Muscle Activity and Kinematic Changes With Dry Needling

Overview

This study assesses the effects of dry needling with electrical stimulation to the low back on muscle activity and changes in movement. The investigators hypothesize that dry needling and electrical stimulation will elicit changes in muscle activity as well as changes in movement.

Full Title of Study: “Changes in Muscle Activity, Squat, and Gait Kinematics After Dry Needling Treatment of the Low Back: A Pilot Study”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: August 2020

Detailed Description

This study will utilize a Vicon motion capture system in conjunction with a Noraxon wireless surface electromyography system to analyze movements and muscle activity of each participant pre and post needling.

Interventions

  • Other: Dry needling with electrical stimulation
    • Paravertebral dry needling to L3, 4, 5 multifidi. Electrical stimulation will be applied through the needles for up to 10 minutes total or to the participant’s tolerance.

Arms, Groups and Cohorts

  • Experimental: Dry needling with electrical stimulation
    • Use of dry needles (this is the generic name for sterile, solid filament needles) are inserted into the lumbar multifidi. Intramuscular electrical stimulation will then be applied by attaching a six-lead electrical stimulation unit to the needles. Electrical stimulation will be applied through the needles at the participant’s desired frequency (between 4-6 Hz) and for up to 10 minutes total.

Clinical Trial Outcome Measures

Primary Measures

  • Muscle activity changes
    • Time Frame: pre/ post dry needling treatment. Participants’ EMG will be recorded over a series of movements of the lumbar spine, will immediately be dry needled with electrical stimulation for up to 10 minutes, then will be immediately reassessed. Total time 2 hrs
    • activity measured and quantified from the amplitude (mV) of the surface EMG electrodes
  • Kinematic changes
    • Time Frame: Participants kinematics will be recorded over a series of movements of the lumbar spine, will immediately be dry needled with electrical stimulation for up to 10 minutes, then will be immediately reassessed. Total time 2 hrs
    • Measurement of lumbopelvic angles during range of motion activities

Participating in This Clinical Trial

Inclusion Criteria

  • English speaking individuals between the ages of 18 and 60 years old
  • without current complaint of low back pain
  • no history of low back or lower extremity surgery

Exclusion Criteria

  • individuals with current complaint of low back pain,
  • lumbar radicular symptoms
  • history of low back surgery or lower extremity surgery
  • pregnancy or planning to become pregnant,
  • currently taking immunosuppressant or anticoagulation use with INR not within therapeutic range
  • needle phobia
  • osteoporosis will be excluded

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 60 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Louisiana State University Health Sciences Center Shreveport
  • Provider of Information About this Clinical Study
    • Principal Investigator: April Brown, Doctor of Physical Therapy, Clinical Instructor – Louisiana State University Health Sciences Center Shreveport
  • Overall Official(s)
    • April J Brown, DPT, Principal Investigator, LSU Health Science Center Shreveport
  • Overall Contact(s)
    • April J Brown, DPT, 318-813-2970, abro52@lsuhsc.edu

References

Association APT. Dry needling in clinical practice:an educational resource paper. Alexandria, VA: American Physical Therapy Association; 2013.

Therapy FoSBoP. Dry Neelding Resource Paper (Intramuscular Manual Therapy). 4th ed. Alexandria, VA: Federation of State Boards of Physical Therapy; 2013.

Caldwell J. Attorney General Opinion 14-0216. In: Justice2015.

Koppenhaver SL, Walker MJ, Su J, McGowen JM, Umlauf L, Harris KD, Ross MD. Changes in lumbar multifidus muscle function and nociceptive sensitivity in low back pain patient responders versus non-responders after dry needling treatment. Man Ther. 2015 Dec;20(6):769-76. doi: 10.1016/j.math.2015.03.003. Epub 2015 Mar 13.

Abbaszadeh-Amirdehi M, Ansari NN, Naghdi S, Olyaei G, Nourbakhsh MR. Neurophysiological and clinical effects of dry needling in patients with upper trapezius myofascial trigger points. J Bodyw Mov Ther. 2017 Jan;21(1):48-52. doi: 10.1016/j.jbmt.2016.04.014. Epub 2016 Apr 14.

Haser C, Stöggl T, Kriner M, Mikoleit J, Wolfahrt B, Scherr J, Halle M, Pfab F. Effect of Dry Needling on Thigh Muscle Strength and Hip Flexion in Elite Soccer Players. Med Sci Sports Exerc. 2017 Feb;49(2):378-383. doi: 10.1249/MSS.0000000000001111.

