged from low (3/10) to high (7/10). The effectiveness of DN was similar to that of the other interventions. DN was associated with significant improvements in functional and sensory outcomes. CONCLUSIONS Dry needling should be considered for the treatment of headache, and may be applied either alone or in combination with pharmacological treatments.
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Affiliation(s)
- D Vázquez-Justes
- Departamento de Neurología, Hospital Universitari Arnau Vilanova, Lleida, Spain
| | | | - V Doménech-García
- Universidad San Jorge, Grupo de investigación iPhysio, Villanueva de Gállego, Zaragoza, Spain
| | - P Herrero
- Universidad San Jorge, Grupo de investigación iPhysio, Villanueva de Gállego, Zaragoza, Spain.
| | - P Bellosta-López
- Universidad San Jorge, Grupo de investigación iPhysio, Villanueva de Gállego, Zaragoza, Spain
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Sánchez-Infante J, Bravo-Sánchez A, Jiménez F, Abián-Vicén J. Authors' reply to the comment on "Effects of dry needling on mechanical and contractile properties of the upper trapezius with latent myofascial trigger points: A randomized controlled trial". Musculoskelet Sci Pract 2022; 59:102525. [PMID: 35177370 DOI: 10.1016/j.msksp.2022.102525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 11/18/2022]
Affiliation(s)
- J Sánchez-Infante
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain; Hospital Universitario de Toledo, Castilla La Mancha, Toledo, Spain
| | - A Bravo-Sánchez
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - F Jiménez
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - J Abián-Vicén
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain.
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Tang CT, Song B. Acupuncture and Dry Needling for Sports Performance and Recovery. Curr Sports Med Rep 2022; 21:213-218. [PMID: 35703748 DOI: 10.1249/jsr.0000000000000968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Acupuncture and dry needling share many similarities in their proposed mechanisms of action and their sports medicine-related applications. Pain is the most common indication for these needling treatments, but there also are some limited studies on their use for ergogenic purposes. Needling can likely improve muscular strength and power, including increasing jump height, and it also can increase flexibility. In terms of sports recovery, acupuncture can not only be used for pain relief after injury, but also can help with routine recovery, such as in delayed onset muscle soreness. There are numerous case reports of acupuncture and dry needling being used to treat athletes for various diagnoses and conditions, however more high quality studies are needed in order to make more specific evidence-based recommendations. Given the high degree of safety and limited adverse events associated with needling treatments, it can likely be promoted in athletes.
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Affiliation(s)
- Chi-Tsai Tang
- Division of Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO
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Vervullens S, Meert L, Baert I, Delrue N, Heusdens CHW, Hallemans A, Van Criekinge T, Smeets RJEM, De Meulemeester K. The effect of one dry needling session on pain, central pain processing, muscle co-contraction and gait characteristics in patients with knee osteoarthritis: a randomized controlled trial. Scand J Pain 2022; 22:396-409. [PMID: 34821140 DOI: 10.1515/sjpain-2021-0091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/07/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To assess the immediate and three days postintervention effect of one dry needling session compared to one sham needling session on pain, central pain processing, muscle co-contraction and spatiotemporal parameters during gait in knee osteoarthritis patients. METHODS A double-blind randomized controlled trial was conducted. Sixty-one knee osteoarthritis patients were randomly assigned to the dry needling or sham needling group. Primary outcomes were pain and central pain processing. Secondary outcomes included muscle co-contraction and spatiotemporal parameters during gait. Patients were assessed at baseline and 15 min after the intervention, and pain also three days after the intervention. Linear mixed models were used to examine between- and within-group differences. RESULTS No significant between-group differences for pain were found, but within-group scores showed a significant decrease 15 min after sham needling and three days after dry needling. The mean conditioned pain modulation effect measured at the m. Trapezius worsened significantly 15 min after sham needling compared to after dry needling (between-group difference). However, individual conditioned pain modulation percentage scores remained stable over time. Various significant within-group differences were found 15 min after sham needling: a decrease of conditioned pain modulation measured at m. Quadriceps and m. Trapezius and stride- and step-time scores, and an increase in step length and widespread pain pressure threshold. A significant decrease in muscle co-contraction index of the m. Vastus Medialis and Semitendinosus was found as within-group difference 15 min after dry needling. CONCLUSIONS Dry needling has no larger effect on pain, central pain processing, muscle co-contraction and gait pattern 15 min and three days postintervention compared to sham needling. Mean conditioned pain modulation scores worsened after sham needling compared to after dry needling. Further research remains necessary.
