Intratissue Electrolysis (EPI) is Effective in Deactivating Myofascial Trigger Points (MTrPs). (EPIEMG)

Camilo Jose Cela University

Status: Completed

Conditions: Myofascial Pain Syndrome (MPS)

Treatments: Other: dry needling; Other: Intratissue Percutaneous Electroly

Study type: Interventional

Funder types: Other

Identifiers

NCT07351331

EPIEMG

Details and patient eligibility

About

Invasive physiotherapy techniques, such as Intratissue Percutaneous Electroly-sis (IPE), have numerous beneficial effects depending on the pathology being treated, in-cluding the deactivation of myofascial trigger points (MTP) caused by myofascial pain syndrome (MPS).

The objectives are (1) evaluate the effectiveness of low intesity IPE treatment com-pared to DN on the shortening of FHB in patients with MPS, in 4 and 12 weeks evaluation, (2) assess the distribution of plantar pressures after the interventions and (3) evaluate the modification of FHB activation following the interventions.

Full description

Patients are divided into two intervention groups (IPE; n=18) and (DN; n=22). Before the intervention, variables of mean and maximum pressure are measured in all patients using a pressure platform, and neuromuscular activity is assessed through surface electromy-ography (sEMG). These measures are repeated at 4- and 12-weeks post-intervention. The results show efficacy in both techniques, with significant differences at both 4 weeks and 12 weeks in favor of the IPE group, both in plantar pressure distribution and muscular activity.

The first measurement (week of November 25, 2024) is considered the baseline measurement since the subjects had not been previously intervened. Therefore, the measurement is first performed using the pressure platform and sEMG, followed by the intervention of DN or IPE based on the group to which the subjects were previously as-signed.

At week 4 from the first measurement (week of December 23, 2024), the second data collection is conducted, using the same procedure as in the first measurement.

At week 12 from the initial measurement (week of February 17, 2025), the third data collection takes place using the same procedure as the previous two, with the difference that in this final measurement there will be no intervention of DN or IPE.

Enrollment: 40 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• subjects with ages between 18 and 65 years,
• hypersensitive spot within a taut band in FHB muscle.
• pain upon stimulation of the MTP.
• painful limit to the full range of motion

Exclusion criteria

• subjets who had bilateral LTP present.
• who have had a lower limb injury or surgery within the last 6 months.
• subjectss with active pathologies at the time of measurement in the lower limb.
• subjectss with cognitive impairment.
• subjectss with belonephobia or contraindications for the use of needles (oral anticoagulant therapy).

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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40 participants in 2 patient groups

Group Percutaneous Intratisular Electrolysis (IPE)

Experimental group

Description:

To perform the intervention correctly, whether for DN or IPE, the patient is positioned in a prone position. followed by disinfection with an antiseptic applied to the region to be addressed, with the therapist always wearing gloves as protection. Once the respective treatment is completed, pressure is applied to the needle entry point for 30 seconds. The IPE intervention is performed with the Physio Invasiva® device (Enraf Nonius Ibérica S.A., Madrid, Spain), following the same approach as in the DN, with gloves worn and the region disinfected beforehand. The tense band is located to introduce the needle into the nodule, attempting to elicit a LTR produced by an MTP (20,34,37,38) , Galvanic current is then applied, with 3 pulses of 5 seconds each at an intensity of 1.5 milliamperes (mA) and current interruption between each pulse (34) , differing from other studies that apply 3 mA or more (37,38) .

Treatment:

Other: Intratissue Percutaneous Electroly

dry needling (DN)

Experimental group

Description:

To perform the intervention correctly, whether for DN or IPE, the patient is positioned in a prone position. followed by disinfection with an antiseptic applied to the region to be addressed, with the therapist always wearing gloves as protection. Once the respective treatment is completed, pressure is applied to the needle entry point for 30 seconds. The intervention with DN is performed using the "quick entries and exits technique of Hong" (35) , with gloves and alcohol disinfectant applied to the region to be treated, in this case, the internal part of the plantar foot (FHB) (33) . Next, the taud band of the FHB muscle is located, and a palpable nodule that is painful to mechanical stimulation is identified in the taud band. The needle is then inserted into the nodule to perform the "quick entry and exit technique" (34) , with 4 entries and exits performed on the FHB, aiming to provoke local twich responses (LTR)

Treatment:

Other: dry needling