Clinical trial NCT02638987: EMG Activity Before, During and After Dry Needling
Official title: EMG Activity, Muscle Tone, Elasticity and Stiffness of the Upper Trapezius Before, During and After Dry Needling
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Neck Pain
Keywords: Dry needling
office workers
myofascial pain
electromyography
Lead sponsor: University Ghent
Sponsor class: OTHER
First posted: 2015-12-23
Enrollment: 24
Sex: FEMALE
Minimum age (years): 25
Maximum age (years): 55
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: OTHER

Brief summary: An experimental study will be conducted to evaluate the effect of a single dry needling session on surface EMG activity (primary outcome measure), muscle tone, elasticity, stiffness and pain (secondary outcome measures) of the upper trapezius, in female office workers with trapezius myalgia.

Detailed description: Neck-shoulder pain is a frequent problem in office workers . These complaints are often related to myofascial problems of neck and shoulder muscles in which the upper trapezius is frequently involved. Trapezius myalgia (TM) is characterized by pain, palpable stiffness and tenderness of the upper part of the trapezius muscle. Several studies show that myofascial trigger points (MTrP) have an important role in the development and maintenance of myofascial pain.

Trigger points are defined as hyperirritable nodules in a contracture of skeletal muscle fibers.

The pathophysiology of MTrPs is still unclear but several hypothesis exist. The most plausible explanation is that, due to sustained postures or repetitive low-level tasks, a sustained irritation of motor end plates with an excessive release of acetylcholine arises. This may lead to a persistent sarcomere contraction, leading to an impaired blood circulation, a reduced oxygenation and energy depletion, sensitizing nociceptors and causing pain.

Dry needling (DN) is a myofascial treatment technique, in which a thin, solid filiform needle is inserted directly into the MTrP. During dry needling, local twitch responses (LTR) can be elicited. These are involuntary contractions of muscle fibers, leading to muscle relaxation, an increase in blood flow, recovery of the muscle metabolism and thus a reduction of pain and stiffness.

In this experimental study, 25 female office workers with trapezius myalgia are recruited from several work places with predominantly computer based tasks. These subjects have to perform at least 20 hours a week of computer work and this since at least one year. Subjects are included based on online questionnaires, a clinical examination of neck an shoulder and the presence of MTRP 2 in the upper trapezius. All participants will receive information and have to sign an informed consent form.

Participants will be subjected to baseline assessment which involves measuring resting surface EMG activity, muscle tone, stiffness, elasticity and pain. Then, subjects have to perform a computer task during 20 minutes while surface EMG activity will be measured every 5 minutes. After this computer task, all measurements will be repeated. After a resting period of 10 minutes, baseline measurements are repeated, followed by a computer task of 20 minutes and repetition of the same assessment. After this computer task, a single dry needling session of MTrP 2 of the upper trapezius will be performed bilaterally. During this treatment, surface EMG activity will be measured to captivate the EMG activity during local twitch responses.

This is followed by repeating the same measurements 1 and 10 minutes after dry needling.

Eligibility criteria: Inclusion Criteria:

* Performing office work since at least one year
* Performing computer based tasks for at least 20 hours a week
* NRS \> or equal to 3/10
* Clinical diagnosis of trapezius myalgia
* Trapezius myalgia is work-related and thus aggravates during working day/week
* Presence of MTrP2 in the upper trapezius muscle (bilaterally)

Exclusion Criteria:

* Being in treatment during the study
* Traumatic injuries/surgery to neck and upper limb region
* Signs of cervical nerve root impingement
* Whiplash injury
* Cardiovascular, neurological, life threatening, systemic and metabolic diseases
* Diagnosis of fibromyalgia/chronic fatigue syndrome
* Shoulder pathology
* Coagulation disorders
* Pregnancy

Primary outcomes:
measure: Changes in surface resting EMG activity of the upper trapezius after dry needling as assessed by the EMG DTS device
timeFrame: Immediately after a typing task of 20 minutes, one minute after dry needling, 10 minutes after dry needling
Secondary outcomes:
measure: Changes in surface resting EMG activity of the upper trapezius after rest as assessed by the EMG DTS device
timeFrame: Immediately after a typing task of 20 minutes, immediately after a resting pause of 10 minutes
measure: Changes in surface resting EMG activity of the upper trapezius during a fatiguing typing task of 20 minutes as assessed by the EMG DTS device
timeFrame: During the typing task, every five minutes EMG activity will be measured for 30 seconds
measure: Differences in active muscle tension of the upper trapezius (ratio between resting EMG activity in upright and lying position) between the (dominant) painful and heterolateral side, as assessed by the EMG DTS device
timeFrame: At baseline
measure: Differences in muscle fatigue of the upper trapezius (ratio between resting EMG activity before and after a typing task of 20 minutes) between the (dominant) painful and heterolateral side, as assessed by the EMG DTS device
timeFrame: Before and after a typing task of 20 minutes
measure: Changes in muscle tone, stiffness and elasticity of the upper trapezius after dry needling as assessed by the MyotonPRO ®
timeFrame: Immediately after a typing task of 20 minutes, one minute after dry needling, 10 minutes after dry needling
measure: Changes in muscle tone, stiffness and elasticity of the upper trapezius after rest as assessed by the MyotonPRO ®
timeFrame: Immediately after a typing task of 20 minutes, immediately after 10 minutes of rest
measure: Changes in muscle tone, stiffness and elasticity of the upper trapezius after a typing task, compared to baseline, as assessed by the MyotonPRO ®
timeFrame: Before and immediately after a typing task of 20 minutes
measure: Differences in muscle tone, stiffness and elasticity of the upper trapezius between the (dominant) painful and heterolateral side, as assessed by the MyotonPRO ®
timeFrame: At baseline
measure: Changes in pain score after dry needling as assessed by the numeric rating scale
timeFrame: Immediately after a typing task of 20 minutes, one minute after dry needling, 10 minutes after dry needling
measure: Changes in pain score after rest as assessed by the numeric rating scale
timeFrame: Immediately after a typing task of 20 minutes, immediately after 10 minutes of rest
measure: Changes in pain score after a typing task of 20 minutes as assessed by the numeric rating scale
timeFrame: Immediately before and after a typing task of 20 minutes
measure: Differences in pain score at baseline between the (dominant) painful side and heterolateral side
timeFrame: At baseline
Other outcomes:
Locations:
Study officials:
affiliation: University Ghent
name: Barbara Cagnie, PhD
role: PRINCIPAL_INVESTIGATOR
References: