scholarly journals Effects of Dry Needling of Latent Trigger Points on Viscoelastic and Muscular Contractile Properties: Preliminary Results of a Randomized Within-Participant Clinical Trial

2021 ◽  
Vol 10 (17) ◽  
pp. 3848
Author(s):  
Albert Pérez-Bellmunt ◽  
Oriol Casasayas-Cos ◽  
Carlos López-de-Celis ◽  
Jacobo Rodríguez-Sanz ◽  
Jorge Rodríguez-Jiménez ◽  
...  

This study aimed to evaluate changes in neuromuscular function and pain perception in latent trigger points (TrPs) in the gastrocnemius muscle after a single session of dry needling. A randomized within-participant clinical trial was conducted. Fifty volunteers with latent TrPs in the gastrocnemius muscles were explored. Each extremity was randomly assigned to a control or experimental (dry needling) group. Viscoelastic parameters and contractile properties were analyzed by tensiomyography. Ankle dorsiflexion range of motion was assessed with the lunge test. Pressure pain thresholds (PPT) and pain perceived were also analyzed. The results observed that three viscoelastic proprieties (myotonometry) showed significant differences in favor of the experimental extremity in the lateral gastrocnemius: stiffness (p = 0.02), relaxation (p = 0.045), and creep (p = 0.03), but not in the medial gastrocnemius. No changes in tensiomyography outcomes were found. The control extremity showed a higher increase in PPTs (i.e., decrease in pressure pain sensitivity) than the experimental extremity (p = 0.03). No significant effects for range of motion or strength were observed. In general, gender did not influence the effects of dry needling over latent TrPs in the gastrocnemius muscle. In conclusion, a single session of dry needling was able to change some parameters of neuromuscular function, such as muscle tone, relaxation, pressure pain sensitivity, and creep in the lateral (but not medial) gastrocnemius but did not improve strength or range of motion.

2019 ◽  
Vol 02 (02) ◽  
pp. 063-063
Author(s):  
Velasco Fernández P. ◽  
Valera Garrido F.

Abstract Aims To evaluate the anatomic variability of the gastrocnemius venous system using ultrasound and the overlap of the same with myofascial trigger points (MTrPs 1 and 2) clinically located in this muscle. Material and Methods In total, 82 legs of 41 healthy adults were studied, belonging to 26 men and 15 women aged between 22 and 50 years. The blood vessels located below MTrP1 and MTrP2, described by Travell and Simons were observed, and each image was analyzed by sectors (medial, central and lateral) to quantify the number of blood vessels, their distribution and overlap with the MTrPs described at this level. Results Examination of the 164 heads of 82 gastrocnemius muscles revealed that at least one vessel exists for each section analyzed. The number of veins per head varied between 1 and 8. The most common pattern in the medial gastrocnemius was three vessels (41.5%) and two vessels (49%) in the lateral gastrocnemius. In 100% of the cases the localization of the veins coincided with the clinical localization of the MTrPs. Conclusions The venous pattern of the proximal gastrocnemius is highly variable among subjects regarding the number of blood vessels and their distribution. There is a complete overlap between the clinical localization of the gastrocnemius MTrPs and the presence of blood vessels.


2020 ◽  
Vol 9 (10) ◽  
pp. 3300
Author(s):  
Marcos J. Navarro-Santana ◽  
Jorge Sanchez-Infante ◽  
César Fernández-de-las-Peñas ◽  
Joshua A. Cleland ◽  
Patricia Martín-Casas ◽  
...  

Our aim was to evaluate the effect of dry needling alone as compared to sham needling, no intervention, or other physical interventions applied over trigger points (TrPs) related with neck pain symptoms. Randomized controlled trials including one group receiving dry needling for TrPs associated with neck pain were identified in electronic databases. Outcomes included pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion. The Cochrane risk of bias tool and the Physiotherapy Evidence Database (PEDro) score were used to assessed risk of bias (RoB) and methodological quality of the trials. The quality of evidence was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Between-groups mean differences (MD) and standardized mean differences (SMD) were calculated (3) Twenty-eight trials were finally included. Dry needling reduced pain immediately after (MD −1.53, 95% CI −2.29 to −0.76) and at short-term (MD −2.31, 95% CI −3.64 to −0.99) when compared with sham/placebo/waiting list/other form of dry needling and, also, at short-term (MD −0.51, 95% CI −0.95 to −0.06) compared with manual therapy. No differences in comparison with other physical therapy interventions were observed. An effect on pain-related disability at the short-term was found when comparing dry needing with sham/placebo/waiting list/other form of dry needling (SMD −0.87, 95% CI −1.60 to −0.14) but not with manual therapy or other interventions. Dry needling was effective for improving pressure pain thresholds immediately after the intervention (MD 55.48 kPa, 95% CI 27.03 to 83.93). No effect on cervical range of motion of dry needling against either comparative group was found. No between-treatment effect was observed in any outcome at mid-term. Low to moderate evidence suggests that dry needling can be effective for improving pain intensity and pain-related disability in individuals with neck pain symptoms associated with TrPs at the short-term. No significant effects on pressure pain sensitivity or cervical range of motion were observed.


