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Arpacı MF, Doğru F, Deniz MA, Çiçek İB, Baykara RA, Erdem C, Taş F, Uzun GB, Köse E. Comparison of the efficacy of extracorporeal shock wave therapy and trigger point dry needling in the treatment of Calcaneal Epin- A randomized trial. J Back Musculoskelet Rehabil 2025:10538127251317864. [PMID: 39973092 DOI: 10.1177/10538127251317864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2025]
Abstract
BACKGROUND Dry needling (DN) and Extracorporeal shock wave therapy (ESWT) are common in calcaneal epin treatment. OBJECTIVE The aim of the study was to compare the effects of both treatments on proprioception, balance, pain, and functional status. METHODS 90 patients which consist of 45 patients as DN + self stretching and 45 patients as ESWT + self stretching. Patients in each group were treated 1 session per week for 4 weeks. Assessments of 15° ankle dorsiflexion and plantar flexion proprioception, one leg standing test (OLST), foot function index (FFI), visual analog scale (VAS) (first step, resting, activity), quality of life scale (SF-36) were performed. The outcomes were recorded at pre-treatment, post-treatment, and 4 weeks after the post-treatment. RESULTS Statistically significant differences were determined in VAS (resting, first step, activity) and FFI values in both treatment methods (p < 0.05). In OLST, SF-36, and FFI evaluations, DN was statistically more effective than the ESWT method (p < 0.001). In the 15° proprioception evaluations, a significant difference was observed in the patient's ankle in both methods, while the DN method is more effective in the indicated stages of evaluation. CONCLUSIONS Both methods applied to epin calcanei patients were effective, but the DN method is a more effective treatment method than the ESWT method in terms of balance, proprioception, foot function, and quality of life.
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Affiliation(s)
- Muhammed Furkan Arpacı
- Department of Anatomy, Faculty of Medicine, Malatya Turgut Özal University, Malatya, Turkey
| | - Feyzi Doğru
- Department of Physiology, Faculty of Medicine, Malatya Turgut Ozal University, Malatya, Turkey
| | - Mine Arğali Deniz
- Department of Physical Therapy and Rehabilitation, Suleyman Demirel University Research and Application Hospital, Isparta, Turkey
| | - İpek Balıkçı Çiçek
- Department of Biostatics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Rabia Aydoğan Baykara
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Malatya Turgut Ozal University, Malatya, Turkey
| | - Cumali Erdem
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Malatya Turgut Ozal University, Malatya, Turkey
| | - Ferhat Taş
- Department of Orthopaedics, Malatya Turgut Ozal University, Malatya, Turkey
| | - Gökçe Bağcı Uzun
- Department of Anatomy, Faculty of Medicine, Malatya Turgut Özal University, Malatya, Turkey
| | - Evren Köse
- Department of Anatomy, Faculty of Medicine, İnönü University, Malatya, Turkey
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Portilla G, Montero de Espinosa F. Device for Dual Ultrasound and Dry Needling Trigger Points Treatment. SENSORS (BASEL, SWITZERLAND) 2023; 23:580. [PMID: 36679375 PMCID: PMC9865287 DOI: 10.3390/s23020580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/21/2022] [Accepted: 12/29/2022] [Indexed: 06/17/2023]
Abstract
Ultrasound is a well-known tool to produce thermal and non-thermal effects on cells and tissues. These effects require an appropriate application of ultrasound in terms of localization and acoustic energy delivered. This article describes a new device that combines ultrasound and dry needling treatments. The non-thermal effects of ultrasound should locally amplify the needle's effects. The ultrasound transducer can mechanically rotate in 3D space to align itself in the direction of the needle. The transducer electronically focuses the acoustic pressure automatically on the needle tip and its surroundings. A computer, using graphical interface software, controls the angulation of the array and the focus position.
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Martínez-Jiménez EM, Losa-Iglesias ME, Antolín-Gil MS, López-López D, Romero-Morales C, Benito-de-Pedro M, Calvo-Lobo C, Becerro-de-Bengoa-Vallejo R. Flexor Digitorum Brevis Muscle Dry Needling Changes Surface and Plantar Pressures: A Pre-Post Study. Life (Basel) 2021; 11:life11010048. [PMID: 33451013 PMCID: PMC7830844 DOI: 10.3390/life11010048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The effects of the dry needling technique and pain reduction have been demonstrated in numerous quality studies. However, the mechanical effects of dry needling are largely unknown. METHODS A total of 18 subjects with flexor digitorum brevis muscle myofascial trigger point were evaluated pre- and post-deep dry needling. We measured static footprint variables in a pre-post study. MAIN FINDINGS We found differences in rearfoot maximum pressure (119.22-111.63 KPa; p = 0.025), midfoot maximum pressure (13.68-17.26 KPa; p = 0.077), midfoot medium pressure (4.75-6.24 KPa; p = 0.035) and forefoot surface (86.58-81.75 cm2; p = 0.020). All variables with significant differences decrease, with the exception of forefoot surface which showed an increase. CONCLUSIONS After flexor digitorum brevis muscle dry needling, midfoot plantar pressures (maximum and medium) and forefoot surface were increased, and rearfoot maximum pressure was decreased.
