Prediction model of rhomboid major and pleura depth based on anthropometric features to decrease the risk of pneumothorax during dry needling

Background: Although mostly common adverse events associated to 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 y skin-to-pleura distances (p<0.001). Sex, BMI, and thorax circumference explained 51.5% of the variance of the rhomboid (p<0.001) and 69.7% of pleura (p<0.001) 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 for avoiding the risk of induced pneumothorax during dry needling.

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Prediction Model of Soleus Muscle Depth Based on Anthropometric Features: Potential Applications for Dry Needling

Diagnostics ◽

10.3390/diagnostics10050284 ◽

2020 ◽

Vol 10 (5) ◽

pp. 284 ◽

Cited By ~ 1

Author(s):

Juan Antonio Valera-Calero ◽

Ladislao Laguna-Rastrojo ◽

Fernando de-Jesús-Franco ◽

Eduardo Cimadevilla-Fernández-Pola ◽

Joshua A. Cleland ◽

...

Keyword(s):

Prediction Model ◽

Soleus Muscle ◽

Diagnostic Study ◽

Regression Analyses ◽

Healthy Individuals ◽

Dry Needling ◽

Anthropometric Features ◽

Potential Applications ◽

Asymptomatic Individuals ◽

Proper Length

This study was conducted to investigate if anthropometric features can predict the depth of the soleus muscle, as assessed with ultrasound imaging, in a sample of healthy individuals to assist clinicians in the application of dry needling. A diagnostic study to calculate the accuracy of a prediction model for soleus muscle depth, as assessed with ultrasonography, in the middle-third and distal-third of the calf, based on anthropometric features such as age, height, weight, body mass index (BMI), calf length, mid-third and distal-third calf girth, was conducted on 48 asymptomatic healthy subjects (75% male) involving a total of 96 calves. Multiple linear regression analyses were used to determine which variables contributed significantly to the variance in the soleus muscle depth at middle-third and distal-third of the calf by gender. Women were found to have a deeper soleus muscle than men (p < 0.001). Weight, height, BMI, and mid-third calf perimeter explained 69.9% of variance in men, whereas mid-third calf perimeter, calf length, height, and distal-third calf girth explained 73% of the variance in women of the distal-third soleus depth (p < 0.001). Additionally, mid-third calf girth and calf length explained 28.8% of variance in men, whereas mid-third calf perimeter, calf length, and weight explained 67.8% of variance in women of the mid-third soleus depth (p < 0.001). This study identified anthropometric features that predict soleus muscle depth, as assessed with ultrasound, in asymptomatic individuals, but these features are different in men and women. Our findings could assist clinicians in choosing the proper length of the needle to avoiding passing through the soleus during dry needling.

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