Effects of Dry Needling on Vertical Jump Performance

Study Overview
=================
Brief Summary
-----------------
Injury prevention and performance enhancement have become two of the main goals in every sport. Myofascial Pain Syndrome is caused mainly by myofascial trigger points which may lead to referred pain, stiffness, shortening and/or muscle weakness. The aim of this study is to evaluate the effects of dry needling of latent myofascial trigger points (LTMTP) on vertical jump height in female volleyball players. The study is a single-blind randomized controlled clinical trial. It is performed on healthy female volleyball practitioners, with no lower limb injuries in the last 6 months, whith LMTP in triceps surae muscles and that are familiar with counter movement jump (CMJ) test. Subjects will be randomly assigned to a control group or an intervention group.

Detailed Description
-----------------
This study will be a single-blind randomized clinical trial carried out in the department of Invasive Physiotherapy of a private Physiotherapy Clinic in Toledo. The inclusion criteria is : healthy female volleyball practitioners; no lower limb injuries in the last 6 months; presence of latent MTPs in gastrocnemius; familiar with performing CMJ tests. Subjects will not be eligible for the study if they have needle phobia; presence of active MTPs in the lower limb; any pathology that prevented the use of dry needling; any pathology that prevented the performance of CMJ test. Subjects wil be randomly assigned to two groups: intervention group and control group. Sealed cards containing numbers 1 to 24 in opaque envelopes which participants will pick at random. Odd-numbered subjects will become part of the control group, while subjects with even numbers will be part of the intervention group. All subjects must sign a copy of the consent form, in which the objectives and procedures of the study will be described and explained. Both groups will perform a standard warm-up session consisting on continuous running, dynamic lower limb stretching, and vertical jumps for 10 minutes (T0). Subsequently, the principal investigator will apply the dry needling technique to those allocated to the experimental group. The second measurement will be carried out immediately after the needling technique (T1). Subjects in the control group will be asked to wait on the intervention couch for a similar time the ones who will receive the treatment. The third and fourth assessments will be perform in the same clinical setting and approximately at the same time of the day after 72 hours (T3) and 7 days (T4) respectively. At each of the study points, participants will performed 3 CMJ tests. CMJ-style jumps will be recorded with the iPhone 15 high-speed camera (Apple Inc., USA). The app My Jump, 2 validated with force platform, calculates the flight time by identifying the takeoff and landing of the subject and transforming it by an equation described in the literature. The best of the three jumps will be recorded. The assessor will be blinded to the allocation group of the participants.

Official Title
-----------------
Effects of Dry Needling on Latent Myofascial Trigger Points on Vertical Jump Performance in Female Athletes.

Conditions
-----------------
Sports Physical Therapy

Intervention / Treatment
-----------------
* Other: dry needling


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: no lower limb injuries in the last 6 months; presence of latent MTPs in gastrocnemius; familiar with performing CMJ tests Exclusion Criteria: needle phobia; presence of active MTPs in the lower limb; any pathology that prevented the use of dry needling; any pathology that prevented the performance of CMJ test.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 25 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: single-blind randomized clinical trial. two groups: intervention group and control group.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: intervention group<br>the principal investigator will apply the dry needling technique to those allocated to the experimental group on the latent trigger points diagnosed on the selection phase. They will receive just one session following Hongs protocol. | Other: dry needling<br>* the area is disinfected by the use of 0.5% chlorhexidine digluconate alcohol solution. The physiotherapist in charge of the intervention uses sterile nitrile gloves, using dry needling needles with dimensions of 0.30 x 50 mm is used. This technique, designed by Hong, applies speed both at the entrance, in order to provoke the local spasm response and at the exit. The inputs and outputs are performed until the REL disappears or until the tolerance threshold of the patient is reached. Immediately after performing the puncture, ischemic compression is performed on the treated muscle, in order to decrease the duration and intensity of post-puncture pain. For this, a digital pressure is made to the point where the patient's sensation ceases to be pressure and becomes pain. Once the patient is noted that pain is repeated again the art up to a total of 2 minutes<br>|
| No Intervention: control group<br>Subjects in the control group will be asked to wait on the intervention couch for a similar time the ones who received the treatment. | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| counter movement jump | The subject is in an upright position with the hands at the waist, having to make a vertical jump after a quick countermovement down. During knee and hip flexion action, the trunk should remain as straight as possible to avoid any possible influence of trunk extension on lower limb performance. | 15 minutes |