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Affiliation(s)
| | - Marta Elena Losa-Iglesias
- Nursing and Stomatology Department, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Madrid, Spain;
| | | | - Daniel López-López
- Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, 15403 Ferrol, Spain;
| | - Carlos Romero-Morales
- Villaviciosa de Odón Campus, Universidad Europea de Madrid, 28670 Madrid, Spain;
- Correspondence:
| | - María Benito-de-Pedro
- Facultad de enfermería Fisioterapiay Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.B.-d.-P.); (C.C.-L.); (R.B.-d.-B.-V.)
| | - César Calvo-Lobo
- Facultad de enfermería Fisioterapiay Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.B.-d.-P.); (C.C.-L.); (R.B.-d.-B.-V.)
| | - Ricardo Becerro-de-Bengoa-Vallejo
- Facultad de enfermería Fisioterapiay Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.B.-d.-P.); (C.C.-L.); (R.B.-d.-B.-V.)
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The effect of dry needling & muscle energy technique separately and in combination in patients suffering shoulder impingement syndrome and active trigger points of infraspinatus. J Bodyw Mov Ther 2020; 26:94-100. [PMID: 33992303 DOI: 10.1016/j.jbmt.2020.12.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 09/09/2020] [Accepted: 12/19/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of a combination of dry needling (DN) and muscle energy technique (MET) on pain intensity (PI), pressure pain threshold (PPT) and shoulder active range of motion (ROM) in patients with shoulder impingement syndrome and active trigger points in the infraspinatus muscle. METHODS 39 patients, aged 20-50 participated in this study. All the cases were randomly assigned into three groups: group 1 (n = 13) received DN, group 2 (n = 13) received MET, and group 3 (n = 13) received DN & MET. The patients were treated for three sessions in a one-week period with at least a two-day break between sessions. RESULTS The results showed a significant improvement in visual analog scale (VAS), PPT and shoulder ROM over time (P < 0.001) in all three groups. There were no significant differences BETWEEN VAS (P = 0.406) PPT (P = 0.293), external rotation(EXT.ROT) (0.476), internal rotation (INT.ROT)(P = 0.476) and extension(EXT) (P = 0.574) ROMs in the three groups; however, DN group was significantly more effective on abduction(ABD) (P = 0.003) and flexion(FLEX) (0.012) ROM compared with other two groups. CONCLUSION In line with previous studies, the present study found that the application of DN, MET and combined of these treatment on active trigger points in the infraspinatus muscle of patients with shoulder impingement syndrome helps reduce pain, increase PPT and enhance the shoulder ROM. Both techniques are effective in the treatment of trigger points. Nevertheless, DN is more effective in enhancing the ROM of flexion & abduction.
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Mis K, Grubic Z, Lorenzon P, Sciancalepore M, Mars T, Pirkmajer S. In Vitro Innervation as an Experimental Model to Study the Expression and Functions of Acetylcholinesterase and Agrin in Human Skeletal Muscle. Molecules 2017; 22:molecules22091418. [PMID: 28846617 PMCID: PMC6151842 DOI: 10.3390/molecules22091418] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 08/18/2017] [Accepted: 08/23/2017] [Indexed: 12/19/2022] Open
Abstract
Acetylcholinesterase (AChE) and agrin, a heparan-sulfate proteoglycan, reside in the basal lamina of the neuromuscular junction (NMJ) and play key roles in cholinergic transmission and synaptogenesis. Unlike most NMJ components, AChE and agrin are expressed in skeletal muscle and α-motor neurons. AChE and agrin are also expressed in various other types of cells, where they have important alternative functions that are not related to their classical roles in NMJ. In this review, we first focus on co-cultures of embryonic rat spinal cord explants with human skeletal muscle cells as an experimental model to study functional innervation in vitro. We describe how this heterologous rat-human model, which enables experimentation on highly developed contracting human myotubes, offers unique opportunities for AChE and agrin research. We then highlight innovative approaches that were used to address salient questions regarding expression and alternative functions of AChE and agrin in developing human skeletal muscle. Results obtained in co-cultures are compared with those obtained in other models in the context of general advances in the field of AChE and agrin neurobiology.
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Affiliation(s)
- Katarina Mis
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloška 4, SI-1000 Ljubljana, Slovenia.
| | - Zoran Grubic
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloška 4, SI-1000 Ljubljana, Slovenia.
| | - Paola Lorenzon
- Department of Life Sciences, University of Trieste, via A. Fleming 22, I-34127 Trieste, Italy.
| | - Marina Sciancalepore
- Department of Life Sciences, University of Trieste, via A. Fleming 22, I-34127 Trieste, Italy.
| | - Tomaz Mars
- Department of Life Sciences, University of Trieste, via A. Fleming 22, I-34127 Trieste, Italy.
| | - Sergej Pirkmajer
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloška 4, SI-1000 Ljubljana, Slovenia.
