Prediction model of rhomboid major and pleura depth based on anthropometric features to decrease the risk of pneumothorax during dry needling

Valera‐Calero, Juan Antonio; Cendra-Martel, Enrique; Fernández-Rodríguez, Tomás; Fernández‐de‐las‐Peñas, César; Gallego-Sendarrubias, Gracia María; Guodemar-Pérez, Jesús

doi:10.1111/ijcp.14176

Cited by 7 publications

(12 citation statements)

References 17 publications

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“…Although this is not the first study conducting regression models to decrease the risk of adverse events during the application of needling techniques applied to musculoskeletal structures predicting the optimal needle length [ 19 , 24 ], this is the first report calculating a specific model for the sartorius muscle.…”

Section: Discussionmentioning

confidence: 99%

Regression Model Decreasing the Risk of Femoral Neurovascular Bundle Accidental Puncture

et al. 2022

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Although most of the adverse events derived from dry needling are minor, avoiding potential hazards for patients including accidental invasion of vessels, ganglia, and nerves is essential to ensure patients’ safety. We aimed to investigate the contribution of predictors explaining the variance of sartorius muscle depth limit at proximal third and middle thigh as these locations lead to an augmented risk of neurovascular bundle invasion during dry needling application. A diagnostic study was conducted on 84 subjects to calculate the accuracy of a prediction model for sartorius depth, as assessed with ultrasound imaging, based on sex, age, height, weight, body mass index (BMI), thigh perimeter, and length. After calculating a correlation matrix, a multiple linear regression analysis was performed to detect those variables contributing to the sartorius deep limit in both locations. Although males showed greater thigh perimeter than women (p < 0.001), the deep limit of the sartorius muscle was significantly more superficial for both the proximal third (p = 0.003) and the mid-third (p = 0.004) points. No side-to-side anthropometric differences were found (p > 0.05). In addition, we found sartorius muscle depth to be associated with the proximal and mid-third girth, gender, height, and BMI (all, p < 0.01). Gender, proximal-third girth, and BMI explained 51.1% and 42.6% of the variance for the sartorius deep limit at the proximal and the mid-third, respectively. This study analyzed whether anthropometric features could predict sartorius muscle depth in healthy participants for assisting clinicians in choosing the optimal needle length to avoid accidental femoral bundle puncture.

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Section: Discussionmentioning

confidence: 99%

Regression Model Decreasing the Risk of Femoral Neurovascular Bundle Accidental Puncture

et al. 2022

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“…Based on previous similar studies, such as the Valera-Calero et al studies [ 13 , 14 ] that described a sample size of ten subjects for each variable, the sample size was calculated to be 70 subjects. This method considered a range from 5 to 10 subjects per potential predictor, and, considering that the regression had 8 variables, the result would be 40 to 80 subjects.…”

Section: Methodsmentioning

confidence: 99%

“…Valera Calero, JA. et al [ 13 ] set out safe instructions to perform dry needling on the rhomboid muscle and to avoid the risk of producing a pneumothorax.…”

Section: Introductionmentioning

confidence: 99%

“…Some authors already support the use of ultrasound imaging to access deep muscles or neurovascular structures more safely with the needle [ 2 ], not only to use eco-guided needling directly but also as a tool to assess and establish potential risks in terms of anthropometric measures depending on the characteristics of the subject [ 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…The approach for this muscle is described in the manual by Travel and Simons [ 3 ]. Currently, several authors [ 2 , 13 , 15 , 16 ] recommend the application of DN accompanied by ultrasound imaging to avoid risks during its performance, but this tool is not available to all physiotherapists. As a result, there is a need to establish safer protocols to prevent serious adverse effects, such as those described in the previous section.…”

Section: Introductionmentioning

confidence: 99%

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Correlation between Anthropometric and Ultrasound Measurement for Dry Needling of the Iliocostalis Lumborum Muscle with a Safety Protocol: A Cross-Sectional Observational Study

