NCT03949998

Brief Summary

In about 15% of adult concussion cases, symptoms last longer than 2 weeks and can largely impact the individual's ability to work, be physically active and participate in everyday life. These symptoms are often partially related to unresolved neck muscle tightness and other neck-related symptoms. Dry needling is a technique that uses acupuncture needles to release muscle knots, decrease neck muscle tightness and decrease neck pain. As far as the investigators are aware, there have been no studies looking at the effects of dry needling on symptoms of chronic concussion. This study will compare the effects of dry needling to traditional hands-on physiotherapy treatment of the neck for concussion-related symptoms. Participants with chronic concussion symptoms will receive either dry needling, hands-on manual physiotherapy or both. Concussion symptoms, symptom severity, neck range of motion and pain with pressure over neck muscles will be compared before and after treatment, and the day after treatment. The investigators expect that the greatest improvement in all of these will be seen in the group receiving both interventions, both immediately after treatment and the following day. If dry needling can immediately improve concussion symptoms, patients may better tolerate therapeutic exercise and experience quicker resolution of chronic symptoms.

Trial Health

30
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Timeline
Completed

Started May 2019

Geographic Reach
1 country

3 active sites

Status
withdrawn

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

April 29, 2019

Completed
15 days until next milestone

First Posted

Study publicly available on registry

May 14, 2019

Completed
1 day until next milestone

Study Start

First participant enrolled

May 15, 2019

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 5, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 5, 2020

Completed
Last Updated

November 9, 2020

Status Verified

November 1, 2020

Enrollment Period

1.5 years

First QC Date

April 29, 2019

Last Update Submit

November 5, 2020

Conditions

Keywords

Dry Needling

Outcome Measures

Primary Outcomes (8)

  • Change from baseline Sport Concussion Assessment Tool v5 (SCAT-5) symptom score, immediately after intervention

    Symptom numeric rating tool validated for concussion patients, 22 listed symptoms that are either present (scored 1) or absent (scored 0), minimum = 0 (good outcome), maximum = 22 (poor outcome)

    within 10 minutes of intervention

  • Change from baseline Sport Concussion Assessment Tool v5 (SCAT-5) symptom score, 12-24 hours after intervention

    Symptom numeric rating tool validated for concussion patients, 22 listed symptoms that are either present (scored 1) or absent (scored 0), minimum = 0 (good outcome), maximum = 22 (poor outcome)

    12-24 hours after intervention

  • Change from baseline Sport Concussion Assessment Tool v5 (SCAT-5) symptom severity, immediately after intervention

    Symptom numeric rating tool validated for concussion patients, 22 listed symptoms that are scored from 0 (absent) to 6 (worst imaginable), minimum = 0 (good outcome), maximum = 132 (poor outcome)

    within 10 minutes of intervention

  • Change from baseline Sport Concussion Assessment Tool v5 (SCAT-5) symptom severity, 12-24 hours after intervention

    Symptom numeric rating tool validated for concussion patients, 22 listed symptoms that are scored from 0 (absent) to 6 (worst imaginable), minimum = 0 (good outcome), maximum = 132 (poor outcome)

    12-24 hours after intervention

  • Change in baseline Cervical Range of Motion, immediately after intervention

    Cervical Active Range in flexion, extension, bilateral side flexion, bilateral rotation, measured in degrees using a CROM (Cervical Range of Motion) tool that measures multidirectional movement, each of the 6 ranges will be reported on their own in degrees and the 6 will also be added together for a total range measurement in degrees

    within 10 minutes of intervention

  • Change in baseline pain score with Cervical Range of Motion, immediately after intervention

    Pain Rating Scale at end of range flexion, extension, bilateral side flexion, bilateral rotation (as measured in Outcome 5), scored 0 (no pain) - 10 (worst pain imaginable), 0 = best outcome, 10 = worst outcome, total score for all 6 movements will be computed out of 60 (0=best, 60=worst)

    within 10 minutes of intervention

  • Change in baseline pain score with Cervical Range of Motion, 12-24 hours after intervention

