Inclusion of Trigger Point Dry Needling in a Multimodal Physical Therapy Program for Postoperative Shoulder Pain: A Randomized Clinical Trial

Arias-Buría, José Luis; Valero-Alcaide, Raquel; Cleland, Joshua A.; Salom‐Moreno, Jaime; Ortega‐Santiago, Ricardo; Atín-Arratibel, M.Á.; Fernández‐de‐las‐Peñas, César

doi:10.1016/j.jmpt.2014.11.007

Cited by 42 publications

(34 citation statements)

References 33 publications

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“…After the full review process, 12 studies were selected for inclusion. 2,7,12,24,27,28,32,33,35,36,38,43 After contact with primary authors of included studies, 1 further study was identified for inclusion, 6 resulting in a total of 13 studies. The absolute degree of rater agreement for the first and second stages of the study selection was 86% and 93%, respectively.…”

Section: Study Selectionmentioning

confidence: 99%

“…This systematic review focused on musculoskeletal pain and included 13 studies: 6 on neck pain (5 on mechanical neck pain 6,24,28,32,43 and 1 on chronic whiplash-associated disorder 38 ), 1 on postoperative shoulder pain, 2 1 on chronic lower back pain, 33 1 on total knee arthroplasty, 27 1 on chronic ankle instability, 35 2 on myofascial pain, 12,36 and 1 on fibromyalgia. 7 Inclusion and exclusion criteria varied greatly across the studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Eight studies 2,6,12,24,33,35,36,43 examined the immediate to 12-week effects of dry needling, and 6 were able to be included in meta-analyses to determine the effect on pain (FIGURE 8). There is moderate-quality evidence suggesting a small effect 8 (SMD, -0.43; 95% CI: -0.77, -0.10) favoring dry needling over other treatment.…”

Section: Dry Needling Versus Other Treatment: Immediate To 12-week Efmentioning

confidence: 99%

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The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis

Gattie¹,

Cleland²,

Snodgrass³

2017

Journal of Orthopaedic & Sports Physical Therapy

207

147

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Study Design Systematic review and meta-analysis. Background An increasing number of physical therapists in the United States and throughout the world are using dry needling to treat musculoskeletal pain. Objective To examine the short- and long-term effectiveness of dry needling delivered by a physical therapist for any musculoskeletal pain condition. Methods Electronic databases were searched. Eligible randomized controlled trials included those with human subjects who had musculoskeletal conditions that were treated with dry needling performed by a physical therapist, compared with a control or other intervention. The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation. Results The initial search returned 218 articles. After screening, 13 were included. Physiotherapy Evidence Database quality scale scores ranged from 4 to 9 (out of a maximum score of 10), with a median score of 7. Eight meta-analyses were performed. In the immediate to 12-week follow-up period, studies provided evidence that dry needling may decrease pain and increase pressure pain threshold when compared to control/sham or other treatment. At 6 to 12 months, dry needling was favored for decreasing pain, but the treatment effect was not statistically significant. Dry needling, when compared to control/sham treatment, provides a statistically significant effect on functional outcomes, but not when compared to other treatments. Conclusion Very low-quality to moderate-quality evidence suggests that dry needling performed by physical therapists is more effective than no treatment, sham dry needling, and other treatments for reducing pain and improving pressure pain threshold in patients presenting with musculoskeletal pain in the immediate to 12-week follow-up period. Low-quality evidence suggests superior outcomes with dry needling for functional outcomes when compared to no treatment or sham needling. However, no difference in functional outcomes exists when compared to other physical therapy treatments. Evidence of long-term benefit of dry needling is currently lacking. Level of Evidence Therapy, level 1a. J Orthop Sports Phys Ther 2017;47(3):133–149. Epub 3 Feb 2017. doi:10.2519/jospt.2017.7096

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Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Dry Needling Versus Other Treatment: Immediate To 12-week Efmentioning

confidence: 99%

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The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis

