Immediate Effect of Dry Needling on Trigger Points

Study Overview
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Brief Summary
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The immediate effects (0-30 minutes) of a dry needling intervention on a trigger point on their viscoelastic properties (tone, elasticity and stiffness)

Detailed Description
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Objectives: To investigate the immediate effects of a dry needling puncture on the viscoelastic properties (tone, stiffness and elasticity) of a trigger point (TP) located in the infraspinatus muscle in participants with non-traumatic chronic shoulder pain. Methods: Forty-eight individuals who presented non-traumatic chronic shoulder pain were recruited. The presence of a TP in the infraspinatus muscle of the painful side was confirmed by an experienced physiotherapist with a palpatory exam according to Travell and Simons criteria. The TP was marked and the viscoelastic properties including tone, stiffness and elasticity were measured with the MyotonPro device by an evaluator. After the first set of measurements (T1), an experienced physiotherapist applied a dry needling puncture to the TP with a pistoning technique to obtain a local twitch response (LTR) with an Optimed 40 x 0.30 mm single use acupuncture needle. The same set of measurements was repeated immediately after the dry needling (T2) and 30 minutes later (T3). Repeated measures ANOVA and post-hoc tests were used to assess changes in viscoelastic properties over time with a significant level set at 0.05.

Official Title
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Immediate Effect of Dry Needling on the Viscoelastic Properties of a Trigger Point on the Infraspinatus Muscle Measured With the MyotonPro

Conditions
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Shoulder Pain

Intervention / Treatment
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* Procedure: Dry needling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: present with chronic shoulder pain of non-traumatic origin (rated at least 2/10 on a numeric rating scale (NRS) for more than 3 months. The pain had to be located in the shoulder area or referred in the area of the infraspinatus as described by Travell and Simons (1999); have a hyperirritable spot within a palpable tight band that reproduced the participant's pain when compressed by palpation; and have a body mass index (BMI) lower than 28 Exclusion Criteria: diagnosis of capsulitis, cancer, or metastasis; previous shoulder or thorax surgery or a mastectomy; shoulder girdle bone fracture; C4-C5 or C6 radiculopathy; known osteoporotic profile (positive bone densitometry); apparent atrophy of the infraspinatus fossa (visual interpretation) and contraindications to receive a DN intervention

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: One group, one measurement of the viscoelastic properties with the MyotonPro of a single trigger point before the dry needle insertion, one measurement with the MyotonPro right after and 30 minutes later
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dry needling of a trigger point in the infraspinatus muscle<br>Insertion a a acupuncture type needle into a trigger point in the infraspinatus muscle on the painful side to decrease the stiffness and tone and increase the elasticity | Procedure: Dry needling<br>* Insertion of a Optimed 40mm x 0.30 single use, sterile acupuncture needle into a active trigger point in the infraspinatus muscle<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tone in Hertz measured with a myotonometer on the trigger point | Measurement of the tone in Hz with the myotonometer MyotonPro on the trigger point | baseline | 
| Tone in Hertz measured with a myotonometer on the trigger point | Measurement of the tone in Hz with the myotonometer MyotonPro on the trigger point | immediately after the intervention | 
| Tone in Hertz measured with a myotonometer on the trigger point | Measurement of the tone in Hz with the myotonometer MyotonPro on the trigger point | 30 minutes after the intervention | 
| Stiffness in N/m with a myotonometer on the trigger point | Measurement of the stiffness in N/m with the myotonometer MyotonPro on the trigger point | baseline | 
| Stiffness in N/m with a myotonometer on the trigger point | Measurement of the stiffness in N/m with the myotonometer MyotonPro on the trigger point | immediately after the intervention | 
| Stiffness in N/m with a myotonometer on the trigger point | Measurement of the stiffness in N/m with the myotonometer MyotonPro on the trigger point | 30 minutes after the intervention | 
| Elasticity (no units: inversely proportional to the decrement of the oscillations) with a myotonometer on the trigger point | Measurement of the elasticity with the MyotonPro | baseline | 
| Elasticity (no units: inversely proportional to the decrement of the oscillations) with a myotonometer on the trigger point | Measurement of the elasticity with the MyotonPro | immediately after the intervention | 
| Elasticity (no units: inversely proportional to the decrement of the oscillations) with a myotonometer on the trigger point | Measurement of the elasticity with the MyotonPro | 30 minutes after the intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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myofascial trigger points,, dry needling,, stiffness