scholarly journals Effects of dry needling in gluteus medius muscle in individuals with chronic ankle instability: a randomized single-blinded controlled clinical trial

2021 ◽  
Author(s):  
Blanca de-la-Cruz-Torres ◽  
Gonzalo Jaen-Crespo ◽  
César Calvo-Lobo ◽  
Emmanuel Navarro-Flores ◽  
Isabel Rodríguez Costa ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Pain Intensity ◽  
Ankle Instability ◽  
Dynamic Balance ◽  
Gluteus Medius ◽  
Chronic Ankle Instability ◽  
Ankle Dorsiflexion ◽  
Control Group ◽  
Dry Needling ◽  
Gluteus Medius Muscle

IntroductionBackground: Lateral ankle sprain (LAS) is the most common musculoskeletal injuries in sport and general population. The goal of the present study was to observe the effectiveness of dry needling (DN) in gluteus medius muscle in patients with chronic ankle instability (CAI).Material and methodsA two-arm (1:1), single-blinded (participants), randomized clinical trial was performed in 40 subjects with chronic ankle instability and were divided in two groups: intervention group who received one session of dry needling in the most hyperalgesic gluteus medius myofascial trigger point (MTrP), (n = 20) and control group (n = 20). Dynamic balance, pain intensity, pain pressure threshold (PPT) and ankle dorsiflexion range of motion (ROM) were assessed at baseline, post-intervention and a 1-week follow up.ResultsThe experimental group reported significant differences with respect to the control group for the anterior and medial dynamic balance (p = .001), PPT -ATL (p = .002) and ankle dorsiflexion ROM (p = .001).ConclusionsThe findings of the present study suggested that the DN in the most hyperalgesic MTrP of the Gmed muscle may increase the anterior and medial dynamic balance, ankle ROM and PPT-ATL at short-term in individuals with CAI. Pain intensity benefits were reported in both groups. Future studies should consider DN as a possible intervention in conjunction with a physical therapy program for individuals with CAI.

scholarly journals Effectiveness of Deep Dry Needling vs Ischemic Compression in the Latent Myofascial Trigger Points of the Shortened Triceps Surae from Triathletes on Ankle Dorsiflexion, Dynamic, and Static Plantar Pressure Distribution: A Clinical Trial

Pain Medicine ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. e172-e181 ◽  
Author(s):  
María Benito-de-Pedro ◽  
Ricardo Becerro-de-Bengoa-Vallejo ◽  
Marta Elena Losa-Iglesias ◽  
David Rodríguez-Sanz ◽  
Daniel López-López ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Plantar Pressure ◽  
Ankle Dorsiflexion ◽  
Triceps Surae ◽  
Control Group ◽  
Single Session ◽  
Dry Needling ◽  
Myofascial Trigger Points ◽  
Plantar Pressures ◽  
Before And After

Abstract Objective To determine the immediate efficacy of a single session of deep dry needling (DDN) vs ischemic compression (ICT) in a latent myofascial trigger point (MTrP) of the shortened triceps surae from triathletes for ankle dorsiflexion and redistribution of plantar pressures and stability. Design A randomized simple blind clinical trial (NCT03273985). Setting An outpatient clinic. Subjects Thirty-four triathletes with a latent MTrP in the shortened gastrocnemius. Methods Triathletes were randomized to receive a single session of DDN (N = 17) or ICT (N = 17) in a latent MTrP of the shortened triceps surae. The primary outcome was ankle dorsiflexion range of motion (ROM) by a universal goniometer. Secondary objectives were distribution of dynamic and static plantar pressures by T-Plate platform pressure, with measurements both before and after five, 10, 15, 20, and 25 minutes of treatment. Results There were no statistically significant differences (P > 0.05) for ankle dorsiflexion ROM or dynamic and static plantar pressures between the experimental group treated with DDN and the control group treated with ICT before and after treatment. Conclusions DDN vs ICT carried out in latent MTrPs of the shortened gastrocnemius of triathletes did not present differences in terms of dorsiflexion ROM of the tibiofibular-talar joint or in static and dynamic plantar pressure changes before and immediately after treatment.

Efficacy of dry needling as an adjunct to manual therapy for patients with chronic mechanical neck pain: a randomised clinical trial

2020 ◽  
Vol 38 (4) ◽  
pp. 244-254
Author(s):  
Gracia M. Gallego-Sendarrubias ◽  
David Rodríguez-Sanz ◽  
Cesar Calvo-Lobo ◽  
Jose Luis Martín
Keyword(s):  
Clinical Trial ◽  
Neck Pain ◽  
Pain Intensity ◽  
Range Of Motion ◽  
Manual Therapy ◽  
Intervention Group ◽  
Control Group ◽  
Dry Needling ◽  
Cervical Range Of Motion ◽  
Neck Disability

Objective: Chronic mechanical neck pain is associated with musculoskeletal tissue alterations. Active trigger points in the trapezius and levator scapulae muscles are common in patients with chronic mechanical neck pain. In this study, we compared the effect of dry needling (DN) combined with manual therapy (MT) to sham dry needling (SDN) combined with MT on pain, pain pressure threshold, cervical range of motion and neck disability in patients with chronic mechanical neck pain. Methods: A randomised, single-blind clinical trial was carried out involving 101 participants with chronic mechanical neck pain, divided into an intervention group (DN+MT, n=47) and a control group (SDN+MT, n=54). Participants received two treatment sessions. The intervention group received MT in conjunction with DN of the most mechano-sensitive myofascial trigger point (MTrP). The control group received MT plus SDN. Outcomes measures were: pain intensity (numeric pain rating scale, NPRS), pressure pain threshold (PPT), cervical range of motion (ROM) and neck disability (neck disability index, NDI). Results: This study found that between-group differences in pain intensity were statistically significant (P<0.01). Pain decreased after the first intervention in the DN+MT group (3.47±0.25 points on the NPRS) and even more so after the second intervention (4.76±0.24 points on the NPRS). After 4 weeks, pain intensity differed from baseline by 4.89±0.27 points on the NPRS. Statistically significant differences (P<0.001) in PPT were also found between the intervention group and the control group. After the first intervention, a significant increase in PPT within the DN+MT group (3.09±0.8 kg/cm2) was observed. Cervical ROM also showed highly statistically significant differences. After 4 weeks, a statistically significant reduction (P<0.001) in NDI was observed between the two groups. Conclusion: Our results show that DN+MT is efficacious and significantly better than SDN+MT at reducing pain intensity, PPT, neck disability and cervical ROM in patients with chronic mechanical neck pain. Level of evidence: 1b.

Effects of balance training on functionality, ankle instability, and dynamic balance outcomes in people with chronic ankle instability: Systematic review and meta-analysis

2021 ◽  
pp. 026921552110220
Author(s):  
Sara Mollà-Casanova ◽  
Marta Inglés ◽  
Pilar Serra-Añó
Keyword(s):  
Systematic Review ◽  
Strength Training ◽  
Randomized Controlled Trials ◽  
Ankle Instability ◽  
Dynamic Balance ◽  
Balance Training ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled

Aim: To identify the effects of balance and strength training on function, ankle instability and dynamic balance in people with chronic ankle instability. Method: The search was conducted on randomized controlled trials that investigated the effects of balance training or strength training in people with chronic ankle instability compared to a control group. Therefore, a systematic electronic search was performed until April 2021 in Pubmed/MEDLINE, Cochrane, and Embase databases. Moreover, an additional search was further performed checking the reference lists of the selected articles. The main outcomes were ankle instability, functionality, and dynamic balance. Finally, a qualitative and quantitative synthesis was performed. Results: Fifteen randomized controlled trials with 457 volunteers were included. Compared to regular exercise, balance training demonstrated to be more effective in terms of improving functionality (0.81 (0.48, 1.14)), ankle instability (0.77 (0.27, 1.26)), and dynamic balance (0.83 (0.57, 1.10)) outcomes. However, when compared to strength training, the effectiveness of balance training was only greater in terms of the functionality outcome (0.49 (0.06, 0.92)), since no differences were found for instability (0.43 (0.00, 0.85)) and dynamic balance (0.21 (−0.15, 0.58)). Conclusions: Based on fair-to-high quality evidence, balance training significantly improves functionality, instability, and dynamic balance outcomes in people with chronic ankle instability Moreover, results of the comparison between balance training versus strength training suggest that the former achieves greater benefits for functionality, but not for instability and dynamic balance. Systematic review registration number: CRD42021224179.

