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Effectiveness of deep dry needling on muscle tone in healthy subjects
The 4th European Congress of the ER-WCPT / Physiotherapy 102S (2016) eS67–eS282
POS258 Effectiveness of deep dry needling on muscle tone in healthy subjects C. Jiménez-Sánchez 1,∗ , E. Bravo-Esteban 1,2 , M. Ortiz-Lucas 1 , O. Mayoral-del Moral 3 , P. Herrero-Gallego 1 , M. Fanlo-Roa 4 , J. Gómez-Soriano 2,5 1 Universidad
de San Jorge de Zaragoza, Iphysio Research Group, Bachelor’s Degree in Physiotherapy, Villanueva de Gallego, Spain 2 Universidad de Castilla La Mancha, Toledo Physiotherapy Research Group (GIFTO), Toledo, Spain 3 Travel & Simons Seminars, Toledo, Spain 4 Universidad de San Jorge de Zaragoza, Student of Bachelor’s Degree in Physiotherapy, Villanueva de Gallego, Spain 5 Hospital Nacional de Parapléjicos, Sensorimotor Function Group, Toledo, Spain Relevance: During the last decades there has been increasing clinical and scientific evidence of the important role of Dry Needling of Myofascial Trigger Points (MTrPs) in the treatment of myofascial pain. However, the role of Dry Needling to manage muscle tone abnormalities such as hypertonia or spasticity has been clinically developed during the last years, although existing scientific evidence is limited. Furthermore, mechanisms of action of Dry Needling to modulate muscle tone have never been studied despite being clinically used. Because of it, the understanding of underlying mechanisms would be the key to support and optimize the application of Dry Needling in spastic subjects. Purpose: The main objective of this study is to analyze the effect of Dry Needling on muscle tone in healthy non-injured subjects. The secondary objective is to study if effects occur due to changes in the neural or mechanical component (or both). Methods/analysis: A double-blinded randomized clinical trial (Toledo Hospital Clinical Research Ethics Committee: number of approval 83) was performed in thirty-five subjects (20 men and 15 women) from the city of Toledo (Spain). Healthy capable volunteers from 18 to 40 years old and with the presence of latent MTrP in the medial and distal fibers of the right soleus muscle were included. The intervention group received deep Dry Needling into the medial MTrP of soleus muscle and the control group received deep Dry Needling distal to the MTrP but in the same taut band. In the current study, the mechanical and the neural properties of muscle tone were evaluated using an isokinetic dynamometry and H-reflex test measurement, respectively. Outcome measures included passive resistive torque to ankle
eS251
dorsiflexion, dorsiflexion passive range of motion, maximal isometric voluntary force, H-reflex and M-response measurements. Outcomes were assessed before the intervention, at 10 minutes and 1 week after. Analysis was performed using the SPSS statistics 22 (SPSS, Chicago, IL). The criterion for statistical significance was set at P < 0.05. The U-Mann Whitney test and Student t-test (where appropriate) were used to test statistical significance of inter-group differences. Depending on the distribution, repeated measures ANOVA or Friedman test was used to compare the study groups before and after treatment and to assess overall group effects, time effects, and groupby-time interaction effects. Post hoc pairwise comparison (Wilcoxon or Bonferroni, where appropriate) was applied to within-group comparisons of treatment efficacy. Results: No statistically significant differences were found for any of the variables regarding intra and inter group analysis (or comparisons). Discussion and conclusions: These results showed no difference on muscle tone between Dry Needling technique into MTrPs and Dry Needling technique into the taut band. This could be due to the isolated intervention in only one MTrP of the muscle, to the biomechanical and neurophysiological tools employed, to both of them or to neither of them. Impact and implications: Further studies in muscle tone abnormalities (such as contracture or spasticity) using other assessment tools or a wider intervention are necessary to allow for a better understanding of the properties of MTrPs and its treatment with Dry Needling. Funding acknowledgement: There was no funding. http://dx.doi.org/10.1016/j.physio.2016.10.314 POS259 Development of a protocol to measure hamstring and quadriceps strength using a Lafayette Manual Muscle Tester L. Brennan ∗ , A. O’Tuama, E. Papadopolous, R. Moss, A. Gilbert, A. Jaggi Royal National Orthopaedic Hospital, Therapies, London, United Kingdom Relevance: Research into lower limb strength often uses laboratory-based equipment to take measurements, whereas strength testing in a clinical based setting relies on subjective grading by the examiner. We have developed a protocol to objectively measure lower limb muscle strength using a simple handheld device for use in clinical settings. Purpose: The purpose of this research was to develop and assess the reliability of a knee strength testing protocol using a hand held dynamometer. Methods/analysis: Firstly, a physical testing protocol was developed. Participants were tested in a prone position on a plinth with their knee at 45◦ flexion. The dynamometer was
