Cost-Effectiveness of Upper Extremity Dry Needling in Chronic Stroke

Introduction: Dry needling is a non-pharmacological approach that has proven to be effective in different neurological conditions. Objective: The aim of this study was to evaluate the cost-effectiveness of a single dry needling session in patients with chronic stroke. Methods: A cost-effectiveness analysis was performed based on a randomized controlled clinical trial. The results obtained from the values of the EuroQol-5D questionnaire and the Modified Modified Ashworth Scale were processed in order to obtain the percentage of treatment responders and the quality-adjusted life years (QALYs) for each alternative. The cost analysis was that of the hospital, clinic, or health center, including the equipment and physiotherapist. The cost per respondent and the incremental cost-effectiveness ratio of each alternative were assessed. Results: Twenty-three patients with stroke were selected. The cost of DN treatment was EUR 14.96, and the data analysis showed a favorable cost-effectiveness ratio of both EUR/QALY and EUR/responder for IG, although the sensitivity analysis using limit values did not confirm the dominance (higher effectiveness with less cost) of the dry needling over the sham dry needling. Conclusions: Dry needling is an affordable alternative with good results in the cost-effectiveness analysis—both immediately, and after two weeks of treatment—compared to sham dry needling in persons with chronic stroke.

Dry Needling and Antithrombotic Drugs

Many clinicians increasingly use dry needling in clinical practice. However, whether patients’ intake of antithrombotic drugs should be considered as a contraindication for dry needling has not been investigated to date. As far as we know, there are no publications in analyzing the intake of antiplatelet or anticoagulant agents in the context of dry needling techniques. A thorough analysis of existing medications and how they may impact various needling approaches may contribute to improved evidence-informed clinical practice. The primary purpose of this paper is to review the current knowledge of antithrombotic therapy in the context of dry needling. In addition, reviewing guidelines of other needling approaches, such as electromyography, acupuncture, botulinum toxin infiltration, and neck ultrasound-guided fine-needle aspiration biopsy, may provide specific insights relevant for dry needling. Based on published data, taking antithrombotic medication should not be considered an absolute contraindication for dry needling techniques. As long as specific dry needling and individual risks are properly considered, it does not change the risk and safety profile of dry needling. Under specific circumstances, the use of ultrasound guidance is recommended when available.

The effects of dry needling on the thumb: A case report

Introduction Dry needling has been identified as a potential intervention for a variety of diagnoses. Limited evidence exists to support the use of dry needling following surgical intervention of a distal radius fracture. This case report demonstrates the impact of dry needling in the thumb following a distal radius fracture. Methods The patient was a 31-year-old healthy female who sustained a distal radius fracture and required surgical intervention. The patient required a volar plate removal and extensor tenolysis. The patient attended traditional occupational therapy with one session of dry needling to assist in improving range of motion and decreasing pain. Results The patient benefited from the use of dry needling. The patient had no pain with functional grasping and pinching following dry needling and improved on the Kapandji score from eight to nine out of ten. The patient also reported a decrease in overall pain, from seven to two on the Numeric Pain Rating Scale. Discussion The patient benefited from dry needling in the thumb to improve both range of motion and pain symptoms. While the evidence is limited, dry needling may be an appropriate intervention to assist in recovery and reduce thumb pain following distal radius fractures.

Agulhamento seco no tratamento da dor miofascial associada a disfunção temporomandibular: uma revisão sistemática