scholarly journals Dry Needling Improves Static and Dynamic Balance in Individuals with Chronic Ankle Instability

2019 ◽  
Vol 51 (Supplement) ◽  
pp. 349
Author(s):  
Jennifer Mullins ◽  
Matthew C. Hoch ◽  
Kyle B. Kosik ◽  
Nicholas R. Heebner ◽  
Philip A. Gribble ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Dynamic Balance ◽  
Chronic Ankle Instability ◽  
Dry Needling

Quantitative Analysis of Deltoid Ligament Degradation in Patients With Chronic Ankle Instability Using Computed Tomographic Images

2021 ◽  
pp. 107110072199707
Author(s):  
Yasunari Ikuta ◽  
Tomoyuki Nakasa ◽  
Junichi Sumii ◽  
Akinori Nekomoto ◽  
Nobuo Adachi
Keyword(s):  
Ankle Instability ◽  
Ct Images ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Deltoid Ligament ◽  
Anterior Talofibular Ligament ◽  
Mri Findings ◽  
Calcaneofibular Ligament ◽  
Level Of Evidence ◽  
Strong Negative Correlation

Background: Rotational ankle instability (RAI) is associated with the faster onset of severe ankle osteoarthritis via dysfunction of the anterior talofibular ligament, calcaneofibular ligament, and deltoid ligament. No specific clinical examination is available for RAI, and diagnostic imaging has limitations in evaluating ligament degradation. This study investigated the deltoid ligament degeneration using Hounsfield unit (HU) values on computed tomography (CT) images. Methods: Patients were enrolled in this retrospective analysis if they had undergone magnetic resonance imaging (MRI) and CT scans of the ankle. The chronic ankle instability (CAI) group comprised 20 ankles with CAI (9 men, 11 women; mean age, 28.7 years) and the control group comprised 28 ankles (16 men, 12 women, mean age, 41.3 years). The average HU values of the deep posterior tibiotalar ligament (dPTL) that constitutes the deltoid ligament were measured on coronal CT images, and MRI results were used as a reference. All patients were subdivided based on the MRI findings of dPTL injury such as fascicular disruption, irregularity, and the loss of striation. Results: A strong negative correlation was identified between age and HU values for all patients (Spearman ρ = −0.63; P < .001). The mean HU values of the dPTL for participants aged <60 years were 81.0 HU for the control group (21 ankles) and 69.5 HU for the CAI group ( P = .0075). No significant differences in the HU values were observed for the dPTL among the MRI subgroups. Conclusion: In addition to the conventional imaging examination such as stress radiographs and MRI, HU measurements of CT images could be useful for quantitatively and noninvasively evaluating degenerative changes in the deltoid ligament for CAI patients to assist the diagnosis of RAI. Level of Evidence: Level III. case-control study.

Predicting dynamic balance improvements following 4-weeks of balance training in chronic ankle instability patients

2019 ◽  
Vol 22 (5) ◽  
pp. 538-543 ◽  
Author(s):  
Christopher J. Burcal ◽  
Michelle A. Sandrey ◽  
Tricia Hubbard-Turner ◽  
Patrick O. McKeon ◽  
Erik A. Wikstrom
Keyword(s):  
Ankle Instability ◽  
Dynamic Balance ◽  
Balance Training ◽  
Chronic Ankle Instability

Comparison of the effect of foot orthoses on Star Excursion Balance Test performance in patients with chronic ankle instability

