Exercises and Dry Needling for Subacromial Pain Syndrome: A Randomized Parallel-Group Trial

Arias-Buría, José Luis; Fernández‐de‐las‐Peñas, César; Palacios‐Ceña, María; Koppenhaver, Shane; Salom‐Moreno, Jaime

doi:10.1016/j.jpain.2016.08.013

Cited by 51 publications

(97 citation statements)

References 31 publications

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“…Following baseline examination, patients were randomly assigned to receive manual therapy, exercise and ultrasound alone or combined with electrical dry needling. Similar to our previous trials,[ 53 , 56 , 57 ] concealed allocation was conducted using a computer-generated randomized table of numbers created by a statistician who was not otherwise involved in the trial and did not participate in analysis or interpretation of the results. Individual and sequentially numbered index cards with the random assignment were prepared for each of the 10 data collection sites.…”

Section: Methodsmentioning

confidence: 99%

Electrical dry needling as an adjunct to exercise, manual therapy and ultrasound for plantar fasciitis: A multi-center randomized clinical trial

et al. 2018

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Study DesignRandomized, single-blinded, multi-center, parallel-group trial.ObjectivesTo compare the effects of adding electrical dry needling into a program of manual therapy, exercise and ultrasound on pain, function and related-disability in individuals with plantar fasciitis (PF).BackgroundThe isolated application of electrical dry needling, manual therapy, exercise, and ultrasound has been found to be effective for PF. However, no previous study has investigated the combined effect of these interventions in this population.MethodsOne hundred and eleven participants (n = 111) with plantar fasciitis were randomized to receive electrical dry needling, manual therapy, exercise and ultrasound (n = 58) or manual therapy, exercise and ultrasound (n = 53). The primary outcome was first-step pain in the morning as measured by the Numeric Pain Rating Scale (NPRS). Secondary outcomes included resting foot pain (NPRS), pain during activity (NPRS), the Lower Extremity Functional Scale (LEFS), the Foot Functional Index (FFI), medication intake, and the Global Rating of Change (GROC). The treatment period was 4 weeks with follow-up assessments at 1 week, 4 weeks, and 3 months after the first treatment session. Both groups received 6 sessions of impairment-based manual therapy directed to the lower limb, self-stretching of the plantar fascia and the Achilles tendon, strengthening exercises for the intrinsic muscles of the foot, and therapeutic ultrasound. In addition, the dry needling group also received 6 sessions of electrical dry needling using a standardized 8-point protocol for 20 minutes. The primary aim was examined with a 2-way mixed-model analysis of covariance (ANCOVA) with treatment group as the between-subjects variable and time as the within-subjects variable after adjusting for baseline outcomes.ResultsThe 2X4 ANCOVA revealed that individuals with PF who received electrical dry needling, manual therapy, exercise and ultrasound experienced significantly greater improvements in first-step morning pain (F = 22.021; P<0.001), resting foot pain (F = 23.931; P<0.001), pain during activity (F = 7.629; P = 0.007), LEFS (F = 13.081; P<0.001), FFI Pain Subscale (F = 13.547; P<0.001), FFI Disability Subscale (F = 8.746; P = 0.004), and FFI Total Score (F = 10.65; P<0.001) than those who received manual therapy, exercise and ultrasound at 3 months. No differences in FFI Activity Limitation Subscale (F = 2.687; P = 0.104) were observed. Significantly (X2 = 9.512; P = 0.023) more patients in the electrical dry needling group completely stopped taking medication for their pain compared to the manual therapy, exercise and ultrasound group at 3 months. Based on the cutoff score of ≥+5 on the GROC, significantly (X2 = 45.582; P<0.001) more patients within the electrical dry needling group (n = 45, 78%) achieved a successful outcome compared to the manual therapy, exercise and ultrasound group (n = 11, 21%). Effect sizes ranged from medium to large (0.53

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Section: Methodsmentioning

confidence: 99%

Electrical dry needling as an adjunct to exercise, manual therapy and ultrasound for plantar fasciitis: A multi-center randomized clinical trial

et al. 2018

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“…Dry needling is a commonly applied intervention for MTrPs [11,12,13]; clinically, static stretching is usually performed after dry needling treatment [14,15,16]. More specifically, the dry needling technique focuses on accurate punctures into the MTrPs, while stretching targets the muscles around the MTrPs.…”

Section: Introductionmentioning

confidence: 99%

“…[21]. A large number of studies have confirmed the beneficial effects of skeletal muscle stretching on muscle performance, range of motion and even neurological responses [13,14,15,16,22,23]. Recently, a study from Austria showed that one minute of static stretching increases H-reflex excitability and decreases muscle spindle sensitivity [16].…”

