Evaluation of deep oscillation therapy for the treatment of lumbar pain syndrome using motion capture systems: A systematic review.

Low back pain is a painful disorder that prevents normal mobilization, increases muscle tension and whose first-line treatment is usually non-steroidal anti-inflammatory drugs, together with non-invasive manual therapies, such as deep oscillation therapy. This systematic review aims to investigate and examine the scientific evidence of the effectiveness of deep oscillation therapy in reducing pain and clinical symptomatology in patients with low back pain, through the use of motion capture technology. To carry out this systematic review, the guidelines of the PRISMA guide were followed. A literature search was performed from 2013 to March 2022 in the PubMed, Elsevier, Science Director, Cochrane Library, and Springer Link databases to collect information on low back pain, deep oscillation, and motion capture. The risk of bias of the articles was assessed using the Cochrane risk of bias tool. Finally, they were included 16 articles and 5 clinical trials which met the eligibility criteria. These articles discussed the effectiveness of deep oscillation therapy in reducing pain, eliminating inflammation, and increasing lumbar range of motion, as well as analyzing the use of motion capture systems in the analysis, diagnosis, and evaluation of a patient with low back pain before, during and after medical treatment. There is no strong scientific evidence that demonstrates the high effectiveness of deep oscillation therapy in patients with low back pain, using motion capture systems. This review outlines the background for future research directed at the use of deep oscillation therapy as a treatment for other types of musculoskeletal injuries.

Bioelectric stimulation controls tissue shape and size.

Epithelial tissues sheath organs and electro-mechanically regulate ion and water transport to regulate development, homeostasis, and hydrostatic organ pressure. Here, we demonstrate how external electrical stimulation allows us to control these processes in living tissues. Specifically, we electrically stimulate hollow, 3D kidneyoids and gut organoids and find that physiological-strength electrical stimulation of ∼ 5 - 10 V/cm powerfully inflates hollow tissues; a process we call electro-inflation. Electro-inflation is mediated by increased ion flux through ion channels/transporters and triggers subsequent osmotic water flow into the lumen, generating hydrostatic pressure that competes against cytoskeletal tension. Our computational studies suggest that electro-inflation is strongly driven by field-induced ion crowding on the outer surface of the tissue. Electrically stimulated tissues also break symmetry in 3D resulting from electrotaxis and affecting tissue shape. The ability of electrical cues to regulate tissue size and shape emphasizes the role and importance of the electrical micro-environment for living tissues.

The fluidic memristor as a collective phenomenon in elastohydrodynamic networks.

Fluid flow networks are ubiquitous and can be found in a broad range of contexts, from human-made systems such as water supply networks to living systems like animal and plant vasculature. In many cases, the elements forming these networks exhibit a highly non-linear pressure-flow relationship. Although we understand how these elements work individually, their collective behavior remains poorly understood. In this work, we combine experiments, theory, and numerical simulations to understand the main mechanisms underlying the collective behavior of soft flow networks with elements that exhibit negative differential resistance. Strikingly, our theoretical analysis and experiments reveal that a minimal network of nonlinear resistors, which we have termed a 'fluidic memristor', displays history-dependent resistance. This new class of element can be understood as a collection of hysteresis loops that allows this fluidic system to store information, and it can be directly used as a tunable resistor in fluidic setups. Our results provide insights that can inform other applications of fluid flow networks in soft materials science, biomedical settings, and soft robotics, and may also motivate new understanding of the flow networks involved in animal and plant physiology.