Pain Medicine ◽  
2019 ◽  
Vol 21 (6) ◽  
pp. 1224-1229
Author(s):  
Luis Baraja-Vegas ◽  
Saúl Martín-Rodríguez ◽  
Francisco Piqueras-Sanchiz ◽  
Julio Martín-Ruiz ◽  
Mireia Yeste Fabregat ◽  
...  

Abstract Objective Trigger points (TrPs) are hypersensitive spots within taut bands of skeletal muscles that elicit referred pain and motor changes. Among the variety of techniques used for treating TrPs, dry needling is one of the most commonly applied interventions. The question of eliciting local twitch responses (LTRs) during TrP dry needling is unclear. Our main aim was to investigate the evolution of the electromyographic (EMG) peak activity of each LTR elicited during dry needling into latent TrPs of the gastrocnemius medialis muscle. Methods Twenty asymptomatic subjects with latent TrPs in the gastrocnemius medialis muscle participated in this cross-sectional study. Changes in EMG signal amplitude (root mean square [RMS]) with superficial EMG were assessed five minutes before, during, and five minutes after dry needling. The peak RMS score of each LTR was calculated (every 0.5 sec). Results Analysis of variance revealed a significant effect (F = 29.069, P <0.001) showing a significant decrease of RMS peak amplitude after each subsequent LTR. Differences were significant (P <0.001) during the first three LTRs, and stable until the end of the procedure. No changes (P =0.958) were found for mean RMS data at rest before (mean = 65.2 mv, 95% confidence interval [CI] = 47.3–83.1) and after (61.0 mv, 95% CI = 42.3–79.7) dry needling. Conclusions We found that, in a series of LTRs elicited during the application of dry needling over latent TrPs in the medial gastrocnemius muscle, the RMS peak amplitude of each subsequent LTR decreased as compared with the initial RMS peak amplitude of previous LTRs. No changes in superficial EMG activity at rest were observed after dry needling of latent TrPs of the gastrocnemius medialis muscle.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Morten Pallisgaard Støve ◽  
Rogerio Pessoto Hirata ◽  
Thorvaldur Skuli Palsson

Abstract Objectives The effect of stretching on joint range of motion is well documented, and although sensory perception has significance for changes in the tolerance to stretch following stretching the underlining mechanisms responsible for these changes is insufficiently understood. The aim of this study was to examine the influence of endogenous pain inhibitory mechanisms on stretch tolerance and to investigate the relationship between range of motion and changes in pain sensitivity. Methods Nineteen healthy males participated in this randomized, repeated-measures crossover study, conducted on 2 separate days. Knee extension range of motion, passive resistive torque, and pressure pain thresholds were recorded before, after, and 10 min after each of four experimental conditions; (i) Exercise-induced hypoalgesia, (ii) two bouts of static stretching, (iii) resting, and (iv) a remote, painful stimulus induced by the cold pressor test. Results Exercise-induced hypoalgesia and cold pressor test caused an increase in range of motion (p<0.034) and pressure pain thresholds (p<0.027). Moderate correlations in pressure pain thresholds were found between exercise-induced hypoalgesia and static stretch (Rho>0.507, p=0.01) and exercise-induced hypoalgesia and the cold pressor test (Rho=0.562, p=0.01). A weak correlation in pressure pain thresholds and changes in range of motion were found following the cold pressor test (Rho=0.460, p=0.047). However, a potential carryover hypoalgesic effect may have affected the results of the static stretch. Conclusions These results suggest that stretch tolerance may be linked with endogenous modulation of pain. Present results suggest, that stretch tolerance may merely be a marker for pain sensitivity which may have clinical significance given that stretching is often prescribed in the rehabilitation of different musculoskeletal pain conditions where reduced endogenous pain inhibition is frequently seen.


BMJ Open ◽  
2013 ◽  
Vol 3 (5) ◽  
pp. e002825 ◽  
Author(s):  
Maryam Abbaszadeh-Amirdehi ◽  
Noureddin Nakhostin Ansari ◽  
Soofia Naghdi ◽  
Gholamreza Olyaei ◽  
Mohammad Reza Nourbakhsh

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