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Affiliation(s)
- Sophie Vervullens
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
- Pain in Motion International Research Group (PiM), www.paininmotion.be, Antwerp, Belgium
| | - Lotte Meert
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
- Pain in Motion International Research Group (PiM), www.paininmotion.be, Antwerp, Belgium
| | - Isabel Baert
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
- Pain in Motion International Research Group (PiM), www.paininmotion.be, Antwerp, Belgium
| | | | | | - Ann Hallemans
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
| | - Tamaya Van Criekinge
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
- Department of Rehabilitation Sciences, Catholic University of Leuven, Campus Bruges, Bruges, Belgium
| | - Rob J E M Smeets
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
- CIR Revalidatie, Eindhoven, The Netherlands
| | - Kayleigh De Meulemeester
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group (PiM), www.paininmotion.be, Antwerp, Belgium
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Dalton B, Swarbrigg C, Raman V, Sheehy M, Glynn S. Acupuncture-D" - Bilateral Pneumothoraces Following Dry Needling. Ir Med J 2022; 115:546. [PMID: 35420007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Presentation A 24-year-old newly graduated junior doctor presented to the emergency department with acute onset chest pain, haemoptysis and exertional dyspnoea following a dry needling session. Diagnosis Chest x-ray showed bilateral pneumothoraces, worse on the right side. Treatment The bilateral pneumothoraces were treated conservatively with supplemental oxygen initially. On the second day of admission, repeat chest x-ray demonstrated a worsening right sided pneumothorax. While vitally stable, the patient however had become increasingly dyspnoeic, and a needle aspiration was performed on the right side with good effect. Conclusion The anatomical location targeted along with the patients low-normal BMI makes her high-risk when considering the skin-to-pleura distance. Although the incidence of pneumothorax is low, it is imperative that we improve awareness both for the treating physician and the diagnosing clinician. We must begin to fill the distinct lack in available literature surrounding the potential adverse effects of dry needling.
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Affiliation(s)
- B Dalton
- Respiratory Dept, Midlands Regional Hospital, Mullingar, Westmeath, Ireland
| | - C Swarbrigg
- Respiratory Dept, Midlands Regional Hospital, Mullingar, Westmeath, Ireland
| | - V Raman
- Department of Radiology, Midlands Regional Hospital, Mullingar, Westmeath, Ireland
| | - M Sheehy
- Respiratory Dept, Midlands Regional Hospital, Mullingar, Westmeath, Ireland
| | - S Glynn
- Respiratory Dept, Midlands Regional Hospital, Mullingar, Westmeath, Ireland
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Babazadeh-Zavieh SS, Ansari NN, Ghotbi N, Naghdi S, Mansouri K, Khanmohammadi M, Haeri SMJ. Effects of dry needling plus exercise therapy on post-stroke spasticity and motor function: A case report. Complement Ther Clin Pract 2022; 46:101520. [PMID: 34875580 DOI: 10.1016/j.ctcp.2021.101520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/14/2021] [Accepted: 11/27/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND PURPOSE The use of dry needling (DN) with other treatments may be more beneficial in managing post-stroke spasticity. We report the effects of DN plus exercise therapy (ET) on wrist flexor spasticity. PATIENT PRESENTATION The patient was a 45-year-old man with an 8-year history of stroke. The outcome measures included the Modified Modified Ashworth Scale (MMAS), Hmax/Mmax ratio, H-reflex latency, Action Research Arm Test (ARAT), Fugl-Meyer Assessment (FMA), and range of motion (ROM) which were assessed before (T1), after (T2), and after 3-week follow-up (T3). CONCLUSION The MMAS was improved at T2 from "3" to "2". The Hmax/Mmax decreased from 0.77 to 0.53 at T3. The H-reflex latency increased from 15.4 ms to 18.5 ms at T3. The wrist active and passive ROM increased ∼30° and ∼20° at T2, respectively. A 4-session DN plus ET may improve spasticity and ROM. No meaningful improvement was observed in function.