López-Castellanos¹,

Ruiz-Astasio²,

Cortés-Campos³

et al. 2022

Healthcare

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Introduction: the management of musculoskeletal pain through the application of dry needling (DN) is effective. The application of this technique can carry very infrequent major risks on muscles, such as on the iliocostalis lumborum due to its proximity to the kidney and the peritoneum. It is important to establish a DN protocol based on the different anthropometric variables of the subjects. Main objective: the main objective of this study was to investigate the correlation between different anthropometric variables and the skin-kidney and skin-peritoneum distances to establish the size of the needle that could perform DN in the iliocostalis lumborum muscle without risk. Design: a cross-sectional observational study was conducted. Methodology: a total of 68 healthy subjects were evaluated. Demographic and anthropometric data, such as age, gender, weight, height, body mass index (BMI), chest (xiphoid process and axilla) and abdomen circumferences, and skinfold thickness were collected. The measurements of skin-upper and lower edge of the iliocostalis lumborum muscle and the skin-peritoneum and/or kidney in the regions of L2 and L4, and on both sides, were assessed using ultrasound imaging. Results: a multiple linear regression analysis was performed, confirming that, in L2 without compression, gender significantly predicted the distance, with the distance being greater in women than in men. The measurement without compression increased with age up to 50 years, and it also increased with higher measurements for the chest-triceps, iliac crest, and thigh skinfold thickness, and decreased with higher measurement for the abdominal circumference. It was verified that the measurement with compression in L2 decreased as the neutral axillary circumference and the skinfold thickness in the abdomen-iliac crest increased, while the distance increased with larger measurements obtained in the neutral abdominal circumference and in the skinfold thickness of the chest-triceps. It was also verified that the measurement with compression in L4 increased up to a body mass index of 25 and then decreased even if the index increased further, and it decreased as the skinfold thickness in the abdomen-iliac crest decreased and increased as the measurements of the neutral abdominal circumference and the skinfold thickness in the chest-triceps increased. In L4 without compression, the gender variable significantly predicted changes in the measurement, with women tending to have a smaller distance compared to men. Conclusions: the measurements of the neutral abdominal circumference, chest-triceps, and abdomen-iliac crest skinfold thickness could help clinicians predict the skin-kidney and skin-peritoneum distances for dry needling of the iliocostalis lumborum with the methodology described.

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Inclusion of cross‐sectional and radiological images for better understanding of musculoskeletal anatomy and decreasing the risk of adverse events during dry needling in undergraduate physiotherapy students

Valera‐Calero

Navarro-Santana

Fernández‐de‐las‐Peñas

et al. 2023

Anatomical Sciences Ed

Self Cite

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Since there is an increasing rate of physiotherapists using invasive procedures during the clinical practice, understanding the cross-sectional anatomy and radiological images is essential for ensuring patients' safety during these interventions. Therefore, the aim of this study was to analyze the students' opinion of including cross-sectional and radiological images to traditional methodologies, to evaluate whether these additional resources improve their ability to identify musculoskeletal structures in radiological images and their understanding of neurovascular and visceral structures related with specific muscles to be avoided during invasive procedures. First-year undergraduate physiotherapy students were enrolled in the study. A brief online survey asking about their opinion about the use of cross-sectional and radiological images as complementary resources was built. In addition, two open-answer tests (before and after the inclusion of these resources) were conducted to evaluate their ability to identify correctly musculoskeletal structures in magnetic resonance and ultrasound images and to evaluate their awareness of high-risk structures related with specific muscles. One-hundred-thirty-two students returned the online survey and one-hundred-forty-eight completed all the tests. In general, students opined crosssectional images to be of utility for learning anatomy (81.8%) and radiological images (93.9%) and felt they benefited from cross-sectional and ultrasound images (78.0%).All tests showed significant improvements after the inclusion of these complementary resources (all, p < 0.001) except for trunk structures in MRI (p = 0.777). The implementation of anatomical cross-sectional and radiological images resulted in better understanding of radiological images and better cognition of possible risk during invasive procedures.

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Prediction model of rhomboid major and pleura depth based on anthropometric features to decrease the risk of pneumothorax during dry needling

Abstract: Background: Although most common adverse events associated with dry needling can be considered minor, serious adverse events including induced pneumothorax cannot be excluded, and safety instructions for reducing the risk of pleura puncture are needed.

Cited by 7 publications

References 17 publications

Regression Model Decreasing the Risk of Femoral Neurovascular Bundle Accidental Puncture

Regression Model Decreasing the Risk of Femoral Neurovascular Bundle Accidental Puncture

Correlation between Anthropometric and Ultrasound Measurement for Dry Needling of the Iliocostalis Lumborum Muscle with a Safety Protocol: A Cross-Sectional Observational Study

Inclusion of cross‐sectional and radiological images for better understanding of musculoskeletal anatomy and decreasing the risk of adverse events during dry needling in undergraduate physiotherapy students

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