Comparison of Dry Needling and IASTM on Hamstring Tightness in Posterior Pelvic Tilt

Study Overview
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Brief Summary
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The purpose of the study is to compare the effects of dry needling (DN) and instrument-assisted soft tissue mobilization (IASTM) on pain, range of motion, lower extremity functional status on hamstring tightness in patients with posterior pelvic tilt.

Detailed Description
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A study conducted analyzed the effects of a 3-week combined treatment using transcutaneous electrical nerve stimulation (TENS) and instrument-assisted soft tissue mobilization (IASTM) on chronic back pain. The findings showed that this short-term combined treatment led to reduced pain levels and improved motor function in Chronic low back pain (CLBP) patients. These results suggest that TENS and IASTM could be beneficial as a complementary approach for managing chronic low back pain. In a randomized trial which shows the results by comparing the efficacy of dry needling (DN) and Graston techniques (GR) in treating upper trapezius myofascial trigger points. Both interventions, were administered twice a week for 2 weeks and when combined with conventional treatment and home exercises, showed significant improvements. However, DN demonstrated superior outcomes in terms of the myofascial diagnostic scale, neck disability index, pain rating, and cervical range of motion. These findings highlight the effectiveness of DN in targeting trigger points and optimizing clinical outcomes. A notable lacuna persists in the literature concerning the effects of dry needling (DN) and instrument-assisted soft tissue mobilization (IASTM) on patients diagnosed with hamstring tightness and concurrent posterior pelvic tilt. The dearth of comparative research, inadequate incorporation of comprehensive outcome measures, and the paucity of studies targeting this specific patient cohort contribute to this research gap. Addressing this gap would yield valuable insights into the comparative efficacies and outcomes of DN and IASTM pertaining to pain modulation, range of motion enhancement and optimization of lower extremity functional status in this distinct population subset.

Official Title
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Comparative Effects of Dry Needling and Instrument Assisted Soft Tissue Mobilization on Hamstring Tightness in Patients With Posterior Pelvic Tilt.

Conditions
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Hamstring Contractures

Intervention / Treatment
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* Device: Dry needling
* Device: IASTM


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Lack of greater or equal to 20 degrees of supine active knee extension Passive SLR less or equal to 75 degrees Atraumatic back or knee pain greater or equal to 2 weeks Individuals willing to participate in the required treatment sessions and follow-up assessments Posterior pelvic tilt 8.9 standard deviation of 4.5 degree Exclusion Criteria: History of herniated lumbar disc/radiculopathy Prior surgery in the hip, knee, or back Self-reported pregnancy History of blood borne pathogens/infectious disease/active infection Metal allergy Positive instability tests indicative of ligamentous tear Positive meniscal tests

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

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: Dry needling<br>dry needling with multimodal physical therapy approach containing hurdler stretch and extended triangular pose | Device: Dry needling<br>* dry needling using 50mm or 60mm sized needles based on individual muscle bulk. Targeted dry needling will be performed on the muscles presenting with tight hamstrings. hurdler Hamstring stretch, extended triangular pose 10 repetitions, 3 sets per session and 2 sessions per week for 4weeks. total 8 sessions , each consisting of 40mins<br>|
| Experimental: IASTM<br>IASTM with multimodal physical therapy approach containing hurdler stretch and extended triangular pose | Device: IASTM<br>* Instrument assisted soft tissue mobilization tools targeting tight hamstrings. hurdler Hamstring stretch, extended triangular pose 10 repetitions, 3 sets per session and 2 sessions per week for 4weeks. total 8 sessions , each consisting of 40mins<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ROM( Posterior pelvic tilt) | The pelvic tilt is the angle between the horizontal plan and a line drawn from the anterior superior iliac spine (ASIS) to the posterior superior iliac spine (PSIS) in quiet standing. The average ranges of anterior and posterior pelvic tilting are 13.0 ± 4.9°, and 8.9 ± 4.5°, | 4th week | 
| ROM(AKE) | The Active Knee Extension Test is used to assess hamstring muscle length and the range of active knee extension in the position of hip flexion.The subject is positioned on the examination table in supine, the lower limb that is'nt examined is positioned in stabilised on the support surface. The opposite limb is elevated so that the hip is in 90degrees of flexion and the knees are extended to reach a position perpendicular to the ground. A lag of 20degrees is considered normal from full extension, anything less than 20degrees is considered as hamstrings tightness. This range needs to be measure using a digital inclinometer | 4th week | 
| ROM(SLR) | The straight leg raise or straight leg lift is a hamstring muscle flexibility test. While the subject is lying on their back, the straight leg is raised as far as possible, and the angle of the leg from the horizontal is measured. The straight leg raise test measures hamstring tightness. Restricted flexibility in the hamstrings will contribute to lower back, pelvis, hip, and knee malalignment. The straight leg raise test focuses on proximal hamstring tightness. The test is performed passively. | 4th week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numeric pain rating scale | The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. no pain) to '10' representing the other pain extreme (e.g. pain as bad as you can imagine or worst pain imaginable) | 4th week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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dry needling, Hamstring tightness, IASTM, Posterior pelvic tilt