Impacto de la COVID-19 en la práctica clínica de la fonoaudiologia en Colombia

Introducción: Son pocos los estudios que describen cómo la pandemia por COVID-19 ha afectado las prácticas clínicas de los profesionales en fonoaudiología, y es aún más escaso el conocimiento de este impacto en países latinoamericanos, como Colombia. Objetivo: Describir el impacto de la pandemia por COVID-19 sobre el ejercicio de la fonoaudiología clínica, así como las adaptaciones implementadas para garantizar la atención de salud en Colombia. Materiales y métodos: Estudio de corte transversal en el que se aplicó un cuestionario online entre enero y febrero de 2021 a fonoaudiólogos clínicos con experiencia en el área. El cuestionario indagó sobre variables sociodemográficas y categorías como el ejercicio profesional clínico y el impacto del COVID-19 en la práctica clínica fonoaudiológica. Los resultados se analizaron descriptivamente y se aplicó Chi2 de independencia para encontrar posibles asociaciones. Resultados: El 9 % de los profesionales perdió su trabajo debido a la pandemia, y del total restante, el 14 % optó por la telesalud. Existen restricciones de intervención, principalmente en la atención deglutoria y de habla, así como adaptaciones que buscan proteger la salud del paciente y el profesional. Se evidencia que el entrenamiento en atención con pacientes con COVID-19 promueve el uso de elementos de protección personal (p < 0,01), la construcción de protocolos de atención institucional (p < 0,01) y la estabilidad de tiempos de intervención durante las sesiones (p < 0,04). Conclusiones: la pandemia por COVID-19 impactó la práctica clínica fonoaudiológica y modificó el actuar de los profesionales no sólo por la adopción de medidas de bioseguridad sino por la transición a la teleconsulta para garantizar la atención en salud.

Introduction: Few studies have described how the COVID-19 pandemic has affected the clinical practices of speech and language therapists, and the knowledge of this impact in Latin American countries, such as Colombia, is even scarcer. The aim of the present study was to describe the impact of the COVID-19 pandemic on the clinical practice of speech and language therapy, as well as the adaptations implemented to guarantee health care in Colombia. Materials and methods: Cross-sectional study, in which an online questionnaire was applied between January and February 2021 to speech and language therapists with experience in the clinical area. The instrument inquired about sociodemographic variables and categories such as clinical professional practice and the impact of COVID-19 on clinical speech and language therapy practice. The results were analyzed descriptively and chi-square for independence was applied to find associations. Results: Nine percent of the professionals lost their jobs due to the pandemic, and of the remaining total, 14% opted for telehealth. There are intervention restrictions, in swallowing and speech care, as well as adaptations that seek to protect the health of the patient and the professional. It is evidenced that training in care with patients with COVID-19 promotes the use of personal protection elements (p<0.01), the construction of institutional care protocols (p<0.01) and the stability of intervention times during the sessions (p<0.04). Conclusions: The COVID-19 pandemic impacted clinical Speech and Language Therapy practice and changed the actions of professionals, not only by adopting biosecurity measures, but also by the transition to telehealth to guarantee health care.

Interfacial morphodynamics of proliferating microbial communities.

In microbial communities, various cell types often coexist by occupying distinct spatial domains. What determines the shape of the interface between such domains-which in turn influences the interactions between cells and overall community function? Here, we address this question by developing a continuum model of a 2D spatially-structured microbial community with two distinct cell types. We find that, depending on the balance of the different cell proliferation rates and substrate friction coefficients, the interface between domains is either stable and smooth, or unstable and develops finger-like protrusions. We establish quantitative principles describing when these different interfacial behaviors arise, and find good agreement both with the results of previous experimental reports as well as new experiments performed here. Our work thus helps to provide a biophysical basis for understanding the interfacial morphodynamics of proliferating microbial communities, as well as a broader range of proliferating active systems.

Tolerance Evaluation of Celery Commercial Cultivars and Genetic Variability of Fusarium oxysporum f. sp. apii.

Celery (Apium graveolens var. dulce) is affected by several plant diseases, such as Fusarium oxysporum f. sp. apii (Foa). Four Foa races have been found in the US. The goals of this study were to determine which races are present in Costa Rica and to quantify the tolerance of the imported commercial cultivars of celery produced in the country. Isolates from 125 symptomatic celery plants from three different geographical locations were analyzed, 65 of which were selected for phylogenetic analysis. All isolates presented a short sequence of five nucleotides that differentiates Foa race 3 in the IGS rDNA region. Three different haplotypes closely related to race 3 were found, which were highly virulent, produced great losses, and affected all cultivars (resistant to races 2 and 4) of imported commercial celery. Additionally, five different cultivars of celery were evaluated against seven pathogen isolates identified as race 3 in greenhouse conditions. Two of the cultivars showed significantly less chlorosis, wilting, mortality, and higher fresh weight. Most of the Foa isolates significantly increased chlorosis, wilting, and mortality compared to non-inoculated control. Celery producers in Costa Rica lack access to seeds resistant to the Foa race 3 present in the country.

