Treatment Time-frame Guideline for Dry Needling in the Lower Limb

Study Overview
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Brief Summary
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This study evaluates the impact of treating myofascial trigger points with a single session of dry needling on maximal isometric strength in the short term. Two groups will receive dry needling in separate muscle groups and a third group will receive no dry needling.

Detailed Description
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Dry needling is a effective treatment for myofascial trigger points. It is very common in a sporting environment. Strength is a key aspect of athletic performance. Despite the prevalence of dry needling within a sporting environment, the effects of dry needling on strength remains unknown. This study will investigate the effects of dry needling on maximal isometric strength with a view to informing clinical practice amongst clinicians working in the elite sport setting.

Official Title
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Treatment Time-frame Guidelines for Myofascial Dry Needling of Latent Myofascial Trigger Points in the Muscles of the Lower Limb Kinetic Chain.

Conditions
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Trigger Points

Intervention / Treatment
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* Procedure: Dry needling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Must have latent trigger points in their rectus femoris and gluteus maximus Exclusion Criteria: Active trigger points in rectus femoris or gluteus maximus Participants with current injuries History of fibromyalgia or myofascial pain syndrome History of blood disorder which prevents dry needling Needle phobia History of surgery in the last 6 months

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
Interventional Model Description: Participants with latent trigger points in rectus femoris (RF) and gluteus maximus (GM) muscles will be stratified evenly into 3 groups (RF dry needling, GM dry needling or control) based on baseline strength. Treatment, data collection and data analysis of all participants will be conducted concurrently.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Rectus femoris dry needling group<br>The rectus femoris dry needling group will have their strength assessed. They will then receive one treatment of dry needling to a trigger point in their rectus femoris muscle. They will have their strength re-assessed 24, 48 & 72 hours after dry needling. | Procedure: Dry needling<br>* Dry needling is an invasive procedure involving inserting acupuncture needles directly into trigger points within muscles. The needle is partially withdrawn and re-inserted repeatedly to maximally stimulate the muscle and it's fibers.<br>* Other names: Myofascial dry needling;|
| Experimental: Gluteus maximus dry needling group<br>The gluteus maximus dry needling group will have their strength assessed. They will then receive one treatment of dry needling to trigger points in their gluteus maximus muscle only. They will have their strength re-assessed 24, 48 & 72 hours after dry needling. | Procedure: Dry needling<br>* Dry needling is an invasive procedure involving inserting acupuncture needles directly into trigger points within muscles. The needle is partially withdrawn and re-inserted repeatedly to maximally stimulate the muscle and it's fibers.<br>* Other names: Myofascial dry needling;|
| No Intervention: Control<br>This group will receive no intervention. They will have their strength assessed at baseline and 24, 48 & 72 hour follow-up | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Isometric peak force during the isometric mid-thigh pull | Measured in newtons. It is the amount of force exerted by pulling against an immovable bar. Peak force is measured as vertical ground reaction by force platforms beneath the participants feet. | Baseline, 24 hours post intervention, 48 hours post intervention, 72 hours post intervention. | 
| Isometric peak rate of force development during the isometric mid-thigh pull | Measured in newtons per second squared. It is the amount of force exerted by pulling against an immovable bar divided by the amount of time it takes to generate the force. It is measured as vertical ground reaction by force platforms beneath the participants feet. | Baseline, 24 hours post intervention, 48 hours post intervention, 72 hours post intervention. | 
| Relative isometric peak force during the isometric mid-thigh pull | Measured in newtons per kg body weight. It is the amount of force exerted by pulling against an immovable bar divided by two thirds the participants body weight. Peak force is measured as vertical ground reaction by force platforms beneath the participants feet. | Baseline, 24 hours post intervention, 48 hours post intervention, 72 hours post intervention. | 
| Relative isometric peak rate of force development during the isometric mid-thigh pull | Measured in newtons per second squared per kg. It is the amount of force exerted by pulling against an immovable bar divided by the amount of time it takes to generate the force divided by two thirds the participants body weight. It is measured as vertical ground reaction by force platforms beneath the participants feet. | Baseline, 24 hours post intervention, 48 hours post intervention, 72 hours post intervention. | 
| Normalised isometric peak rate of force development during the isometric mid-thigh pull | Measured in newtons per second squared and expressed relative to each participant peak force. It is the amount of force exerted by pulling against an immovable bar divided by the amount of time it takes to generate the force divided by the peak vertical ground reaction force produced during the trial. It is measured as vertical ground reaction by force platforms beneath the participants feet. | Baseline, 24 hours post intervention, 48 hours post intervention, 72 hours post intervention. | 
| Isometric time interval rate of force development during the isometric mid-thigh pull | Measured in newtons per second squared. It is the amount of force exerted by pulling against an immovable bar divided by the amount of time it takes to generate the force. With values expressed in specific time interval windows (0ms to 50ms, 0-100ms, 0-150ms, 0-200ms, 0-250ms) It is measured as vertical ground reaction by force platforms beneath the participants feet. | Baseline, 24 hours post intervention, 48 hours post intervention, 72 hours post intervention. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dry needling, Strength, Latent trigger points