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Cagnie B, Barbe T, De Ridder E, Van Oosterwijck J, Cools A, Danneels L. The influence of dry needling of the trapezius muscle on muscle blood flow and oxygenation. J Manipulative Physiol Ther 2013. [PMID: 23206963 DOI: 10.1016/j.jmpt.2012.10.005] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effect of dry needling on the blood flow and oxygen saturation of the trapezius muscle. METHODS Twenty healthy participants participated in this study. One single dry needling procedure was performed in the right upper trapezius, at a point located midway between the acromion edge and the seventh cervical vertebrae. Using the oxygen to see device, blood flow and oxygen saturation were evaluated at the treated point and 3 distant points (similar point in the left upper trapezius and 30 mm laterally from this midpoint). Measurements were taken at baseline and in the recovery period (0, 5, and 15 minutes posttreatment). RESULTS After removal of the needle, the blood flow and oxygen saturation increased significantly from the pretreatment level in the treated point (P ≤ .001), and these values remained high throughout the 15-minute recovery period. There were only minor changes in the distant points. CONCLUSIONS These results suggest that dry needling enhances the blood flow in the stimulated region of the trapezius muscle but not in a distant region used in this study.
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Affiliation(s)
- Barbara Cagnie
- Physical Therapist and Postdoctoral Researcher, Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
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Jevsek M, Mars T, Mis K, Grubic Z. Origin of acetylcholinesterase in the neuromuscular junction formed in the in vitro innervated human muscle. Eur J Neurosci 2004; 20:2865-71. [PMID: 15579140 DOI: 10.1111/j.1460-9568.2004.03752.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Synaptic basal lamina is interposed between the pre- and postsynaptic membrane of the neuromuscular junction (NMJ). This position permits deposition of basal lamina-bound NMJ components of both neuronal and muscle fibre origin. One such molecule is acetylcholinesterase (AChE). The origin of NMJ AChE has been investigated previously as the answer would elucidate the relative contributions of muscle fibers and motor neurons to NMJ formation. However, in the experimental models used in prior investigations either the neuronal or muscular components of the NMJs were removed, or the NMJs were poorly differentiated. Therefore, the question of AChE origin in the intact and functional NMJ remains open. Here, we have approached this question using an in vitro model in which motor neurons, growing from embryonic rat spinal cord explants, form well differentiated NMJs with cultured human myotubes. By immunocytochemical staining with species-specific anti-AChE antibodies, we are able to differentiate between human (muscular) and rat (neuronal) AChE at the NMJ. We observed strong signal at the NMJ after staining with human AChE antibodies, which suggests a significant muscular AChE contribution. However, a weaker, but still clearly recognizable signal is observed after staining with rat AChE antibodies, suggesting a smaller fraction of AChE was derived from motor neurons. This is the first report demonstrating that both motor neuron and myotube contribute synaptic AChE under conditions where they interact with each other in the formation of an intact and functional NMJ.
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Affiliation(s)
- Marko Jevsek
- Laboratory for Molecular Neurobiology, Institute of Pathophysiology, Medical School, University of Ljubljana, Zaloska 4, 1000 Ljubljana, Slovenia
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Abstract
The review explains why the myotoxic phospholipases A2 and cardiotoxins are such important tools in the study of the regeneration and maturation of mammalian skeletal muscle. The role of satellite cells as precursors of cell-based regeneration is discussed and recent controversies on the origin of myogenic cells involved in the regeneration of mature skeletal muscle are addressed. This is followed by discussions of sarcomere reconstruction, myosin and sarcoplasmic reticulum ATPase expression, the electrophysiological properties of regenerating muscle, and the reconstruction of the neuromuscular junction. The emphasis throughout is on the plastic changes of major structural and functional proteins that occur during regeneration, and on other influences that determine the final outcome of regenerative activity such as innervation, thyroid status, mechanical work and the functional integrity of the microcirculation. The review closes with a discussion of some of the factors--such as active regeneration--that influence the success of gene-based therapies applied to inherited muscle disease.
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Affiliation(s)
- J B Harris
- School of Neurology, Neurobiology and Psychiatry, Faculty of Medical Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH, UK.
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Schliebs R. Neuronal plasticity and degeneration. Int J Dev Neurosci 2001; 19:229-30. [PMID: 11337191 DOI: 10.1016/s0736-5748(01)00006-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- R Schliebs
- Department of Neurochemistry, University of Leipzig, Paul Flechsig Institute of Brain Research, Jahnallee 59, 04109, Leipzig, Germany.
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