Pattern formation by bacteria-phage interactions.

The interactions between bacteria and phages-viruses that infect bacteria-play critical roles in agriculture, ecology, and medicine; however, how these interactions influence the spatial organization of both bacteria and phages remain largely unexplored. Here, we address this gap in knowledge by developing a theoretical model of motile, proliferating bacteria that aggregate via motility-induced phase separation (MIPS) and encounter phage that infect and lyse the cells. We find that the non-reciprocal predator-prey interactions between phage and bacteria strongly alter spatial organization, in some cases giving rise to a rich array of finite-scale stationary and dynamic patterns in which bacteria and phage coexist. We establish principles describing the onset and characteristics of these diverse behaviors, thereby helping to provide a biophysical basis for understanding pattern formation in bacteria-phage systems, as well as in a broader range of active and living systems with similar predator-prey or other non-reciprocal interactions.

Morphological instability and roughening of growing 3D bacterial colonies.

How do growing bacterial colonies get their shapes? While colony morphogenesis is well studied in two dimensions, many bacteria grow as large colonies in three-dimensional (3D) environments, such as gels and tissues in the body or subsurface soils and sediments. Here, we describe the morphodynamics of large colonies of bacteria growing in three dimensions. Using experiments in transparent 3D granular hydrogel matrices, we show that dense colonies of four different species of bacteria generically become morphologically unstable and roughen as they consume nutrients and grow beyond a critical size-eventually adopting a characteristic branched, broccoli-like morphology independent of variations in the cell type and environmental conditions. This behavior reflects a key difference between two-dimensional (2D) and 3D colonies; while a 2D colony may access the nutrients needed for growth from the third dimension, a 3D colony inevitably becomes nutrient limited in its interior, driving a transition to unstable growth at its surface. We elucidate the onset of the instability using linear stability analysis and numerical simulations of a continuum model that treats the colony as an "active fluid" whose dynamics are driven by nutrient-dependent cellular growth. We find that when all dimensions of the colony substantially exceed the nutrient penetration length, nutrient-limited growth drives a 3D morphological instability that recapitulates essential features of the experimental observations. Our work thus provides a framework to predict and control the organization of growing colonies-as well as other forms of growing active matter, such as tumors and engineered living materials-in 3D environments.

Comparison of dry needling and self-stretching in muscle extensibility, pain, stiffness, and physical function in hip osteoarthritis: A randomized controlled trial.

BACKGROUND AND PURPOSE: Patients with hip osteoarthritis (OA) present myofascial trigger points in the hip muscles that may reduce muscle extensibility, provoke pain and stiffness, and decrease physical function. The purpose of the study was to compare the effects of dry needling (DN) intervention with a self-stretching protocol on muscle extensibility, pain, stiffness, and physical function in patients with hip OA. MATERIALS AND METHODS: A single-blinded randomised controlled trial was designed. Thirty-eight participants with hip OA were randomly assigned to the DN group (n = 19) or the stretching group (n = 19). The DN group received three sessions of DN, and the stretching group followed a 3-week protocol. Hip muscle extensibility was the primary outcome and was measured using the Ely test, the modified Ober test, and the Active Knee Extension test. Pain, stiffness, and physical function were the secondary outcomes measured with the WOMAC questionnaire. The variables were assessed before and after treatment by blinded examiners. RESULTS: DN was more effective than self-stretching for improving hip flexor and abductor muscles extensibility (p < 0.05). DN and self-stretching techniques improved hip extensor muscles extensibility, pain, stiffness, and physical function in patients with hip OA (<0.05). The DN group showed large effect sizes in all the variables (d > 0.8). CONCLUSION: Three sessions of DN were more effective than three weeks of self-stretching to improve hip muscle extensibility in patients with hip OA. DN and self-stretching techniques decreased pain and stiffness and improved physical function in patients with hip OA.

Membrane fission during bacterial spore development requires cellular inflation driven by DNA translocation.