Dor miofascial é um distúrbio muscular que esta frequentemente associada às desordens temporomandibulares, afeta os músculos da mastigação e pode levar a limitações funcionais. Esta revisão sistemática tem como objetivo identificar a literatura científica sobre os efeitos do agulhamento seco superficial e profundo para o tratamento da dor em pacientes com disfunção temporomandibular (DTM) miofascial. Trata-se de uma revisão sistemática buscando estudos primários nas bases de dados PubMed e Biblioteca Virtual em Saúde - BVS (que reúne bases de dados como LILACS - Literatura Latino-americana e do Caribe em Ciências da Saúde, MEDLINE - Medical Literature Analysis and Retrieval System Online, SciELO - Scientific Electronic Library Online, dentre outras) com os descritores “temporomandibular joint disorders dry needling”, or “myofascial temporomandibular dysfunction dry needling”, or “temporomandibular dysfunction dry needling”, assim artigos inglês, português ou espanhol que respondem à questão norteadora de utilização do agulhamento seco no tratamento de DTM miofascial foram incluídos; teses, monografias, associações de tratamentos, artigos que estavam em outras línguas que não as citadas acima e revisões sistemáticas foram excluídas. Nove estudos foram considerados elegíveis. Um estudo comparou o agulhamento seco superficial e profundo. Quatro estudos utilizaram apenas agulhamento seco profundo e outros 4 estudos não especificaram o tipo de agulhamento utilizado. Diante disso, os resultados encontrados sugerem que não há dados suficientes para tirar conclusões sólidas sobre qual tipo de agulhamento seco é melhor para o tratamento da dor miofascial associada à DTM. Ensaios clínicos randomizados de baixo risco de viés são fortemente necessários.

Gambaran Penurunan Nyeri Pada Pasien Low Back Pain Setelah Pemberian Dry Needling : Literatur Review

Low back pain (LBP) is intermittent pain associated with ligaments, muscles and bones in the back area, resulting from bending, lifting, or straining movements.All ages can experience LBP (low back pain), which can lead to a decrease in productivity, as you get older, LBP complaints increase. The effectiveness of dry needling in reducing pain in patients can reduce muscle contractures and provide biochemical effects such as releasing analgesic endorphins, increasing blood flow, and improving the chemical environment. To the description of dry needling to reduce pain in patients with low back pain. Literature search in this study through keyword selection and database. Then carry out a critical review process with inclusion and exclusion criteria. Furthermore, the article selection process uses an online database, the total number of articles reviewed in Pubmed is 1 and Google Scholar is 4. The five articles have the effect of dry needling on reducing pain in cases of low back pain, evidenced by the average pre-test result of 17.32 and the average post-test result of 12.88 so that a difference of 4.44 was obtained from the VAS measurement before and after the dry needling intervention. A review of the five articles with a total of 213 respondents after being given dry needling intervention showed a decrease in pain in cases of low back pain using the VAS measuring instrument. For health workers to improve physiotherapy in patients with low back pain with dry needlingKeywords: Low back pain, dry needling, pain AbstrakLow back pain (LBP) adalah nyeri hilang timbul yang berkaitan dengan ligamen, otot dan tulang pada area punggung, akibat dari gerakan membungkuk,mengangkat, atau mengejan. Semua usia dapat mengalami LBP, yang dapat mengakibatkan penurunkan produktivitas, semakin bertambahnya usia semakin meningkat pula keluhan LBP. Adanya efektivitas dry needling terhadap penurunan nyeri pada pasien dapat mengurangi kontraktur otot serta memberikan efek biokimia seperti melepaskan endorfin analgesik, meningkatkan aliran darah, dan meningkatkan lingkungan kimiawi. Untuk menganalisa gambaran dry needling terhadap penurunan nyeri pada pasien low back pain. Pencarian literatur dalam penelitian ini melalui pemilihan kata kunci dan database. Kemudian melakukan poses telaah kritis dengan kriteria inklusi dan ekslusi. Selanjutnya proses selesi artikel menggunakan database online, total artikel yang di review di Pubmed sebanyak 1 dan Google scholar sebanyak 4. Kelima artikel yang berjumlah 212 orang responden, usia yang dapat mengalami low back pain adalah dari usia 10-70 tahun dan adanya pengaruh dry needling terhadap penurunan nyeri pada kasus low back pain, dibuktikan dengan rata-rata hasil pre test sejumlah 17,32 dan rata-rata hasil post test sejumlah 12,88 sehingga di dapatkan selisih sejumlah 4,44 dari pengukuran VAS sebelum dan setelah pemberian intervensi dry needling. Review dari kelima artikel dengan jumlah 213 orang responden sesudah diberikan intervensi dry needling menunjukan hasil adanya penurunan nyeri pada kasus low back pain dengan menggunakan alat ukur VAS. Pada tenaga kesehatan untuk meningkatkan fisioterapi pada penderita low back pain dengan dry needling.Kata kunci : Low back pain, dry needling, nyeri

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

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.