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Introduction: Physiotherapy treatment is a common intervention for low back pain (LBP) patients. These interventions have been related to physiological effects in the central nervous system. Thus, the aim of this study was to analyze the effect of physiotherapy treatment in patients with LBP in the autonomic nervous system activation and subjective pain perception of patients. Methods: A total of 30 male subjects diagnosed with non-specific subacute LBP received a 50 min session consisting of (a) a manual therapy based on joint mobilization and soft tissues techniques in the lumbo-pelvic area, (b) a stretching program, and (c) motor control exercises of the core muscles. The autonomic modification of participants was assessed prior to and after the physiotherapy treatment. Results: Heart rate variability (HRV) analysis reported a significant increase in average RR (p = 0.001), RMSSD (p = 0.008), LRMSSD (p = 0.001), SDNN (p = 0.005), and PNN50 (p = 0.024) after the session. Frequency-domain measures showed a significant increase in LF (p = 0.030) and HF (p = 0.014), and a decrease in LF/HF ratio (p = 0.046). A significant decrease was found in minimum HR values (p = 0.001) and average HR (p = 0.001). Moreover, maximal HR decreased its value from 116.7 ± 26.1 to 113.7 ± 40.8 after intervention. In addition, subjective pain perception (VAS scores) was significantly lower (p = 0.001) in the post-session assessment. Conclusions: Physiotherapy treatment produced an increase in parasympathetic nervous system activation and a decrease in subjective pain perception in non-specific subacute LBP patients.

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IntroductionBackground: Lateral ankle sprain (LAS) is the most common musculoskeletal injuries in sport and general population. The goal of the present study was to observe the effectiveness of dry needling (DN) in gluteus medius muscle in patients with chronic ankle instability (CAI).Material and methodsA two-arm (1:1), single-blinded (participants), randomized clinical trial was performed in 40 subjects with chronic ankle instability and were divided in two groups: intervention group who received one session of dry needling in the most hyperalgesic gluteus medius myofascial trigger point (MTrP), (n = 20) and control group (n = 20). Dynamic balance, pain intensity, pain pressure threshold (PPT) and ankle dorsiflexion range of motion (ROM) were assessed at baseline, post-intervention and a 1-week follow up.ResultsThe experimental group reported significant differences with respect to the control group for the anterior and medial dynamic balance (p = .001), PPT -ATL (p = .002) and ankle dorsiflexion ROM (p = .001).ConclusionsThe findings of the present study suggested that the DN in the most hyperalgesic MTrP of the Gmed muscle may increase the anterior and medial dynamic balance, ankle ROM and PPT-ATL at short-term in individuals with CAI. Pain intensity benefits were reported in both groups. Future studies should consider DN as a possible intervention in conjunction with a physical therapy program for individuals with CAI.