Gattie¹,

Cleland²,

Snodgrass³

2017

Journal of Orthopaedic & Sports Physical Therapy

207

147

View full text Add to dashboard Cite

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“…Manual joint mobilizations may be helpful in the early phase of rehabilitation if normal scapulohumeral rhythm is not achieved or added in the intermediate phase if stiffness persists [7]. The use of electrotherapy is not recommended with the exception of transcutaneous electrical nerve stimulation [8] or perhaps dry needling (acupuncture) to active trigger points in shoulder girdle muscles during the irst treatment session [14]. Our survey respondents reported the use of elements that aligns well with the limited guidance available in the current PHF rehabilitation literature [7][8][9][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation of proximal humerus fractures: An environmental scan of Canadian physiotherapy practice patterns

Kwan¹,

MacIntyre²

2017

J Nov Physiother Rehabil

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Background: Proximal humerus fractures (PHFs) are common injuries particularly in older adults. Evidencebased protocols for PHF rehabilitation are lacking and physiotherapists use a variety of interventions.Purpose: To determine practice patterns and perceptions of physiotherapists who treat adults with PHF in Ontario, Canada.Method: A paper and pencil survey asking about respondent demographics and management of Neer Group 1 (minimally/nondisplaced) and complex (displaced 3-and 4-part) PHF was mailed to 875 randomly selected physiotherapists who were registered with the College of Physiotherapists of Ontario in 2013/2014 and working in practice areas likely to be accessed by adults with PHF. Results:The response rate was low (10%); 83 physiotherapists completed the survey -80% had experience managing PHF. Respondents treated 1-5 individuals with PHF annually; more treated Neer Group 1 PHF (89%) than complex PHF (68%). Most individuals with PHF were older than 60 years (64%), female (76%) and accessed physiotherapy through a doctor's referral (91%) more than 1 month post injury (33%). Main fi ndings:Physiotherapists manage PHF using multi-component interventions and a minimum of 76% include the following elements: education and progression of passive, active assisted, active range of motion exercises and muscle retraining to build coordination and strength. Use of other elements was variable. The main factors infl uencing the treatment plan were the ability of the individual with PHF to comply, bone quality, and fracture type. Most respondents were unsure that there is suffi cient PHF rehabilitation literature to guide treatment. Conclusions:This environmental scan is the fi rst North American study to document practice patterns and attitudes of physiotherapists providing PHF rehabilitation. Elements used by physiotherapists in Ontario treating small numbers of individuals with Neer Group 1 or complex PHFs each year align well with the limited PHF rehabilitation literature available. Potential implications:Multi-disciplinary collaborations to design and conduct large, high quality, multi-centre prognostic studies and RCTs that evaluate the effectiveness of key aspects of non-surgical PHF rehabilitation in various patient groups are needed. Meanwhile, consensus guidelines should be developed in the context of regionspecifi c physiotherapy service models to inform best practice in PHF rehabilitation management.

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“…[20] Treating myofascial pain with dry needling has been shown to be an effective way to manage pain, improve mobility, reduce sensitivity of MTrPs, and improve the quality of life. [21] Being point specific with dry needling seems to produce more effective results than non-point-specific dry needling. Using dry needling on MTrPs of the hamstrings and gluteal muscles did not show significant Abstract Dry needling is used by medical professionals throughout the United States to treat pain and to help patients improve quality of life.…”

Section: Dry Needling As An Interventionmentioning

confidence: 98%

Dry Needling and its Use in Health Care A Treatment Modality and Adjunct for Pain Management

G¹

2015

J Pain Relief

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Inclusion of Trigger Point Dry Needling in a Multimodal Physical Therapy Program for Postoperative Shoulder Pain: A Randomized Clinical Trial

Cited by 42 publications

References 33 publications

The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis

The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis

Rehabilitation of proximal humerus fractures: An environmental scan of Canadian physiotherapy practice patterns

Dry Needling and its Use in Health Care A Treatment Modality and Adjunct for Pain Management

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