Effect of Dry Needling on Muscle Mechanical Properties and Muscle Contractility in Latent Trigger Points

Study Overview
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Brief Summary
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The purpose of this study is to determine whether application of Dry Needling (DN) is effective for improved Muscle Mechanical Properties and Muscle Contractility in Latent Trigger Points point (LTrP) of upper trapezius. Randomized controlled trial, in parallel with cross-control design. Two groups with LTrP in upper trapezius, and will be randomly selected to DN group or Sham-Dn group.

Official Title
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Effects of Dry Needling on Stiffness in Latent Trigger Points a Randomized Controlled Trial

Conditions
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Trigger Point Pain, Myofascial

Intervention / Treatment
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* Device: Intervention-Dry Needling
* Device: Control-Dry Needling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age between 18 and 30 years The presence of LTrP in the middle third of the upper trapezius muscle on the dominant side Being able to provide written informed consent Being able to follow instructions and realize clinical tests Exclusion Criteria: Any pharmacological therapeutic Any medical treatment or physical therapies at cervical region during the 6-month before this study - Any diagnosed health problem Any history of head and upper extremity surgery or trauma Any red flags to DN, (ie: metabolic diseases, pregnancy, kinesiophobia, Infection, cancer) Absence of recurrent history of neck pain No neck pain symptomatology the previous 6 months Cervical disk herniation

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 30 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Deep Dry Needling<br>Intervention-Dry Needling: Deep Dry Needing into the latent trigger point of the upper trapezius muscle | Device: Intervention-Dry Needling<br>* Deep Dry Needling into the site of the latent Trigger Point of the upper trapezius muscle. 1 session in upper trapezius muscle moving the needle up and down ten times.<br>|
| Sham Comparator: Sham Dry Needling<br>Control-Dry Needling: Sham Dry Needling into the latent trigger point of the upper trapezius muscle | Device: Control-Dry Needling<br>* Sham Dry Needling into the site of the latent Trigger Point of the upper trapezius muscle with non-penetrating needles<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Stiffness | This outcome measure is obtained by a device named MyotonPro. Stiffness reflects the resistance of the muscle to the force deforming the muscle. | Baseline, at 30 minutes after treatment, at 24 hours after treatment, at 72 hours after treatment | 
| Change in Maximal Radial Displacement (Dm) | This outcome measure is obtained by a device named Tensiomiography. The variable Dm is given by the radial displacement of the muscular belly in a transverse plane, expressed in millimeters (mm) and depends on muscle tone or stiffness. A low Dm is related to a high muscle tone or an excess of stiffness, while a high Dm value indicates a lack of muscle tone or stiffness defect. | Baseline, at 30 minutes after treatment, at 24 hours after treatment, at 72 hours after treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Oscillation Frequency | This outcome measure is obtained by a device named MyotonPro. The frequency of the damped oscillations characterizes the muscle tone. | Baseline, at 30 minutes after treatment, at 24 hours after treatment, at 72 hours after treatment | 
| Change in Decrement (elasticity) | This outcome measure is obtained by a device named MyotonPro.The logarithmic decrement of the damping oscillations characterizes muscle elasticity which is the ability of the muscle to restore its initial shape after contraction | Baseline, at 30 minutes after treatment, at 24 hours after treatment, at 72 hours after treatment | 
| Change in Mechanical Stress Relaxation Time [ms] | This outcome measure is obtained by a device named MyotonPro. Mechanical Stress Relaxation Time [ms] is the time for a muscle to recover tis shape from deformation after a voluntary contraction or a removal of an external force. | Baseline, at 30 minutes after treatment, at 24 hours after treatment, at 72 hours after treatment | 
| Change in Ratio of deformation and Relaxation time, characterising Creep (Deborah number) | This outcome measure is obtained by a device named MyotonPro. Ratio of deformation and Relaxation time, characterising Creep (Deborah number) is the gradual elongation of a tissue over time when placed under a constant tensile stress. | Baseline, at 30 minutes after treatment, at 24 hours after treatment, at 72 hours after treatment | 
| Change in Contraction time (Tc) | This outcome measure is obtained by a device named Tensiomiography. Contraction time (Tc) as a time between 10% and 90% of the contraction | Baseline, at 30 minutes after treatment, at 24 hours after treatment, at 72 hours after treatment | 
| Change in Delay time (Td) | This outcome measure is obtained by a device named Tensiomiography. Delay time (Td) as a time between the electrical impulse and 10% of the contraction | Baseline, at 30 minutes after treatment, at 24 hours after treatment, at 72 hours after treatment | 
| Change in Sustain time (Ts) | This outcome measure is obtained by a device named Tensiomiography. Sustain time (Ts) as a time between 50% of the contraction and 50% of the relaxation | Baseline, at 30 minutes after treatment, at 24 hours after treatment, at 72 hours after treatment | 
| Change in Relaxation time (Tr) | This outcome measure is obtained by a device named Tensiomiography. Relaxation time (Tr) as a time between 90% and 50% of the relaxation | Baseline, at 30 minutes after treatment, at 24 hours after treatment, at 72 hours after treatment | 
| Change in Pressure Pain Perception (PPP) | Change in Pain Pressure Threshold (PPT) as assessed using an manual mechanical algometer. The procedure performed was the same as the prior described, but pressure was kept until 2.5 kg/cm2 and maintained for 5 seconds, whereas the subject had to characterize the level of pain using a 10-mm visual analog scale (VAS) | Baseline, at 30 minutes after treatment, at 24 hours after treatment, at 72 hours after treatment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Latent trigger point, Dry needling, Myotonometer, Tensiomyography