Effectiveness of Trigger Point Dry Needling on Plantar Fasciitis

NCT05588349 | Unknown

• 1 other identifier: ChineseUHK2022
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

Plantar fasciitis could lead to pain, disability and impaired balance. Dry needling that targets myofascial trigger points (MTrPs) has been shown to be beneficial in reducing pain, improving range of motion and function in patients with musculoskeletal conditions. Previous systematic review suggested a positive effect of dry needling on improving pain intensity and pain-related disability in patients with plantar heel pain (Llurda-Almuzara et al., 2021). However, the generalisability of the result is limited by small number of trials and heterogenicity in the dry needling application. Also, there is currently no evidence on its effect on dynamic balance and ankle dorsiflexion range of motion. This randomized controlled trial is designed to investigate the effectiveness of dry needling on pain, pain-related disability, dynamic balance and ankle dorsiflexion range of motion in patients with plantar fasciitis.

Conditions

Plantar Fascitis

Keywords

Plantar fasciitis; Dry needling

Outcome Measures

Primary Outcomes (1)

• Change in first-step pain intensity

  The change in first-step pain intensity will be measured by the numeric pain rating scale (NPRS), which is a 11-point scale ranging from 0 ("no pain") to 10 ("the worst pain imaginable").

  Baseline to 4 weeks

Secondary Outcomes (3)

• Change in pain-related disability

  Baseline to 4 weeks

• Change in dynamic balance

  Baseline to 4 weeks

• Change in weight bearing ankle dorsiflexion range of motion

  Baseline to 4 weeks

Study Arms (2)

Dry needling + stretching exercise

EXPERIMENTAL

After locating the MTrPs, hand hygiene of the physiotherapist will be done and the needling site will be disinfected with alcohol swab. 0.30 x 50 mm disposable stainless-steel needles (DongBang Acupuncture Inc., Boryeong, Korea) will be used. The needle will be inserted into the muscle and pistoned in an up-and-down fashion using the "fast in and fast out" technique in order to provoke the local twitch response (LTR). This will be repeated until either the LTRs are exhausted, or the participant's tolerance threshold is met. If the participant is sensitive to the needle stimulation, the manipulation will be reduced. The needle will be left in situ for five minutes (Cotchett et al., 2011). Participants will receive dry needling once per week for three weeks. Plantar fascia and calf stretching exercise will be taught

Other: Dry needling

Stretching exercise

ACTIVE COMPARATOR

Plantar fascia stretching exercise: Participants will be instructed to sit with the affected foot placed on the contralateral thigh with the toes being grasped and pulled into extension until a stretch is felt in the plantar fascia. Calf stretching exercise: To focus on stretching the gastrocnemius, participants will be taught to stand with both hands holding onto the wall and keep the affected leg back with knee straightened and heel in contact with the floor. Slowly lean forward to the wall until a stretch is felt in the calf. To focus on stretching the soleus, the same procedures will be taught except with the affected knee being bent.

Other: Stretching exercise

Interventions

Dry needling OTHER

Dry needling + stretching exercise

Dry needling + stretching exercise

Stretching exercise OTHER

Stretching exercise only

Stretching exercise

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age of 18-65 years
• Clinical diagnosis of plantar fasciitis in accordance with the clinical guidelines of the Orthopaedic Section of the American Physical Therapy Association (APTA)
• Pain intensity of a minimum score of 5 on 11-point NPRS
• Presence of trigger points of the gastrocnemius or soleus muscles or both
• History of plantar heel pain for over 1 month

You may not qualify if:

• Needle allergy or phobia
• Bleeding disorders or severe vascular disease
• Pregnancy
• Cancer
• Fracture or surgery in the foot region or leg
• Infection
• Dermatological disease in the area of needling
• History of injection therapy in the heel during the previous three months
• Cognitive impairment
• Neurological disorders affecting balance

Sponsors & Collaborators

• Chinese University of Hong Kong: lead

Study Sites (1)

Our Lady of Maryknoll Hospital

Hong Kong, Hong Kong

RECRUITING

Related Publications (2)

• Llurda-Almuzara L, Labata-Lezaun N, Meca-Rivera T, Navarro-Santana MJ, Cleland JA, Fernandez-de-Las-Penas C, Perez-Bellmunt A. Is Dry Needling Effective for the Management of Plantar Heel Pain or Plantar Fasciitis? An Updated Systematic Review and Meta-Analysis. Pain Med. 2021 Jul 25;22(7):1630-1641. doi: 10.1093/pm/pnab114.

  PMID: 33760098 BACKGROUND

• Cotchett MP, Landorf KB, Munteanu SE, Raspovic AM. Consensus for dry needling for plantar heel pain (plantar fasciitis): a modified Delphi study. Acupunct Med. 2011 Sep;29(3):193-202. doi: 10.1136/aim.2010.003145. Epub 2011 Apr 18.

  PMID: 21504939 BACKGROUND

MeSH Terms

Conditions

Fasciitis, Plantar

Interventions

Dry Needling; Muscle Stretching Exercises

Condition Hierarchy (Ancestors)

Fasciitis; Musculoskeletal Diseases; Foot Diseases

Intervention Hierarchy (Ancestors)

Complementary Therapies; Therapeutics; Physical Therapy Modalities; Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Central Study Contacts

Wong

CONTACT

64323868; 1155168950@link.cuhk.edu.hk

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: Student

Model Details: Dry needling plus stretching exercise versus stretching exercise alone

Study Record Dates

• First Submitted: October 15, 2022
• First Posted: October 20, 2022
• Study Start: February 1, 2023
• Primary Completion: April 30, 2023
• Study Completion: May 31, 2023
• Last Updated: February 14, 2023

Record last verified: 2023-02

Data Sharing

• IPD Sharing: Will not share

Locations

HK (1)