Comparative Study, Between Dry Needling Techniques, in the Evolution of Myofascial Pain Shoulder in Athletes. Elastography as Indicator in the Repair of Myofascial Tissue, Post-dry Needling.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 77
- 试验地点
- 2
- 主要终点
- Number of input-output of acupuncture needle in the infraspinatus and supraspinatus muscles.
研究概览
简要总结
This study evaluates the deep dry needling technique as a percutaneous technique included in the professional field of physiotherapy.
The project quantifies a significant limit on the number of local twitch responses necessary for the favorable treatment of myofascial pain and analyzes the injury degree and/or the repair of myofascial tissue, with "Elastography".
详细描述
The myofascial shoulder pain caused by myofascial trigger points, is one of the main causes of medical consultation and functional disability in the general population and particularly in the amateur athlete.
Nowadays, many physiotherapists all over the world, study and practice the dry needling as a therapeutic tool for the treatment of myofascial trigger points. The most used modality is the technique described by Hong:
- This technique introduces an acupuncture needle in the skin until reaching the dysfunctional muscle fiber. To do so, it uses maneuvers "fast in" and "fast out" of needle, until the extinction of local twitch responses or the tolerance of the patient.
- The local twitch response is defined as a reflex and transitory contraction of a group of muscle fibers associated with a myofascial trigger points.
- The technique eliminates muscle contractile activity by mechanical interruption of their muscle fibers, mechanism which finishes with the sensitization of nearby nerves and with the start of the nociceptive modulation peripheral, segmental and central.
The dry needling technique, in its eagerness to obtain local twitch responses, pierces the muscle fibers both dysfunctional and normal, the fascial tissue that wraps the myofascial trigger points and also neuro-vascular structures. That is, the treatment of myofascial trigger points with dry needling, makes reference to a mechanical trauma done with a acupuncture needle.
The myofascial tissue injured can suffer repair or regeneration, which is mainly due to the extension of the lesion. The process of healing of a wound is strictly regulated by multiple growth factors and cytokines, which are released into the wound. The alterations that disturb the healing process, can lead to chronic wounds that do not heal or to an excessive fibrosis.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Treatment
- 盲法
- Double (Participant, Investigator)
入排标准
- 年龄范围
- 18 Years 至 49 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Unilateral shoulder pain or referred pain pattern of the infraspinatus muscle.
- •Pain Intensity with a minimum score of 2 on the Wong-Baker scale, using the homolateral "test hand-back".
- •Process time more than 1 and less than 10 weeks.
- •Age of 18 years old to 49 years old.
- •Written Informed Form.
排除标准
- •Conventional pharmacological treatment of NSAIDs and / or muscle relaxants, the 48 hours before or during the study.
- •Coagulation pathology or anticoagulant therapy.
- •Pretreatment with infiltration and / or steroid injections during the last year.
- •Physiotherapy Pretreatment, in the cervical region or shoulder girdle during or in the last week taking part in the study.
- •Dry needling pretreatment in the cervical region and / or shoulder girdle during or in the last month before taking part in the study.
- •History of fracture or dislocation of the shoulder to study, in the last year.
- •Dermatological disorders or erosions in the treatment area (infraspinatus fossa).
- •Metals allergy such as chromium or nickel.
- •Fibromyalgia diagnosis, myelopathy, cervical radiculopathy or neurologic disease.
- •Fear of needles.
- •Pregnant women.
- •Suffering a traumatic accident of the upper extremity and / or cervical-thoracic spine during the study (it will pass to the zero week).
- •Medical-legal litigious, by financial compensation.
- •Drugs or alcohol abuse / consumption history.
- •Cognitive inability to complete the health forms.
研究组 & 干预措施
High Intensity Dry Needling
Maneuver of Input-Output with the acupuncture needle, until the disappearance of local twitch responses or patient tolerance.
干预措施: High Intensity Dry Needling (Other)
Low Intensity Dry Needling
Maximum 10 input-output maneuvers with acupuncture needle or maximum 3 local twitch responses or patient tolerance.
干预措施: Low intensity Dry Needling (Other)
Fascial mechanotransduction Dry needling
Maneuver of input, screwing and pulling out of the needle acupuncture.
干预措施: Fascial Mechanotransduction Dry Needling (Other)
Placebo Dry Needling Technique
Technique is performed with the "Park´s Sham device".
干预措施: Technique Placebo of Dry Needling (Other)
结局指标
主要结局
Number of input-output of acupuncture needle in the infraspinatus and supraspinatus muscles.
时间窗: Three interventions during 40 days.
This outcome only used with High Intensity Dry Needling and Low Intensity Dry Needling techniques. The number of input-output of the acupuncture needle are established in each technique. The first 3 interventions are recorded with a compact sporty camera with a bracket on the head. This method allows recording, specifically, the number of input-output of the acupuncture needle.
Number of local twitch response in the infraspinatus and supraspinatus muscles.
时间窗: Three interventions during 40 days.
The limits of number of local twitch response are established in each technique to study.
次要结局
- Feeling of shoulder pain(Four interventions during 40 days.)
- Life quality related to health shoulder.(Two interventions during 40 days.)
- Active joint range of motion(Four interventions during 40 days.)
- Quality of the myofascial tissue by elastography(Two interventions during 40 days. A third intervention at 6 months after the second, to determine the degree of myofascial fibrosis.)
- Pressure pain threshold(Four interventions during 40 days.)
研究者
Francisco jiménez Hidalgo
Physiotherapist
University of the Basque Country (UPV/EHU)