Effects on Neuromuscular Function After Dry Needling in Myofascial Trigger Points in the Gastrocnemius Muscles
Condition: Myofascial Trigger Point Pain
MeSH terms: Myofascial Pain Syndromes
Study type: Interventional

Summary: 
      Trigger points (TrPs) are a common musculoskeletal cause of local and referred muscle pain,
      as well as local inflammation in the muscle and fascia. From a clinical and sensory
      viewpoint, TrPs may be classified as active or latent. The principal difference is the
      reproduction of symptoms experienced by an individual (active) with or without stimulation.
      Local and referred pain elicited from latent TrPs may be transient in duration upon
      stimulation, and latent TrPs may be present without spontaneous symptoms.

      Both active and latent TrPs induce motor dysfunctions such as stiffness, restricted range of
      motion, and accelerated fatigability in the affected muscle. The interrater reliability of
      manual identification of latent TrPs in the calf muscles has been found to range from small
      to moderate. The clinical relevance of latent TrPs has increased in the last decade,4 and
      some studies have investigated the effects of treating them. Among all manual therapies
      targeted to latent TrPs, ischemic compression, or TrP pressure release, is the most commonly
      used. Although TrPs may affect any muscle, the gastrocnemius muscle may be the most
      susceptible in the lower extremity to developing them. It has been reported that 13% to 30%
      of the asymptomatic population has latent TrPs in these muscles, and their presence may
      affect sport practice.

      The purpose of this study will be to evaluate changes in neuromuscular function, pain
      perception, and basic physical properties in myofascial trigger points (TrPs) after a single
      treatment session of dry needling in the gastrocnemius muscle.

      A randomized within-participant clinical trial with a blinded assessor will be conducted. 50
      asymptomatic volunteers (100 gastrocnemius-muscle) with MrPs gastrocnemius-muscle TrPs will
      bilaterally explored. Each extremity will be randomly assigned to the control group (no
      treatment) or the experimental group (60 seconds of dry needling over each TrP).
      Neuromuscular function of the gastrocnemius muscle will be assessed using a MyotonPro and a
      tensiomyography. Muscle flexibility will be analyzed using the lunge test and the passive
      ankle range of motion. The strength will be determined with a handheld dynamometer
      (MicroFET2). Pain perception will be analyzed with a 0-to-10 numerical pain rating scale and
      determination of pressure pain thresholds over each latent TrP.
    


Intervention name(s): Dry needling
Intervention type(s): Other
Intervention description(s): The experimental extremity will received a single treatment session of TrP dry needling as follows: the therapist will located the TrP and will applied manual compression until the participant will reported pain. After that, dry needling technique will be performed on the TrPs for 60 seconds.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A randomized within-participant clinical trial
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: dry needling; gastrocnemius; myofascial trigger point