A Single Dry Needling Session of the Obliquus Capitis Inferior for the Altered Sensorimotor Function in People With Neck Pain
Condition: Whiplash Syndrome; Neck Pain
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      Neck pain is the 3rd cause of disability worldwide and represents an enormous socioeconomic
      burden. It has been reported that people with neck pain, with traumatic and non-traumatic
      onset, have an alteration of the sensorimotor function compared to pain-free people, such as
      deficits in the head and neck repositioning or alteration of the body balance. It has been
      suggested that alterations on the proprioception of the suboccipital muscles may cause a
      decrease in head and neck repositioning accuracy and changes in head and neck positioning
      patterns. The suboccipital muscles, particularly the obliquus capitis inferior (OCI), has a
      greater density of muscular spindles compared to lower cervical segments, which is believed
      to play an important role in the proprioception. The alteration of the JPE is more often
      found in patients with a dysfunction in the upper cervical spine, but people with lower
      dysfunction can also exhibit it. However, no conclusive results on JPE have been reported
      with articular techniques targeting the upper cervical spine. On the contrary, positive
      results on this test have been observed after the retraining of the upper cervical muscles.
      As OCI is a deep muscle, dry needling seems to be the most appropriate passive modality of
      treatment to target that muscle and restore the abnormal cervical sensorimotor control.
      However, this hypothesis has never been tested.
    

Detailed description: 
      The aim of the proposed study is to investigate if a single dry needling (DN) session
      modifies the altered sensorimotor function in people with neck pain. The secondary objectives
      will be to investigate the effects of a single DN session on muscle length (indirectly
      measured with FRT) and to investigate the effects of a single DN session on self-reported
      pain.

      With this aim, a random control trial (RCT) design will be conducted with two groups;
      intervention group (dry needling of the OCI) and placebo group (sham needling). Sham needling
      has shown to be a valid control method in dry needling research.

      The study will take two days. In the first day, the outcome measures will be measured before
      (baseline) and immediately after the intervention (immediate follow-up). In the second day
      (one-week follow-up), outcome measures will be measured again. Pain intensity, measured with
      the visual analogue scale, will be only measured at baseline and one-week follow-up.

      The baseline and follow-up assessments will be performed by an independent assessor who will
      be blinded to the intervention allocation. The interventions will be provided by a therapist
      with dry needling training and 3-years of musculoskeletal experience who will be blinded to
      outcome measures.
    

Intervention name(s): dry needling; Sham needling
Intervention type(s): Other; Other
Intervention description(s): Participants allocated in this group will receive a single session of dry needling of the obliquus capitis inferior. Prior to the intervention, participants will receive information about the procedure and will be free to withdraw. The needle was shown to the participant before the intervention. Participants will be requested to lie in prone on the plinth. Participants' skin will be sterilized with antiseptic spray for the skin. The therapist will clean his hands and use sterilized gloves. The needle will be moved up and down within the muscle, using a "fast-in and fast-out" technique. Needle insertions will be repeated 12 times.; Sham needling has shown to be a valid control method in dry needling research. The procedure in the sham group will be the same as the experimental group to guarantee the participants' blinding. Prior to the intervention, participants will receive information about the procedure and will be free to withdraw. The sham needle (same appearance/material as the true needle) was shown to the participant before the intervention to guarantee the blinding.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment