Ana Mendigutía-Gómez1, María T Quintana-García1, Miriam Martín-Sevilla1, Diego de Lorenzo-Barrientos2, Jorge Rodríguez-Jiménez3,4, César Fernández-de-Las-Peñas3,4,5, José L Arias-Buría3,4. 1. Department of Physical Therapy-Rehabilitation, Hospital Beata María Ana, Madrid, Spain. 2. Instituto Nacional de Estadística, Madrid, Spain. 3. Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain. 4. Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Spain. 5. Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Spain.
Abstract
OBJECTIVES: To determine the presence of post-needling induced pain in subjects who had suffered a stroke and receivedtrigger point (TrP) dry needling (DN), and to investigate the effects of including TrP-DN into a rehabilitation program for shoulder pain in this population. METHODS: A randomized clinical trial was conducted. Sixteen patients who had suffered a stroke and presented with shoulder pain were randomly assigned to receive rehabilitation alone or rehabilitation combined with DN. Both groups received a neurorehabilitation session including modulatory interventions targeting the central nervous system. Patients in the DN group also received a single session of DN over active TrPs in the shoulder musculature. A numerical pain rating scale (NPRS, 0-10) was used to asses post-needling induced pain at 1 min, 24 h, and 72 h after needling. Shoulder pain (NPRS, 0-10) was assessed at baseline, and 3 and 7 days after DN in both groups. RESULTS: Five (62%) patients receiving TrP-DN reported post-needling induced pain. Post hoc analysis found that post-needling induced pain decreased significantly at 24 and 72 h (both p < 0.001) after DN. Patients receiving TrP-DN plus rehabilitation exhibited greater decreases in shoulder pain intensity at 3 days (Δ = -4.2, 95% confidence interval (CI) = -5.8 to -2.6) and 7 days (Δ = -4.3, 95% CI = -5.9 to -2.7) after the intervention compared with those receiving rehabilitation alone (all p < 0.001). CONCLUSION: This trial found that 50% of stroke patients receiving DN experienced post-needling induced pain, a side effect that almost disappeared 72 h after the intervention without any additional therapeutic action. In addition, the inclusion of TrP-DN into a rehabilitation session was effective at decreasing shoulder pain in these patients.
RCT Entities:
OBJECTIVES: To determine the presence of post-needling induced pain in subjects who had suffered a stroke and received trigger point (TrP) dry needling (DN), and to investigate the effects of including TrP-DN into a rehabilitation program for shoulder pain in this population. METHODS: A randomized clinical trial was conducted. Sixteen patients who had suffered a stroke and presented with shoulder pain were randomly assigned to receive rehabilitation alone or rehabilitation combined with DN. Both groups received a neurorehabilitation session including modulatory interventions targeting the central nervous system. Patients in the DN group also received a single session of DN over active TrPs in the shoulder musculature. A numerical pain rating scale (NPRS, 0-10) was used to asses post-needling induced pain at 1 min, 24 h, and 72 h after needling. Shoulder pain (NPRS, 0-10) was assessed at baseline, and 3 and 7 days after DN in both groups. RESULTS: Five (62%) patients receiving TrP-DN reported post-needling induced pain. Post hoc analysis found that post-needling induced pain decreased significantly at 24 and 72 h (both p < 0.001) after DN. Patients receiving TrP-DN plus rehabilitation exhibited greater decreases in shoulder pain intensity at 3 days (Δ = -4.2, 95% confidence interval (CI) = -5.8 to -2.6) and 7 days (Δ = -4.3, 95% CI = -5.9 to -2.7) after the intervention compared with those receiving rehabilitation alone (all p < 0.001). CONCLUSION: This trial found that 50% of strokepatients receiving DN experienced post-needling induced pain, a side effect that almost disappeared 72 h after the intervention without any additional therapeutic action. In addition, the inclusion of TrP-DN into a rehabilitation session was effective at decreasing shoulder pain in these patients.
Authors: Isis Gabriele De Souza; Raphael Fabricio De Souza; Felipe Douglas Silva Barbosa; Kelly Regina Dias Da Silva Scipioni; Felipe J Aidar; Aristela De Freitas Zanona Journal: Occup Ther Int Date: 2021-05-03 Impact factor: 1.448