Dunning J, Butts R, Young I, Mourad F, Galante V, Bliton P, Tanner M, Fernández-de-Las-Peñas C. Periosteal Electrical Dry Needling as an Adjunct to Exercise and Manual Therapy for Knee Osteoarthritis: A Multicenter Randomized Clinical Trial. Clin J Pain. 2018 Dec;34(12):1149-1158. doi: 10.1097/AJP.0000000000000634.

Unverzagt C, Berglund K, Thomas JJ. DRY NEEDLING FOR MYOFASCIAL TRIGGER POINT PAIN: A CLINICAL COMMENTARY. Int J Sports Phys Ther. 2015 Jun;10(3):402-18.

Liu L, Huang QM, Liu QG, Thitham N, Li LH, Ma YT, Zhao JM. Evidence for Dry Needling in the Management of Myofascial Trigger Points Associated With Low Back Pain: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2018 Jan;99(1):144-152.e2. doi: 10.1016/j.apmr.2017.06.008. Epub 2017 Jul 8. Review.

Jayaseelan DJ, Moats N, Ricardo CR. Rehabilitation of proximal hamstring tendinopathy utilizing eccentric training, lumbopelvic stabilization, and trigger point dry needling: 2 case reports. J Orthop Sports Phys Ther. 2014 Mar;44(3):198-205. doi: 10.2519/jospt.2014.4905. Epub 2013 Nov 21.

Rainey CE. The use of trigger point dry needling and intramuscular electrical stimulation for a subject with chronic low back pain: a case report. Int J Sports Phys Ther. 2013 Apr;8(2):145-61.

Koppenhaver SL, Walker MJ, Rettig C, Davis J, Nelson C, Su J, Fernández-de-Las-Peñas C, Hebert JJ. The association between dry needling-induced twitch response and change in pain and muscle function in patients with low back pain: a quasi-experimental study. Physiotherapy. 2017 Jun;103(2):131-137. doi: 10.1016/j.physio.2016.05.002. Epub 2016 May 20.

Dar G, Hicks GE. The immediate effect of dry needling on multifidus muscles' function in healthy individuals. J Back Musculoskelet Rehabil. 2016 Apr 27;29(2):273-278.

Ge HY, Fernández-de-Las-Peñas C, Yue SW. Myofascial trigger points: spontaneous electrical activity and its consequences for pain induction and propagation. Chin Med. 2011 Mar 25;6:13. doi: 10.1186/1749-8546-6-13.

Lucas KR, Rich PA, Polus BI. Muscle activation patterns in the scapular positioning muscles during loaded scapular plane elevation: the effects of Latent Myofascial Trigger Points. Clin Biomech (Bristol, Avon). 2010 Oct;25(8):765-70. doi: 10.1016/j.clinbiomech.2010.05.006. Epub 2010 Jul 27.

Ge HY, Monterde S, Graven-Nielsen T, Arendt-Nielsen L. Latent myofascial trigger points are associated with an increased intramuscular electromyographic activity during synergistic muscle activation. J Pain. 2014 Feb;15(2):181-7. doi: 10.1016/j.jpain.2013.10.009. Epub 2013 Nov 2.

Ibarra JM, Ge HY, Wang C, Martínez Vizcaíno V, Graven-Nielsen T, Arendt-Nielsen L. Latent myofascial trigger points are associated with an increased antagonistic muscle activity during agonist muscle contraction. J Pain. 2011 Dec;12(12):1282-8. doi: 10.1016/j.jpain.2011.09.005. Epub 2011 Nov 11.

Baima J, Isaac Z. Clean versus sterile technique for common joint injections: a review from the physiatry perspective. Curr Rev Musculoskelet Med. 2008 Jun;1(2):88-91. doi: 10.1007/s12178-007-9011-2.

Administration FaD. Code of Federal Regulations Title 21. 2018; https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=880.5580. Accessed March 24, 2019.

Clinical trials entries are delivered from the US National Institutes of Health and are not reviewed separately by this site. Please see the identifier information above for retrieving further details from the government database.

At TrialBulletin.com, we keep tabs on over 200,000 clinical trials in the US and abroad, using medical data supplied directly by the US National Institutes of Health. Please see the About and Contact page for details.