Does Percutaneous Neuromodulation Promote Recovery in Hockey Players With Grade 0 Adductor Injuries?

NCT07082556 | Completed DMC

• 1 other identifier: NMP-e_hockey_aductores
• Study Type: interventional
• Target: 11
• Locations: 1 country
• Sites: 1

Brief Summary

Ice hockey is a widely practiced sport, particularly in North America and Europe, with over 2,500 professional players in North America and approximately 2,000 in Europe. Its global expansion has extended participation to regions such as Africa and Australia. This sport demands high physical performance, speed, strategy, and specific preparation to prevent injuries. The most common injuries include muscular and joint trauma, especially in the knees, shoulders, and groin region, where "groin pain" is a frequent issue. Injuries to the hip joint, such as femoroacetabular impingement (FAI), acetabular labrum and cartilage lesions, and intra-articular loose bodies, are prevalent. Extra-articular injuries primarily involve the adductor and abdominal muscles. The biomechanics of ice skating require repetitive and forceful hip movements, increasing eccentric load on the adductors, particularly at higher skating speeds, thereby raising the risk of strains. Studies have shown that the adductor muscles, particularly the adductor longus, are the most frequently injured. Risk factors include a history of previous injury, high training intensity, strength imbalances between adductors and abductors, and inadequate preseason preparation. A critical threshold is the adductor/abductor strength ratio: if it falls below 80%, the risk of injury increases 17-fold. Invasive physiotherapy has gained prominence as an effective option for the treatment and prevention of such injuries. Ultrasound-guided invasive techniques, such as ultrasound-guided percutaneous neuromodulation (US-guided PNM), have demonstrated the ability to reduce muscle stiffness, improve intra- and intermuscular coordination, and enhance endurance. These techniques have shown greater efficacy than conventional methods, contributing to improved athletic performance and reduced injury risk. US-guided PNM is a minimally invasive technique that delivers electrical stimulation via needles placed under ultrasound guidance near peripheral nerves or motor points. The stimulation is adjusted according to therapeutic goals, whether to reduce pain, improve neuromuscular function, or modulate muscle tone. Its efficacy has been documented in studies showing improvements in flexibility, strength, and post-exertion recovery, with effects observed even in the contralateral limb, attributed to the crossover phenomenon. Given the high incidence of adductor injuries among hockey players and the associated risk factors, this clinical study aimed to evaluate the effectiveness of a single session of US-guided PNM in players with grade 0 (muscle contracture) injuries of the adductor muscles. Three primary variables were assessed: muscle strength (Adductor Squeeze Test), hip mobility (Bent Knee Fall Out Test), and subjective pain (VAS scale), both in daily activities and during on- and off-ice training.

Conditions

Grade 0 Adductor Injurie

Keywords

Neromodulation; Percutaneous; Ultrasound; Obturator nerve; hockey players

Outcome Measures

Primary Outcomes (3)

• VAS (ADL)

  Pain during the activities of the daily life. This variable will be assessed through the Visual Analogue Scale (0-10 points)

  2 times, immediately pre-intervention and immediately after the first training posterior to the intervention.

• VAS (ON ice)

  Pain during hockey training on ice. This variable will be assessed through the Visual Analogue Scale (0-10 points)

  2 times, immediately pre-intervention and immediately after the first training posterior to the intervention.

• VAS (OFF ice)

  Pain during training out of the ice. This variable will be assessed through the Visual Analogue Scale (0-10 points)

  2 times, immediately pre-intervention and immediately after the first training posterior to the intervention.

Secondary Outcomes (2)

• Maximum Isometric Strength. Hip Adductors

  2 times, immediately pre-intervention and immediately post-intervention

• Passive hip mobility

  2 times, immediately pre-intervention and immediately post-intervention.

Study Arms (1)

US-guided PNM

EXPERIMENTAL

Each participant will be treated with US-guided PNM targeting the anterior branch of the obturator nerve.

Other: US-guided PNM

Interventions

US-guided PNM OTHER

Stimulation will be applied for 15 minutes at 4 Hz, using a 250 ms pulse duration.

US-guided PNM

Eligibility Criteria

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

You may qualify if:

• Age over 18 years
• Pain in the adductor region
• Clinical diagnosis with ultrasound confirmation of the absence of structural damage, consistent with a grade 0 muscle injury (contracture) localized in the adductors

You may not qualify if:

• Presence of muscle injuries above grade 0
• Concomitant neurological, systemic, or orthopedic conditions
• Recent application of neuromodulation techniques or other similar treatments performed by healthcare professionals within the last 7 days
• Belonephobia (fear of needles)
• Infections or skin disorders localized in the inguinal region

Sponsors & Collaborators

• Universidad de Zaragoza: lead

Study Sites (1)

University of Zaragoza

Zaragoza, 50006, Spain

Location

Study Officials

• Pablo Herrero, Physiotherapist

  Universidad de Zaragoza

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: OTHER
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: June 27, 2025
• First Posted: July 24, 2025
• Study Start: June 27, 2025
• Primary Completion: September 1, 2025
• Study Completion: October 1, 2025
• Last Updated: January 20, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: Once research has been published
• Access Criteria: Study protocol will be publish in a scientific journal

Locations

ES (1)