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Affiliation(s)
| | - Noureddin Nakhostin Ansari
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran; Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Nastaran Ghotbi
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | - Soofia Naghdi
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Korosh Mansouri
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Khanmohammadi
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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De Meulemeester K, Calders P, Cagnie B. Exploring the Underlying Mechanisms of Action of Dry Needling: What Is the Immediate Effect on Muscle Electrophysiology? An Experimental Randomized Controlled Trial. Am J Phys Med Rehabil 2022; 101:18-25. [PMID: 34915542 DOI: 10.1097/phm.0000000000001732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Dry needling is a commonly used treatment technique for myofascial pain syndromes, such as trapezius myalgia. Despite the shown positive clinical effects on pain, the underlying mechanisms of action, such as the effect on muscle electrophysiology, remain unclear. The aim of this study was to investigate the effect of dry needling, compared with sham needling, in the upper trapezius muscle on surface electromyography activity and the relation with pain in office workers with trapezius myalgia. DESIGN For this experimental randomized controlled trial, 43 office workers with work-related trapezius myalgia were included. Surface electromyography activity was measured before and after a pain-provoking computer task and immediately after, 15, and 30 mins after treatment with dry or sham needling. Pain scores were evaluated at the same time points as well as 1, 2, and 7 days after treatment. RESULTS No significant differences in surface electromyography activity between dry needling and sham needling were found. Significant positive low to moderate Spearman correlations were found between surface electromyography activity and pain levels after dry needling treatment. CONCLUSIONS This study shows no immediate effects of dry needling on the electrophysiology of the upper trapezius muscle, compared with sham needling.
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Murillo C, Treleaven J, Cagnie B, Peral J, Falla D, Lluch E. Effects of dry needling of the obliquus capitis inferior on sensorimotor control and cervical mobility in people with neck pain: A double-blind, randomized sham-controlled trial. Braz J Phys Ther 2021; 25:826-836. [PMID: 34535409 PMCID: PMC8721073 DOI: 10.1016/j.bjpt.2021.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 06/14/2021] [Accepted: 07/30/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Impairments of sensorimotor control relating to head and eye movement control and postural stability are often present in people with neck pain. The upper cervical spine and particularly the obliquus capitis inferior (OCI) play an important proprioceptive role; and its impairment may alter cervical sensorimotor control. Dry needling (DN) is a valid technique to target the OCI. OBJECTIVES To investigate if a single DN session of the OCI muscle improves head and eye movement control-related outcomes, postural stability, and cervical mobility in people with neck pain. METHODS Forty people with neck pain were randomly assigned to receive a single session of DN or sham needling of the OCI. Cervical joint position error (JPE), cervical movement sense, standing balance and oculomotor control were examined at baseline, immediately post-intervention, and at one-week follow-up. Active cervical rotation range of motion and the flexion rotation test were used to examine the global and upper cervical rotation mobility, respectively. RESULTS Linear mixed-models revealed that the DN group showed a decrease of JPE immediately post-intervention compared to the sham group (mean difference [MD]= -0.93°; 95% confidence interval [CI]: -1.85, -0.02) which was maintained at one-week follow-up (MD= -1.64°; 95%CI: -2.85, -0.43). No effects on standing balance or cervical movement sense were observed in both groups. Upper cervical mobility showed an increase immediately after DN compared to the sham group (MD= 5.14°; 95%CI: 0.77, 9.75) which remained stable at one-week follow-up (MD= 6.98°; 95%CI: 1.31, 12.40). Both group showed an immediate increase in global cervical mobility (MD= -0.14°; 95%CI: -5.29, 4.89). CONCLUSION The results from the current study suggest that a single session of DN of the OCI reduces JPE deficits and increases upper cervical mobility in patients with neck pain. Future trials should examine if the addition of this technique to sensorimotor control training add further benefits in the management of neck pain.
