Accuracy of rib palpation for dry needling of deep periscapular musculature, measured with ultrasound

Cushman, Daniel M.; Scholl, Linda Vernon; Ludlow, Monica; Cunningham, Shellie; Teramoto, Masaru

doi:10.1016/j.jbmt.2020.10.008

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…Research-based practice is central to improving the quality of health care by obtaining information about the knowledge, attitudes, practice patterns, the needs of practitioners [ 18 ] and to evaluate the impact of clinical research on practice [ 13 ]. Soliciting practitioner input is also essential when existing healthcare policies are being updated or to inform new policies [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Extrapolation errors in Liu et al.’s CAM integrative review of health care professionals in New Zealand

McDowell,

Kohut,

Betts

2024

BMC Complement Med Ther

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This letter is to highlight errors made by Liu et al. in their 2020 paper in BMC Complementary Medicine and Therapies, “Complementary and alternative medicine—practice, attitudes, and knowledge among healthcare professionals in New Zealand: an integrative review”. Substantial errors in their citation of the recent research and methodology by McDowell, Kohut & Betts (2019) pertaining to the practice of acupuncture in New Zealand by physiotherapists are presented. The actual results of McDowell et al.’s work and the true state of acupuncture use by their sample group is reported.

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Section: Discussionmentioning

confidence: 99%

Extrapolation errors in Liu et al.’s CAM integrative review of health care professionals in New Zealand

McDowell,

Kohut,

Betts

2024

BMC Complement Med Ther

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“…Studies have shown that ultrasound imaging for procedural guidance enhances clinician skill and confidence [15][16][17]. Studies describing clinician safety and skill with the procedural aspects of TrPDN or TrPI have examined patient positioning [18], the accuracy of rib palpation and needling of muscles requiring intercostal blocking [17,19], adverse event incidence [6][7][8][9][10], but not the needling of muscles with risk of iatrogenic injury to neurovascular structures where the muscle cannot be directly palpated. More study is needed to investigate how variation in patient anatomy influences the achievement of advancing the dry needle to target tissue, as well as how the learner's confidence with the anatomical specifics of the target tissue influences the procedural learning process.…”

Section: Discussionmentioning

confidence: 99%

Participatory action ultrasound imaging in increasing clinician confidence with new approaches to trigger point dry needling of the lateral pterygoid

Ball,

Levi,

Barrett

et al. 2024

Explor Musculoskeletal Dis

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Upon self-reflection, some clinicians privately confess a lack of confidence in being able to safely perform trigger point dry needling (TrPDN) or trigger point injection (TrPI) on craniofacial muscles. Procedural performance anxiety seems to be more pronounced relative to those muscles that cannot be palpated and/or have an increased risk of iatrogenic injury to neurovascular structures. Participatory action ultrasound imaging (PAUI) can be a useful tool in enhancing clinician confidence. A clinician-subject with a left lateral pterygoid trigger point was dry-needled under ultrasound guidance by a clinician-needler with extensive training and experience relative to evaluation and treatment of patients with craniofacial pain. Prior to PAUI, both the clinician-needler and clinician-observer describe low-to-moderate anxiety in the performance of TrPDN of the lateral pterygoid, using a lateral-to-medial approach. By contrast, both the clinician-needler and clinician-observer expressed high anxiety, objectively confirmed by the state-trait anxiety inventory (STAI) form Y-1 (STAI Y-1), in the performance of a newly learned cephalo-caudal approach. Following an initial round of clinical training without PAUI, subjective anxiety remained high despite a lower theoretical risk to the maxillary artery using the cepalo-caudal approach. A second round of training was performed with the addition of PAUI; the clinician-needler was able to reach the target tissue within 2 min in each of 3 attempts. Upon visual inspection and interpretation of the images and cine, the clinician-needler and clinician-observer both expressed a “significant” decrease in self-reported anxiety in performing the cephalo-caudal approach, objectively verified by improvements in the STAI Y-1 score of both clinicians. This case report presents PAUI as a means for future research and clinician education regarding risk assessment of TrPDN or TrPI of muscles with risk of iatrogenic injury.

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Participatory action imaging in increasing clinician confidence of trigger point dry needling or trigger point injection of muscles requiring use of intercostal blocking: A case report

Ball¹,

Ball

Satriano

et al. 2021

AJIR

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Some clinicians privately report a lack of confidence of being able to safely perform trigger point dry needling (TrPDN) or trigger point injection (TrPI) on muscles that require intercostal blocking, presumably resulting in procedural underutilization. Participatory action imaging (PAI), combined with procedural training and literature review of adverse event incidence, can be a useful tool in enhancing clinician confidence. A 6’ 2”, 185 lbs, 53-year-old male clinician subject with a latissimus dorsi trigger point (TrP) and privately reported high anxiety of performing TrPDN using the intercostal blocking technique, was examined to determine how clinician subject confidence could be improved through PAI and education regarding the degree of coverage of the intercostal space and rib during intercostal blocking. The clinician subject was placed in a left lateral decubitus position and rib imaged with a Siemens Acuson S2000 Ultrasound system with an 18L6 16 Hz high definition linear probe without intercostal blocking, and subsequently with intercostal blocking during maximal exhalation and inhalation, respectively. During intercostal blocking with maximal exhalation, the pleural space and an additional 13% of each side of the rib’s superior and inferior borders were completely blocked by the examiner’s fingers. During intercostal blocking with maximal inhalation, the pleural space and an additional 3% of each side of the rib’s superior and inferior borders were completely blocked by the fingers of the clinician. On visual inspection and interpretation of the images (e.g., PAI), the clinician subject reported a “significant” decrease in self-reported anxiety in performing the intercostal blocking technique (STAI Y-1 score improvement to “low to no anxiety range”). While more study is needed to investigate how variation in patient anatomy (weight, height, and morphology), clinician anatomy (hand size), needle direction, and specific rib being used for influences patient safety, this case report presents PAI as a previously undescribed means for future research and clinician education regarding risk assessment of TrPDN or TrPI of muscles requiring intercostal blocking.

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Accuracy of rib palpation for dry needling of deep periscapular musculature, measured with ultrasound

Cited by 3 publications

References 21 publications

Extrapolation errors in Liu et al.’s CAM integrative review of health care professionals in New Zealand

Extrapolation errors in Liu et al.’s CAM integrative review of health care professionals in New Zealand

Participatory action ultrasound imaging in increasing clinician confidence with new approaches to trigger point dry needling of the lateral pterygoid

Participatory action imaging in increasing clinician confidence of trigger point dry needling or trigger point injection of muscles requiring use of intercostal blocking: A case report

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