Ischemic Compression on Post-needling Soreness

NCT02169700 | Completed DMC

• 1 other identifier: 10/2014
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

Myofascial trigger points (MTrPs) are identified through physical examination as hypersensitive spots within taut bands of skeletal muscle, painful on compression, triggering characteristic referred pain and generating motor dysfunction as well as autonomic phenomena. Different dry needling procedures have been described in the treatment of MTrPs. Needling therapies which consist in partially inserting and withdrawing the needle from the trigger point site in order to elicit local twitch responses are associated with higher effectiveness in releasing MTrPs. Deep dry needling has obtained a grade A recommendation compared to sham, for immediate reduction of pain in patients with upper-quadrant myofascial pain syndrome. Nevertheless, trigger point dry needling are frequently associated to a post-needling soreness. The application of ischemic compression (IC) after trigger point injection in the upper trapezius muscle has shown higher reduction of pain and disability in myofascial pain patients, compared with trigger point injection alone. To the authors' knowledge, no previous studies have evaluated the effectiveness of IC or any manual therapy methods for the treatment of post-needling soreness. The aims of this study were: (a) to evaluate the effectiveness of IC on reducing post-needling soreness after dry needling of one latent MTrP in the upper trapezius muscle, and (b) to investigate the effect dry needling combined with IC, compared to dry needling alone and dry needling combined with placebo IC will have on cervical range of motion (c) to determine whether psychological factors are predictive of postneedling pain and (d) to analyze if the relationships between psychological variables and postneedling pain varied as a function of postneedling soreness treatment

Conditions

Neck Pain

Keywords

Ischemic compression; Myofascial trigger points; Post-needling soreness

Outcome Measures

Primary Outcomes (1)

• Visual analog scale (VAS)

  VAS. Despite being a subjective evaluation, it has been documented in previous studies its reliability and validity and its sensitivity to the clinical changes. For this reason, this scale has been used in numerous clinical trials. The patient places a vertical mark on a flat horizontal line of 10 cm. One extreme is 0 (no pain) and the other extreme is 10 (maximum pain) and it must be a difference of 2 points in the evaluation range to produce minimal improvement which is clinically significant

  From Baseline in pain intensity at during needling and at 72 hours

Secondary Outcomes (1)

• Cervical Range of Motion (CROM)

  CROM measurements were taken before needling, after the intervention, and at 24 and 72 hours post-treatment.

Other Outcomes (1)

• Psychological variables

  Before dry needling intervention

Study Arms (3)

Ischemic compression. Dry Needling

EXPERIMENTAL

Ischemic compression was carried out after dry needling.

Procedure: Ischemic compression. Dry Needling

Sham Ischemic compression. Dry Needling

SHAM COMPARATOR

Sham Ischemic compression was carried out after dry needling.

Procedure: Ischemic compression. Dry Needling

Control group

NO INTERVENTION

No intervention. Control group

Interventions

Ischemic compression. Dry Needling PROCEDURE

Ischemic compression was carried out after dry needling. Dry needling was performed with a solid filament needle. Subjects were asked to lie in a prone position. The MTrP was held firmly in a pincer grasp. Before inserting the needle, the patient was advised about the possible sharp pain and muscle twitching. The needle was inserted perpendicular to the skin. Then, the muscle fibers were repeatedly perforated by rapidly inserting and partially withdrawing the needles from the MTrP until two local twitch responses were elicited from the muscle. On removal of the needle, the area was compressed firmly with a cotton bud for two minutes. Immediately after the needling, subjects were randomly assigned to one of three groups (IC, sham and control).

Ischemic compression. Dry Needling; Sham Ischemic compression. Dry Needling

Eligibility Criteria

• Age: 18 Years - 39 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Subjects were included if they presented at least one latent MTrP in the upper trapezius muscle

You may not qualify if:

• Presence of coagulation disorders
• Neck or facial pain
• Previous application of a dry needling technique
• MTrP therapy in head or neck within the previous 3 months
• Fibromyalgia
• An insurmountable fear of needles as a reason of refusing the treatment
• History of surgery in the head or neck area

Sponsors & Collaborators

• Universidad Rey Juan Carlos: lead

Study Sites (1)

Universidad Rey Juan Carlos

Alcorcón, Madrid, 28922, Spain

Location

Related Publications (1)

• Martin-Pintado-Zugasti A, Pecos-Martin D, Rodriguez-Fernandez AL, Alguacil-Diego IM, Portillo-Aceituno A, Gallego-Izquierdo T, Fernandez-Carnero J. Ischemic Compression After Dry Needling of a Latent Myofascial Trigger Point Reduces Postneedling Soreness Intensity and Duration. PM R. 2015 Oct;7(10):1026-1034. doi: 10.1016/j.pmrj.2015.03.021. Epub 2015 Mar 31.

  PMID: 25836591 DERIVED

MeSH Terms

Conditions

Neck Pain

Condition Hierarchy (Ancestors)

Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Josué Fernández Carnero, PhD

  Universidad Rey Juan Carlos

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD

Study Record Dates

• First Submitted: June 17, 2014
• First Posted: June 23, 2014
• Study Start: December 1, 2013
• Primary Completion: February 1, 2014
• Study Completion: May 1, 2014
• Last Updated: September 29, 2015

Record last verified: 2015-09

Locations

ES (1)