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Affiliation(s)
- Carlos Murillo
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Pain in Motion International Research Group, Brussels, Belgium.
| | - Julia Treleaven
- Division of Physiotherapy, SHRS, University of Queensland, Brisbane, Australia
| | - Barbara Cagnie
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Javier Peral
- Department of Physical Therapy, University of Alcala, Madrid, Spain; Department of Physical Therapy, University of Valencia, Valencia, Spain
| | - Deborah Falla
- Center of Precision Rehabilitation for Spinal Pain, School of Sport, exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Enrique Lluch
- Pain in Motion International Research Group, Brussels, Belgium; Department of Physical Therapy, University of Valencia, Valencia, Spain
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Rodríguez-Sanz J, Pérez-Bellmunt A, López-de-Celis C, Hidalgo-García C, Koppenhaver SL, Canet-Vintró M, Fernández-de-Las-Peñas C. Accuracy and safety of dry needling placement in the popliteus muscle: A cadaveric study. Int J Clin Pract 2021; 75:e14669. [PMID: 34324778 DOI: 10.1111/ijcp.14669] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 07/26/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The popliteus muscle attaches posteriorly to the joint capsule of the knee. Although it is an important rotational stabiliser and has been implicated in various knee pathologies, research on its treatment with dry needling is scarce. OBJECTIVE To determine if a needle accurately and safely penetrates the popliteus muscle during the clinical application of dry needling. METHODS A cadaveric descriptive study was conducted. Needling insertion of the popliteus muscle was conducted in 11 cryopreserved cadavers with a 50-mm needle. The needle was inserted at upper third of the posterior part of the tibia closest to the knee towards the popliteus. The needle was advanced into the muscle based upon clinician judgement. Cross-sectional anatomical dissections were photographed and analysed by photometry. Safety of the intervention was assessed by calculating the distance from the tip of the needle to the proximate neurovascular structures. RESULTS Accurate needle penetration of the popliteus muscle was observed in 10 out of 11 (91%) of the cadavers (mean needle penetration: 25.7 ± 6.7mm, 95% CI 21.3-30.3 mm). The distances from the tip of the needle were 17±6mm (95% CI 13-21 mm) to the tibial nerve and 15 ± 0.7mm (95% CI 10-20 mm) to the popliteus vascular bundle. CONCLUSION The results from this cadaveric study support the notion that needling of the popliteus can be accurately and safely conducted by an experienced clinician. Future studies investigating the clinical effectiveness of these interventions are needed.
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Affiliation(s)
- Jacobo Rodríguez-Sanz
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), Barcelona, Spain
- ACTIUM Functional Anatomy Group, Barcelona, Spain
| | - Albert Pérez-Bellmunt
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), Barcelona, Spain
- ACTIUM Functional Anatomy Group, Barcelona, Spain
| | - Carlos López-de-Celis
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), Barcelona, Spain
- ACTIUM Functional Anatomy Group, Barcelona, Spain
| | | | | | - Max Canet-Vintró
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), Barcelona, Spain
- ACTIUM Functional Anatomy Group, Barcelona, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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Güngör E, Karakuzu Güngör Z. Comparison of the efficacy of corticosteroid, dry needling, and PRP application in lateral epicondylitis. Eur J Orthop Surg Traumatol 2021; 32:1569-1575. [PMID: 34613469 DOI: 10.1007/s00590-021-03138-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 09/27/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to compare the short-term efficacy of dry needling, corticosteroids, and platelet-rich plasma application (PRP) in the management of lateral epicondylitis. METHODS The study included 72 patients diagnosed with lateral epicondylitis divided into three groups of 24 individuals using the sealed envelope method. Group 1 underwent dry needling, Group 2 received 40 mg methylprednisolone acetate, and Group 3 received PRP treatment. Patients were assessed using the visual analog scale (VAS) and the Disabilities of the Shoulder, Arm, and Hand (DASH) score, and Jamar grip strength before treatment and 3rd week and 3rd month. RESULTS At the 3rd month, the mean VAS score was 1.16 ± 0.56 in dry needling group and 0.75 ± 0.60 in corticosteroids group, showing a statistically significant difference between dry needling and corticosteroids group, and between corticosteroids and PRP group (p = 0.015 and p = 0.000, respectively). At the 3rd week and 3rd month, VAS scores decreased in each treatment modality group, showing a statistically significant difference between the groups (p < 0.01). Jamar grip strength increased over time in all groups. There were no significant differences between the DASH scores of all groups at the 3rd week (p > 0.05). DASH scores decreased significantly from the 3rd week to the 3rd month in dry needling and corticosteroids group (p < 0.01), while it increased slightly in PRP group during the same period with a statistically insignificant change (p > 0.05). DASH scores decreased significantly at the 3rd month for all groups (p = 0.014). CONCLUSION Dry needling is an effective and safe application for the short-term treatment of lateral epicondylitis.
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Affiliation(s)
- Erdal Güngör
- Department of Orthopedic and Traumatology, Batman Training and Research Hospital, Batman, Turkey.
| | - Zeynep Karakuzu Güngör
- Department of Physical Medicine and Rehabilitation, Batman Training and Research Hospital, Batman, Turkey
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Yasar MF, Yaksi E, Kurul R, Alisik T, Seker Z. Comparison of dry needling and kinesio taping methods in the treatment of myofascial pain syndrome: A single blinded randomised controlled study. Int J Clin Pract 2021; 75:e14561. [PMID: 34159691 DOI: 10.1111/ijcp.14561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/21/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aim of this study was to compare the effectiveness of kinesio taping (KT) and dry needling (DN) in the treatment of myofascial pain syndrome (MPS) of the trapezius muscle. METHODS The patients with MPS were divided into 3 groups as those who received exercise only (control group), those who received KT and exercise (KT group) and those who received DN and exercise (DN group) by using a sealed opaque envelope randomisation method. Visual Analog Scale (VAS), Pressure Pain Threshold (PPT), Neck Disability Index (NDI) and Global Perceived Effect Scale (GPES) were measured twice at baseline and at the end of the second week by blinded evaluator. RESULTS A total of 26 patients were assigned to KT group, 32 to DN group and 30 to control group. The results of the study showed that PPT, VAS and NDI scores were significantly improved in the KT (1.61 ± 1.25, -2.66 ± 1.24 and -7.08 ± 6.24, respectively) and DN (1.30 ± 1.13, -3.34 ± 1.40 and -10.63 ± 7.80 respectively) groups (P < .001 for all). In the control group, no significant improvement was found in the VAS (.10 ± 1.39) and NDI (-.83 ± 4.91) scores (P > .05), with a significant decrease in PPT (-.98 ± 1.92) (P = .014). KT and DN methods in MPS treatment have more positive effects in terms of pain, disability and global effect compared to the control group. CONCLUSIONS In the treatment of MPS, adding DN or KT to exercise programme may provide important contributions to the treatment.
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Affiliation(s)
- Mustafa Fatih Yasar
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Elif Yaksi
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Ramazan Kurul
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Tugba Alisik
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Zeynep Seker
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
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Nowak Z, Chęciński M, Nitecka-Buchta A, Bulanda S, Ilczuk-Rypuła D, Postek-Stefańska L, Baron S. Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials. Int J Environ Res Public Health 2021; 18:ijerph18189552. [PMID: 34574476 PMCID: PMC8465617 DOI: 10.3390/ijerph18189552] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 11/21/2022]
Abstract
Background: Myofascial pain is an important cause of disability among the whole population, and it is a common symptom of temporomandibular joint disorders (TMDs). Its management techniques vary widely; however, in recent years, there has been a growing interest especially in needling therapies within masticatory muscles, due to their simplicity and effectiveness in pain reduction. Methods: The construction of the following study is based on PICOS and PRISMA protocols. A systematic literature search was conducted based on the PubMed and BASE search engines. Searching the abovementioned databases yielded a total of 367 articles. The screening procedure and analysis of full texts resulted in the inclusion of 28 articles for detailed analysis. Results: According to analyzed data, clinicians manage myofascial pain either with wet or dry needling therapies. The most thoroughly studied approach that prevails significantly within the clinical trials is injecting the botulinum toxin into the masseter and temporalis. Other common methods are the application of local anesthetics or dry needling; however, we notice the introduction of entirely new substances, such as platelet-rich plasma or collagen. In the analyzed articles, the target muscles for the needling therapies are most commonly localized by manual palpation although there are a variety of navigational support systems described: EMG, MRI or EIP electrotherapy equipment, which often aid the access to located deeper lateral and medial pterygoid muscle. Conclusions: Needling therapies within masticatory muscles provide satisfactory effects while being simple, safe and accessible procedures although there still is a need for high quality clinical trials investigating especially injections of non-Botox substances and needling within lateral and medial pterygoid muscles.
