Objective: The aim of this study was to evaluate the effectiveness of treating myofascial trigger points [TrPs] with dry needling [DN] compared to percutaneous electrical nerve stimulation [PENS]. Method: In this clinical trial, 122 subjects suffering from non-specific chronic low back pain [CLBP] were treated. They were randomly distributed into two treatment groups: one taking PENS and the other taking DN of TrPs on the deep lumbar paraspinal muscles [lumbar multifidi], quadratus lumborum, and gluteus medius. Four variables were measured: perceived pain and sleep quality using a visual analog scale [VAS], pressure-pain tolerance threshold on TrPs with an algometer, and quality of life assessed with the Oswestry Disability Index.Results: At least one TrP was found in all patients, most commonly situated in the quadratus lumborum muscle [97.6 percent]. The improvement achieved for both treatment groups was similar in all the measured variables, although the DN group carried out fewer sessions than the PENS group.Conclusions: It could be concluded that the effectiveness of DN is comparable to that of PENS and, therefore, it may be considered as another useful tool with limited adverse effects within the multidisciplinary approach required in the management of non-specific CLBP.
Background: Rotator cuff tendinopathy and subacromial impingement syndrome present complex patomechanical situations, frequent difficulties in clinical diagnosis and lack of effectiveness in treatment. Based on clinical experience, we have therefore considered the existence of another pathological entity as the possible origin of pain and dysfunction. The hypothesis of this study is to relate subacromial impingement syndrome (SIS) with myofascial pain syndrome (MPS), since myofascial trigger points (MTrPs) cause pain, functional limitation, lack of coordination and alterations in quality of movement, even prior to a tendinopathy. MTrPs can coexist with any degenerative subacromial condition. If they are not taken into consideration, they could perpetuate and aggravate the problem, hindering diagnosis and making the applied treatments ineffective.
Background
About 40% of patients who have had COVID-19 still have symptoms three months later whereas a 10% may experience physical and/or psychological consequences two years later. Therefore, it is necessary to perform preventive interventions when patients are discharged from the hospital to decrease the aforementioned sequelae. The purpose of this pilot-controlled trial will be to determine the efficacy of a rehabilitation program on functional status and psychosocial factors for post-COVID-19 patients when it is delivered through a tele-care platform versus a booklet-based rehabilitation.
Methods
The estimated sample size will be of 50 participants who have been discharged after COVID-19 and have a level of fatigue equal or greater than 4 on the Fatigue Severity Scale. The primary outcome will be the severity of fatigue. Participants will be randomly allocated to an “asynchronous telerehabilitation group” or to a “booklet-based rehabilitation group”. Treatment in both groups will be the same and will consist of a combination of therapeutic exercise and an educative program. Treatment outcomes will be evaluated the last day of the intervention and at three- and six-months follow-up.
Discussion
The telerehabilitation intervention appears to be a viable and efficacy option in decreasing severe fatigue and other fitness variables such as strength and aerobic capacity, similar to other traditional rehabilitation formats such as through an explanatory booklet.
Clinical trial registration
This trial has been prospectively registered at clinialtrials.gov identifier: NCT04794036.
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