Effects of Dry Needling on Stiffness 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 reduced on Stiffness in Latent trigger point (LTrP) of upper trapezius. The secondary purposes are to determine the correlation on two elastography for stiffness measure (Shear-wave elastography and Strain elastography). 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 Myofascial Trigger Points: a Randomized Controlled Trial

Conditions
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Trigger Points

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: 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>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 1 session in upper trapezius muscle moving the needle up and down ten times.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change on Stiffness (Shear wave elastography and Strain Elastography) | Shear-wave Elastography (SWE) as assessed using an Logiq S8 US system (GE Healthcare). The stiffness was determined with measuring velocity of shear waves in trapezius muscle on SWE exam. Strain elastography (SEL) as assessed using an Logiq S8 US system (GE Healthcare). The stiffness was determined by applying light repetitive compression with the hand-held transducer | 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 Pain Pressure Threshold (PPT) | Pressure-Pain Threshold as assessed by an manual mechanical algometer. PPT is the minimal amount of pressure that produces pain and is used to assess abnormalities in nociceptive processing or hyperalgesia. | Baseline, at 30 minutes after treatment, at 24 hours after treatment, at 72 hours after treatment | 
| Change in Thickness of muscle | The muscle was scanned in the longitudinal and axial planes, taking care to avoid anisotropy. B-Mode gray scale was employed to measure muscle thickness | Baseline, at 30 minutes after treatment, at 24 hours after treatment, at 72 hours after treatment | 
| Change in Post-needling soreness | The procedure performed was the subject had to characterize the level of pain using a visual analog scale (VAS), ranging from 0mm (no pain) to 10mm (worst imaginable pain) | 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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Stiffness, Pain, Latent trigger point, Dry Needling