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Affiliation(s)
- Zuzanna Nowak
- Department of Temporomandibular Disorders, Medical University of Silesia in Katowice, Traugutta sq. 2, 41-800 Zabrze, Poland; (A.N.-B.); (S.B.)
- Correspondence:
| | - Maciej Chęciński
- Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland;
| | - Aleksandra Nitecka-Buchta
- Department of Temporomandibular Disorders, Medical University of Silesia in Katowice, Traugutta sq. 2, 41-800 Zabrze, Poland; (A.N.-B.); (S.B.)
| | - Sylwia Bulanda
- Department of Pediatric Dentistry, Medical University of Silesia in Katowice, Traugutta sq. 2, 41-800 Zabrze, Poland; (S.B.); (D.I.-R.); (L.P.-S.)
| | - Danuta Ilczuk-Rypuła
- Department of Pediatric Dentistry, Medical University of Silesia in Katowice, Traugutta sq. 2, 41-800 Zabrze, Poland; (S.B.); (D.I.-R.); (L.P.-S.)
| | - Lidia Postek-Stefańska
- Department of Pediatric Dentistry, Medical University of Silesia in Katowice, Traugutta sq. 2, 41-800 Zabrze, Poland; (S.B.); (D.I.-R.); (L.P.-S.)
| | - Stefan Baron
- Department of Temporomandibular Disorders, Medical University of Silesia in Katowice, Traugutta sq. 2, 41-800 Zabrze, Poland; (A.N.-B.); (S.B.)
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Fernández-de-las-Peñas C, López-de-Celis C, Rodríguez-Sanz J, Hidalgo-García C, Donnelly JM, Cedeño-Bermúdez SA, Pérez-Bellmunt A. Is Dry Needling of the Supinator a Safe Procedure? A Potential Treatment for Lateral Epicondylalgia or Radial Tunnel Syndrome. A Cadaveric Study. Int J Environ Res Public Health 2021; 18:ijerph18179162. [PMID: 34501752 PMCID: PMC8430708 DOI: 10.3390/ijerph18179162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 11/16/2022]
Abstract
The supinator muscle is involved in two pain conditions of the forearm and wrist: lateral epicondylalgia and radial tunnel syndrome. Its close anatomical relationship with the radial nerve at the arcade of Frohse encourages research on dry needling approaches. Our aim was to determine if a solid filiform needle safely penetrates the supinator muscle during the clinical application of dry needling. Needle insertion of the supinator muscle was conducted in ten cryopreserved forearm specimens with a 30 × 0.32 mm filiform needle. With the forearm pronated, the needle was inserted perpendicular into the skin at the dorsal aspect of the forearm at a point located 4cm distal to the lateral epicondyle. The needle was advanced to a depth judged to be in the supinator muscle. Safety was assessed by measuring the distance from the needle to the surrounding neurovascular bundles of the radial nerve. Accurate needle penetration of the supinator muscle was observed in 100% of the forearms (needle penetration:16.4 ± 2.7 mm 95% CI 14.5 mm to 18.3 mm). No neurovascular bundle of the radial nerve was pierced in any of the specimen’s forearms. The distances from the tip of the needle were 7.8 ± 2.9 mm (95% CI 5.7 mm to 9.8 mm) to the deep branch of the radial nerve and 8.6 ± 4.3 mm (95% CI 5.5 mm to 11.7 mm) to the superficial branch of the radial nerve. The results from this cadaveric study support the assumption that needling of the supinator muscle can be accurately and safely conducted by an experienced clinician.
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Affiliation(s)
- César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), 28922 Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Correspondence: ; Tel.: +34-91-488-88-84
| | - Carlos López-de-Celis
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, Sant Cugat del Vallès, 08017 Barcelona, Spain; (C.L.-d.-C.); (J.R.-S.); (S.A.C.-B.); (A.P.-B.)
- ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
| | - Jacobo Rodríguez-Sanz
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, Sant Cugat del Vallès, 08017 Barcelona, Spain; (C.L.-d.-C.); (J.R.-S.); (S.A.C.-B.); (A.P.-B.)
- ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
| | - César Hidalgo-García
- Unidad de Investigación en Fisioterapia, Universidad de Zaragoza, 50001 Zaragoza, Spain;
| | - Joseph M. Donnelly
- Department of Physical Therapy, Miami Campus, University of Saint Augustine for Health Sciences, Coral Gables, FL 33134, USA;
| | - Simón A Cedeño-Bermúdez
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, Sant Cugat del Vallès, 08017 Barcelona, Spain; (C.L.-d.-C.); (J.R.-S.); (S.A.C.-B.); (A.P.-B.)
- ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
| | - Albert Pérez-Bellmunt
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, Sant Cugat del Vallès, 08017 Barcelona, Spain; (C.L.-d.-C.); (J.R.-S.); (S.A.C.-B.); (A.P.-B.)
- ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
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Morag O, Shalit N. Trigger Point Dry Needling to Address Testicular Pain of a Pancreatic Cancer Patient. J Pain Symptom Manage 2021; 62:e1-e3. [PMID: 33722687 DOI: 10.1016/j.jpainsymman.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/23/2021] [Accepted: 03/04/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Ofir Morag
- Pain Management Institute, Sheba Medical Center, Tel Hashomer, Israel; Cancer Pain Unit, The Cancer Center at Sheba Medical Center, Tel Hashomer, Israel.
| | - Natalie Shalit
- Cancer Pain Unit, The Cancer Center at Sheba Medical Center, Tel Hashomer, Israel
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Valera-Calero JA, Cendra-Martel E, Fernández-Rodríguez T, Fernández-de-Las-Peñas C, Gallego-Sendarrubias GM, Guodemar-Pérez J. Prediction model of rhomboid major and pleura depth based on anthropometric features to decrease the risk of pneumothorax during dry needling. Int J Clin Pract 2021; 75:e14176. [PMID: 33759289 DOI: 10.1111/ijcp.14176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Although most common adverse events associated with dry needling can be considered minor, serious adverse events including induced pneumothorax cannot be excluded, and safety instructions for reducing the risk of pleura puncture are needed. OBJECTIVE To investigate if anthropometric features can predict the rhomboid major muscle and pleura depth in a sample of healthy subjects to avoid the risk of pneumothorax during dry needling. METHODS A diagnostic study was conducted on 59 healthy subjects (52.5% male) involving a total of 236 measurements (both sides in maximum inspiration and expiration), to calculate the accuracy of a prediction model for both pleura and rhomboid depth, as assessed with ultrasound imaging, based on sex, age, height, weight, body mass index (BMI), breathing and chest circumference. A correlation matrix and a multiple linear regression analyses were used to detect those variables contributing significantly to the variance in both locations. RESULTS Men showed greater height, weight, BMI, thorax circumference and skin-to-rhomboid, rhomboid-to-pleura and skin-to-pleura distances (P < .001). Sex, BMI, and thorax circumference explained 51.5% of the variance of the rhomboid (P < .001) and 69.7% of pleura (P < .001) depth limit. In general, inserting a maximum length of 19 mm is recommended to reach the deep limit of rhomboid major decreasing the risk of passing through the pleura. CONCLUSION This study identified that gender, BMI and thorax circumference can predict both rhomboid and pleura depth, as assessed with ultrasonography, in healthy subjects. Our findings could assist clinicians in the needle length election in avoiding the risk of induced pneumothorax during dry needling.
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Affiliation(s)
- Juan Antonio Valera-Calero
- Department of Physical Therapy, Universidad Camilo José Cela, Madrid, Spain
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Madrid, Spain
| | | | | | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Madrid, Spain
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