POS258 Effectiveness of deep dry needling on muscle tone in healthy subjects C. Jiménez-Sánchez 1,∗ , E. Bravo-Esteban 1,2 , M. Ortiz-Lucas 1 , O. Mayoral-del Moral 3 , P. Herrero-Gallego 1 , M. Fanlo-Roa 4 , J. Gómez-Soriano 2,5 1 Universidad
de San Jorge de Zaragoza, Iphysio Research Group, Bachelor’s Degree in Physiotherapy, Villanueva de Gallego, Spain 2 Universidad de Castilla La Mancha, Toledo Physiotherapy Research Group (GIFTO), Toledo, Spain 3 Travel & Simons Seminars, Toledo, Spain 4 Universidad de San Jorge de Zaragoza, Student of Bachelor’s Degree in Physiotherapy, Villanueva de Gallego, Spain 5 Hospital Nacional de Parapléjicos, Sensorimotor Function Group, Toledo, Spain Relevance: During the last decades there has been increasing clinical and scientific evidence of the important role of Dry Needling of Myofascial Trigger Points (MTrPs) in the treatment of myofascial pain. However, the role of Dry Needling to manage muscle tone abnormalities such as hypertonia or spasticity has been clinically developed during the last years, although existing scientific evidence is limited. Furthermore, mechanisms of action of Dry Needling to modulate muscle tone have never been studied despite being clinically used. Because of it, the understanding of underlying mechanisms would be the key to support and optimize the application of Dry Needling in spastic subjects. Purpose: The main objective of this study is to analyze the effect of Dry Needling on muscle tone in healthy non-injured subjects. The secondary objective is to study if effects occur due to changes in the neural or mechanical component (or both). Methods/analysis: A double-blinded randomized clinical trial (Toledo Hospital Clinical Research Ethics Committee: number of approval 83) was performed in thirty-five subjects (20 men and 15 women) from the city of Toledo (Spain). Healthy capable volunteers from 18 to 40 years old and with the presence of latent MTrP in the medial and distal fibers of the right soleus muscle were included. The intervention group received deep Dry Needling into the medial MTrP of soleus muscle and the control group received deep Dry Needling distal to the MTrP but in the same taut band. In the current study, the mechanical and the neural properties of muscle tone were evaluated using an isokinetic dynamometry and H-reflex test measurement, respectively. Outcome measures included passive resistive torque to ankle
eS251
dorsiflexion, dorsiflexion passive range of motion, maximal isometric voluntary force, H-reflex and M-response measurements. Outcomes were assessed before the intervention, at 10 minutes and 1 week after. Analysis was performed using the SPSS statistics 22 (SPSS, Chicago, IL). The criterion for statistical significance was set at P < 0.05. The U-Mann Whitney test and Student t-test (where appropriate) were used to test statistical significance of inter-group differences. Depending on the distribution, repeated measures ANOVA or Friedman test was used to compare the study groups before and after treatment and to assess overall group effects, time effects, and groupby-time interaction effects. Post hoc pairwise comparison (Wilcoxon or Bonferroni, where appropriate) was applied to within-group comparisons of treatment efficacy. Results: No statistically significant differences were found for any of the variables regarding intra and inter group analysis (or comparisons). Discussion and conclusions: These results showed no difference on muscle tone between Dry Needling technique into MTrPs and Dry Needling technique into the taut band. This could be due to the isolated intervention in only one MTrP of the muscle, to the biomechanical and neurophysiological tools employed, to both of them or to neither of them. Impact and implications: Further studies in muscle tone abnormalities (such as contracture or spasticity) using other assessment tools or a wider intervention are necessary to allow for a better understanding of the properties of MTrPs and its treatment with Dry Needling. Funding acknowledgement: There was no funding. http://dx.doi.org/10.1016/j.physio.2016.10.314 POS259 Development of a protocol to measure hamstring and quadriceps strength using a Lafayette Manual Muscle Tester L. Brennan ∗ , A. O’Tuama, E. Papadopolous, R. Moss, A. Gilbert, A. Jaggi Royal National Orthopaedic Hospital, Therapies, London, United Kingdom Relevance: Research into lower limb strength often uses laboratory-based equipment to take measurements, whereas strength testing in a clinical based setting relies on subjective grading by the examiner. We have developed a protocol to objectively measure lower limb muscle strength using a simple handheld device for use in clinical settings. Purpose: The purpose of this research was to develop and assess the reliability of a knee strength testing protocol using a hand held dynamometer. Methods/analysis: Firstly, a physical testing protocol was developed. Participants were tested in a prone position on a plinth with their knee at 45◦ flexion. The dynamometer was