Triceps Surae Trigger Point Size and Muscle Extensibility

Study Overview
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Brief Summary
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The purpose of this study is to determine the effectiveness of dry needling in improving ankle range of motion and functional outcomes. There have been an increasing number of studies on dry needling as an intervention for pain but none thus far that have studied functional outcome measures of the ankle. The study will include healthy male subjects between the ages of 18-30 years old randomized in to 3 intervention groups of: dry needling of the triceps surae, triceps surae stretching only, dry needling and stretching. The subjects who receive dry needling as an intervention will have the trigger point identified and dry needling performed while under musculoskeletal ultrasound visualization. The subjects will undergo pre and post intervention testing including Lower Quarter Y-Balance test, passive ankle dorsiflexion, closed chain half kneeling dorsiflexion, standing dorsiflexion, deep squat, multisegmental flexion as well as Marx Activity Level Scale. There will be 3 days between the initial testing/intervention and follow up. These outcomes will be the primary variables of interest. Ultrasound, Y balance testing, self stretching, and range of motion measurements are safe and pose no risk to the subject. Dry Needling has been found to be very safe and effective in the hands of physical therapists with a calculated risk of adverse events to be less than 0.04%.

Official Title
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Effectiveness of Dry Needling to Decrease Trigger Point Size and Increase Soft Tissue Extensibility in the Triceps Surae Muscle as Measured Via Musculoskeletal Ultrasound

Conditions
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Limited Dorsiflexion, Limited Ankle Range of Motion

Intervention / Treatment
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* Procedure: Dry Needling
* Procedure: Stretching


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male 18-30 Years Old No history of ankle surgery No current ankle injuries Exclusion Criteria: hypothyroidism fibromyalgia connective tissue disorders chronic pain bleeding disorders including use of anti-coagulants vitamin D and B12 deficiencies active sites of cancer local or systemic infections local skin lesions, local lymphedema peripheral vascular disease including varicose veins compromised immune system needle phobia

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

Sexes Eligible for Study
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Male

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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dry Needling<br>Dry Needling to Triceps Surae | Procedure: Dry Needling<br> <br> |
| Experimental: Stretching<br>Subjects will be given a home exercise program of stretches which are commonly prescribed to improve ankle dorsiflexion. | Procedure: Stretching<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of Ankle Dorsiflexion Range Of Motion | Ankle range of motion measures will be record before and immediately after the intervention. | Baseline and 10 Minutes | 
| Change in Ankle Dorsiflexion Range of Motion | Ankle dorsiflexion will again be measured at three days after the intervention to determine short term effectiveness of results. | Baseline and 3 Days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Y-Balance Test for the Lower Quarter | Test of balance and functional performance of lower extremities. | Baseline and 20 Minutes | 
| Change in Y Balance Test for the Lower Quarter | Y Balance Test for the Lower Quarter will be assessed again at 3 days after the intervention to assess short term effectiveness. | Baseline and 3 Days |