2018 ◽  
Vol 43 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Faezeh Abbasi ◽  
Mahmood bahramizadeh ◽  
Mohammad Hadadi
Keyword(s):  
Ankle Sprain ◽  
Ankle Instability ◽  
Dynamic Balance ◽  
Chronic Ankle Instability ◽  
Textured Surface ◽  
Foot Orthoses ◽  
Textured Surfaces ◽  
Balance Test ◽  
Star Excursion Balance Test ◽  
Foot Orthosis

Background: Chronic ankle instability as a prevalent consequence of ankle sprain causes various impairments such as balance and postural control deficits. Foot orthoses are one of the common interventions for rehabilitation of patients with chronic ankle instability. Objectives: To investigate the effect of custom-molded foot orthoses with textured surfaces on dynamic balance of chronic ankle instability patients and to compare their effects with other types of foot orthoses. Study design: This is a repeated measure design. Methods: A total of 30 participants were recruited based on the guideline introduced by the International Ankle Consortium. The effect of prefabricated, custom-molded, and custom-molded with textured surface foot orthoses was evaluated on dynamic balance by the Star Excursion Balance Test. Normalized reach distances in anteromedial, medial, and posteromedial directions of the test were computed to be used for statistical analysis. Results: The foot orthoses increased reach distances compared to the no-orthosis conditions in all three directions. The custom-molded with textured surface foot orthosis has significant differences compared with prefabricated foot orthosis ( p = 0.001) in all measured directions and with custom-molded foot orthosis ( p < 0.01) in medial and posteromedial directions. Conclusion: Foot orthoses improve reach distances in patients with chronic ankle instability. Custom-molded with textured surface foot orthosis has a more pronounced effect compared with other foot orthoses. Clinical relevance The custom-molded foot orthosis with textured surface could be an effective device to improve dynamic balance in chronic ankle instability (CAI) patients. It may be considered as an efficient intervention to reduce ankle sprain recurrence in these individuals, although further research should be conducted.

scholarly journals Bilateral Proprioceptive Evaluation in Individuals With Unilateral Chronic Ankle Instability

2017 ◽  
Vol 52 (4) ◽  
pp. 360-367 ◽  
Author(s):  
Andreia S. P. Sousa ◽  
João Leite ◽  
Bianca Costa ◽  
Rubim Santos
Keyword(s):  
Outcome Measure ◽  
Ankle Instability ◽  
Position Sense ◽  
Chronic Ankle Instability ◽  
Joint Position Sense ◽  
Control Group ◽  
Injured Limb ◽  
History Of ◽  
Ankle Proprioception ◽  
Force Sense

Context:  Despite extensive research on chronic ankle instability, the findings regarding proprioception have been conflicting and focused only on the injured limb. Also, the different components of proprioception have been evaluated in isolation. Objective:  To evaluate bilateral ankle proprioception in individuals with unilateral ankle instability. Design:  Cohort study. Setting:  Research laboratory center in a university. Patients or Other Participants:  Twenty-four individuals with a history of unilateral ankle sprain and chronic ankle instability (mechanical ankle instability group, n = 10; functional ankle instability [FAI] group, n = 14) and 20 controls. Main Outcome Measure(s):  Ankle active and passive joint position sense, kinesthesia, and force sense. Results:  We observed a significant interaction between the effects of limb and group for kinesthesia (F = 3.27, P = .049). Increased error values were observed in the injured limb of the FAI group compared with the control group (P = .031, Cohen d = 0.47). Differences were also evident for force sense (F = 9.31, P &lt; .001): the FAI group demonstrated increased error versus the control group (injured limb: P &lt; .001, Cohen d = 1.28; uninjured limb: P = .009, Cohen d = 0.89) and the mechanical ankle instability group (uninjured limb: P = .023, Cohen d = 0.76). Conclusions:  Individuals with unilateral FAI had increased error ipsilaterally (injured limb) for inversion movement detection (kinesthesia) and evertor force sense and increased error contralaterally (uninjured limb) for evertor force sense.

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