    Pain Rating Scale at end of range flexion, extension, bilateral side flexion, bilateral rotation (as measured in Outcome 5), scored 0 (no pain) - 10 (worst pain imaginable), 0 = best outcome, 10 = worst outcome, total score for all 6 movements will be computed out of 60 (0=best, 60=worst)

    12-24 hours after intervention

  • Change in baseline of Pain Pressure Threshold (the smallest amount of pressure that evokes pain) as measured using a pressure algometer, immediately after baseline

    The pressure algometer is applied to the test muscle (in this case bilateral upper fibres trapezius, levator scapulae, suboccipital group and cervical multifidus at the base of the neck) and pressure is applied incrementally until pain is reported, the outcome is the least amount of pressure (in kilograms) applied over a muscle that evokes pain (lowest = 0 kg, higher values are better outcomes)

    within 10 minutes of intervention

Study Arms (3)

Dry Needling

EXPERIMENTAL

Participants will receive dry needling of the following muscles as indicated: upper fibres trapezius, levator scapulae, cervical multifidus, suboccipitals.

Device: Dry Needling

Dry Needling + Manual Therapy

ACTIVE COMPARATOR

Participants will receive dry needling of the following muscles as indicated: upper fibres trapezius, levator scapulae, cervical multifidus, suboccipitals IN ADDITION TO manual therapy of the above muscles and/or cervical joint traction and/or mobilization as indicated.

Device: Dry NeedlingOther: Manual Therapy

Manual Therapy

ACTIVE COMPARATOR

Participants will receive manual therapy of the following muscles as indicated: upper fibres trapezius, levator scapulae, cervical multifidus, suboccipitals and/or cervical joint traction and/or mobilization as indicated.

Other: Manual Therapy

Interventions

Comparison between dry needling and/or manual therapy of the cervical region.

Also known as: Intramuscular Stimulation (Gunn IMS), Integrated Dry Needling (IDN)
Dry NeedlingDry Needling + Manual Therapy

soft tissue release, cervical traction and/or cervical mobilization

Dry Needling + Manual TherapyManual Therapy

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • experiencing concussion symptoms at least 4 weeks following an external impact injury to the head

You may not qualify if:

  • medical diagnoses of depression and/or anxiety
  • skull fractures
  • subdural or epidural haematomas
  • parenchymal bleeds
  • recent infection
  • vascular anomaly
  • hypertension
  • current or past smoker
  • high cholesterol
  • family history of stroke
  • migraine
  • malignant/inflammatory disease
  • osteoporosis
  • bleeding disorde
  • damaged heart valves
  • +2 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

Eramosa Physiotherapy - Elora

Elora, Ontario, N0B1S0, Canada

Location

Eramosa Physiotherapy - Bullfrog Mall

Guelph, Ontario, N1E6R2, Canada

Location

Health and Performance Centre

Guelph, Ontario, N1G2W1, Canada

Location

MeSH Terms

Conditions

Post-Concussion Syndrome

Interventions

Dry NeedlingMusculoskeletal Manipulations

Condition Hierarchy (Ancestors)

Brain ConcussionHead Injuries, ClosedCraniocerebral TraumaTrauma, Nervous SystemNervous System DiseasesWounds and InjuriesWounds, Nonpenetrating

Intervention Hierarchy (Ancestors)

Complementary TherapiesTherapeuticsPhysical Therapy ModalitiesRehabilitation

Study Officials

  • Margo Mountjoy, MD

    Adjunct Professor

    PRINCIPAL INVESTIGATOR
0

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Adjunct Professor

Study Record Dates

First Submitted

April 29, 2019

First Posted

May 14, 2019

Study Start

May 15, 2019

Primary Completion

November 5, 2020

Study Completion

November 5, 2020

Last Updated

November 9, 2020

Record last verified: 2020-11

Data Sharing

IPD Sharing
Will not share

Locations