Neuromodulation in Patients With Hamstring Shortening

Jose Antonio Garcia Vidal

Status: Completed

Conditions: Hamstring Contractures

Treatments: Other: Ultrasound-guided Percutaneous Neuromodulation; Other: Ultrasound-guided Percutaneous Needle

Study type: Interventional

Funder types: Other

Identifiers

NCT03637439

1858/2018

Details and patient eligibility

About

The flexibility of the hamstrings is a very important component both for general health and when exercising. The lack of hamstring flexibility has been related to the increase in the likelihood of suffering a large number of musculoskeletal pathologies, due to the possibility of causing important muscle imbalances, which include lumbar spine pathologies, such as disc hernias or spondyloarthrosis. In addition, the decrease in the flexibility of the hamstring musculature is also related to the increased likelihood of suffering muscle strains, patellar tendon tendinopathies, femoropatellar syndrome and decreased lumbopelvic rhythm.

Clinically, an invasive technique has appeared, known as Ultrasound-guided Percutaneous Neuromodulation (PNM). This minimally invasive intervention consists in the application of a percutaneous electrical stimulation (PES) through an acupuncture needle-like electrode that is placed in close proximity to the nerve or motor point of the muscle with ultrasound guidance. At the clinical level, the PES is always used with the therapeutic aim of relieving chronic pain and neuropathic pain. Similarly, in sports, PES is used with the aim of improving muscular activity. Therefore, according to the characteristics and the therapeutic benefits of this technique, further research is needed to discover multiple clinical indications.

The aim of this study was to examine the effects on flexibility and strength of an ultrasound-guided percutaneous neuromodulation intervention in patients with shortening of the hamstring muscles.

Enrollment: 40 patients

Sex: Male

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• over 18 years
• to practice some sports activity 2 or more times a week
• get less than 70º in PKE (Passive Knee Extension) with hip 90º

Exclusion criteria

• any previous surgery or acute trauma in the back or lower extremity.
• pain at the time of performing the assessment tests
• belonephobia
• anticoagulant consumption
• pregnancy
• hemorrhagic disorders
• immunosuppression
• inability to understand or carry out evaluations

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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40 participants in 2 patient groups

PNM group

Experimental group

Description:

Subjects were treated only once. Specifically, this consisted in the application of a square wave biphasic electrical current, with 10 Hz frequency, a 250µs pulse width, and the maximal tolerable intensity to cause an exacerbated muscle contraction for a total of 1.5 mins, according to the protocol (Valera \& Minaya). The subjects were lying prone in decubitus. The middle part of the sciatic nerve was located using an ultrasound machine (cross section), then an acupuncture needle (0.30 mm x 40 mm) was inserted in a short axis approach, perpendicular to the surface of the skin, to the perineurium of the sciatic nerve.

Treatment:

Other: Ultrasound-guided Percutaneous Neuromodulation

Control group

Sham Comparator group

Description:

The subjects were lying prone in decubitus. The same puncture protocol was performed on the sciatic nerve for 1.5 minutes, but without the application of electricity.

Treatment:

Other: Ultrasound-guided Percutaneous Needle