Section: Introductionmentioning

confidence: 99%

Proteins and Signaling Pathways Response to Dry Needling Combined with Static Stretching Treatment for Chronic Myofascial Pain in a RAT Model: An Explorative Proteomic Study

Huang

Barbero

et al. 2019

IJMS

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A quantitative proteomic analysis of the response to dry needling combined with static stretching treatment was performed in a rat model of active myofascial trigger points (MTrPs). 36 rats were divided into a model group (MG), a stretching group (SG) and a dry needling combined with stretching group (SDG). We performed three biological replicates to compare large-scale differential protein expression between groups by tandem mass tag (TMT) labeling technology based on nanoscale liquid chromatography mass spectrometry analysis (LC–MS/MS). Hierarchical clustering, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment and protein-protein interaction network analyses were performed for the general characterization of overall enriched proteins. For validation of the results of TMT, the candidate proteins were verified by parallel reaction monitoring (PRM) analysis. 285 differentially expressed proteins between groups were identified and quantified. Tight junction pathway played a dominant role in dry needling combined with static stretching treatment for the rat model of active MTrPs. Three candidate proteins, namely actinin alpha 3, calsequestrin-1 and parvalbumin alpha, were further validated, consistent with the results of LC–MS/MS. This is the first proteomics-based study to report the therapeutic mechanism underlying dry needling and static stretching treatment for MTrPs. Further functional verification of the potential signaling pathways and the enriched proteins is warranted.

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“…Exercise program: As there is not a consensus about exercises for shoulder pain [ 28 ], patients of both groups were instructed in how to perform three different eccentric exercises used in other similar studies [ 3 , 15 , 20 ] for the supraspinatus that were to be performed daily at home from the first to the last day of treatment (3 × 10 repetitions):…”

Section: Methodsmentioning

confidence: 99%

“…The effects of this therapy include an increase in muscle blood flow and oxygenation, the suppression of spontaneous electrical activity in the area, the release of endogenous opioids, segmental inhibition induced by Gate Control mechanisms, and the release of inflammatory mediators [ 11 ]. This approach alone has shown good clinical results in shoulder and neck pain improvement in the short and medium terms [ 12 , 13 , 14 ] but also when delivered along with an exercise program [ 15 ]. Moreover, a recent study of Arias-Buría et al supports its cost-effectiveness for the management of subacromial pain syndrome [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Percutaneous Electrolysis in Supraspinatus Tendinopathy: A Single-Blinded Randomized Controlled Trial

Rodríguez-Huguet

Góngora-Rodríguez²,

Rodríguez-Huguet

et al. 2020

JCM

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Supraspinatus tendinopathy is one of the most common causes of shoulder pain. Many studies support conservative treatments such as exercise, trigger point dry needling or corticosteroid injections. Otherwise, a minimally invasive approach with percutaneous electrolysis (PE) has also been used successfully in shoulder pain, although evidence about its long-term effects is scarce. The aim of this trial was to determine the effects of PE on supraspinatus tendinopathy compared with trigger point dry needling (TDN). Thirty-six patients with supraspinatus tendinopathy were randomly assigned to either a PE group (n = 18) or a TDN group (n = 18). Both groups also performed eccentric exercises. The main outcome to be measured was the Numerical Pain Rating Scale (NPRS), but the shoulder range of motion (ROM) and trigger point pressure pain threshold (PPT) were also considered. A one-year follow-up was conducted. Significant differences favoring the PE group were found regarding pain at one-year follow-up (p = 0.002). The improvement achieved in the PE group was greater in the NPRS (p < 0.001), proximal PPT, middle PPT, distal PPT (all p < 0.001) and ranges of movement. PE seems to be more effective than TDN in relieving pain and improving ROM and PPT supraspinatus values in patients with supraspinatus tendinopathy, both right after treatment and at one-year follow-up.

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Exercises and Dry Needling for Subacromial Pain Syndrome: A Randomized Parallel-Group Trial

Abstract: This study found that the inclusion of 2 sessions of TrP-DN into an exercise program was effective for improving shoulder pain-related disability at short-, medium-, and long-term; however, no greater improvement in shoulder pain was observed.

Cited by 51 publications

References 31 publications

Electrical dry needling as an adjunct to exercise, manual therapy and ultrasound for plantar fasciitis: A multi-center randomized clinical trial

Electrical dry needling as an adjunct to exercise, manual therapy and ultrasound for plantar fasciitis: A multi-center randomized clinical trial

Proteins and Signaling Pathways Response to Dry Needling Combined with Static Stretching Treatment for Chronic Myofascial Pain in a RAT Model: An Explorative Proteomic Study

Effectiveness of Percutaneous Electrolysis in Supraspinatus Tendinopathy: A Single-Blinded Randomized Controlled Trial

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