Physiotherapy in the Reduction of Post-needling Soreness

University of Alcala

Status: Completed

Conditions: Soreness, Muscle; Dry Needling; Trigger Point Pain, Myofascial

Treatments: Other: Isometric contraction exercise; Other: Concentric contraction exercise; Other: Eccentric contraction exercise; Other: Analytic passive stretching

Study type: Interventional

Funder types: Other

Identifiers

NCT04695548

CEIM/HU/2020/43

Details and patient eligibility

About

Dry needling is a minimally invasive technique which generates good results and neuromuscular benefits. Its application involves a highly prevalent effect called post-needling soreness. It is defined as a residual pain, located in the incision area, with a self-limiting period of 24-72 hours, as a result of a physiological process generated by the technique.

So far, different clinical trials have been carried out to measure the effectiveness of several techniques for reducing post-needling soreness, reaching positive results. However, no studies have been found with the aim of distinguish which method is more effective for this goal; therefore, it is clear the need to continue investigating on the subject and comparing these techniques among them.

Full description

Main objective. To figure out if one of the four techniques (isometric, concentric, eccentric contraction exercise and analytic passive stretching) is more effective for reducing post- needling soreness immediately, at 12, 24, 48 and 72 hours.

Objectives. To verify if there is a correlation between independent variables and post-needling soreness.

Study type. Non-blinded randomized clinical trial. Intervention. Dry needling on an active myofascial trigger point in superior trapezius, followed by one of the following treatments according to the specific group: 1) concentric contraction exercise, 2) isometric contraction exercise, 3) eccentric contraction exercise or 4) analytic passive stretching.

Enrollment: 60 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age between 18 and 65 years;
• Cervical pain.
• Presence of an active PGM in the upper trapezius muscle.

Exclusion criteria

• Traumatic history in the cervical region;
• Inability to understand or perform the required exercises;
• Pregnancy in the first trimester;
• Altered state of coagulation;
• Immunosuppression status;
• State of alteration of sensitivity (e.g. central sensitization processes, fibromyalgia, etc.);
• Unavoidable fear of needles;
• Lack of knowledge about the use of the WhatsApp or Telegram messaging platform

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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60 participants in 4 patient groups

Concentric contraction exercise

Experimental group

Description:

After applying the dry needling technique to the upper trapezius muscle, the participant will be placed in a standing position, with the shoulders positioned in the scapular plane. A medium stiffness Theraband elastic band will be placed between the participant's ipsilateral foot on the side on which the dry needling technique was applied and the acromio-clavicular joint on the same side.The exercise will consist of raising the shoulder against the resistance of the elastic band, slowly and for 5 seconds

Treatment:

Other: Concentric contraction exercise

Isometric contraction exercise

Experimental group

Description:

After applying the dry needling technique to the upper trapezius muscle, the participant will be placed in a standing position, with the shoulders positioned in the scapular plane. A medium stiffness Theraband elastic band will be placed between the participant's ipsilateral foot on the side on which the dry needling technique was applied and the acromio-clavicular joint on the same side.The exercise will consist of raising the shoulder and maintaining the tension of the elastic band for 5 seconds

Treatment:

Other: Isometric contraction exercise

Eccentric contraction exercise

Experimental group

Description:

After applying the dry needling technique to the upper trapezius muscle, the participant will be placed in a standing position, with the shoulders positioned in the scapular plane. A medium stiffness Theraband elastic band will be placed between the participant's ipsilateral foot on the side on which the dry needling technique was applied and the acromio-clavicular joint on the same side.The exercise will consist of raising the shoulder against the resistance of the elastic band, slowly and for 5 seconds

Treatment:

Other: Eccentric contraction exercise

Analytic passive stretching.

Experimental group

Description:

After applying the dry needling technique to the upper trapezius muscle, the patient remains supine position. The analytical passive stretch of the upper trapezius will be performed only once, bringing the muscle to the limit of elastic tension perceived by the subject. The passive stretching technique will be held for 30 seconds.

Treatment:

Other: Analytic passive stretching