Bacteria require membrane fission for both cell division and endospore formation. In Bacillus subtilis, sporulation initiates with an asymmetric division that generates a large mother cell and a smaller forespore that contains only a quarter of its genome. As the mother cell membranes engulf the forespore, a DNA translocase pumps the rest of the chromosome into the small forespore compartment, inflating it due to increased turgor. When the engulfing membrane undergoes fission, the forespore is released into the mother cell cytoplasm. The B. subtilis protein FisB catalyzes membrane fission during sporulation, but the molecular basis is unclear. Here, we show that forespore inflation and FisB accumulation are both required for an efficient membrane fission. Forespore inflation leads to higher membrane tension in the engulfment membrane than in the mother cell membrane, causing the membrane to flow through the neck connecting the two membrane compartments. Thus, the mother cell supplies some of the membrane required for the growth of the membranes surrounding the forespore. The oligomerization of FisB at the membrane neck slows the equilibration of membrane tension by impeding the membrane flow. This leads to a further increase in the tension of the engulfment membrane, promoting its fission through lysis. Collectively, our data indicate that DNA translocation has a previously unappreciated second function in energizing the FisB-mediated membrane fission under energy-limited conditions.

Cellular Sensing Governs the Stability of Chemotactic Fronts.

In contexts ranging from embryonic development to bacterial ecology, cell populations migrate chemotactically along self-generated chemical gradients, often forming a propagating front. Here, we theoretically show that the stability of such chemotactic fronts to morphological perturbations is determined by limitations in the ability of individual cells to sense and thereby respond to the chemical gradient. Specifically, cells at bulging parts of a front are exposed to a smaller gradient, which slows them down and promotes stability, but they also respond more strongly to the gradient, which speeds them up and promotes instability. We predict that this competition leads to chemotactic fingering when sensing is limited at too low chemical concentrations. Guided by this finding and by experimental data on E. coli chemotaxis, we suggest that the cells' sensory machinery might have evolved to avoid these limitations and ensure stable front propagation. Finally, as sensing of any stimuli is necessarily limited in living and active matter in general, the principle of sensing-induced stability may operate in other types of directed migration such as durotaxis, electrotaxis, and phototaxis.

Impacto de la pandemia COVID-19 en la práctica clínica profesional de la terapia ocupacional / Impacto da pandemia COVID-19 na prática clínica profissional de terapia ocupacional / Impact of the COVID-19 pandemic on the professional clinical practice of occupational therapy

Resumen Introducción Una serie de medidas restrictivas para el cuidado de la salud emergieron limitando acciones que incluyen el quehacer de terapeutas ocupacionales y proponiendo adaptaciones para brindar atención a las personas que así lo requieran. Objetivo Identificar el impacto y las adaptaciones en la atención de los profesionales clínicos de terapia ocupacional a causa de la pandemia por COVID-19 en Colombia. Método Estudio de corte transversal que aplica cuestionario online en enero-febrero de 2021 a terapeutas ocupacionales colombianos en ambientes clínicos/hospitalarios. Se analizaron variables sociodemográficas, ejercicio profesional clínico y el impacto del COVID-19 en cuanto a la pérdida del empleo, modificaciones y adaptaciones para la intervención. Se realizan análisis descriptivos por variable y se aplica prueba Chi-cuadrado de independencia para asociaciones entre variables. Resultados 382 terapeutas ocupacionales colombianos participaron. El tiempo promedio de ejercicio profesional fue de 10.8 años. Del total, el 89% trabajaba antes de la pandemia y continuó sus labores, al menos el 64% adujo que perdió su trabajo por el COVID-19. De los que continuaron trabajando el 20.5% lo hizo de manera virtual y el 79.5% en clínica presencial. A nivel virtual, el 89% lo hizo debido a exigencia laboral y al menos el 53% lo realizó sin formación en telesalud. Presencialmente, el 68% reportó restricciones en las acciones practicadas y disminución de remisiones a terapia. Conclusiones La pandemia ha redimensionado el actuar del terapeuta ocupacional, modificando los medios y formas de intervención y permitiendo la reinvención de su quehacer.

Resumo Introdução Uma série de medidas restritivas de atenção à saúde emergiram limitando as ações que incluem o trabalho do terapeuta ocupacional, requerendo adaptações para atender as pessoas que dele necessitam. Objetivo Identificar o impacto e as adaptações no atendimento de profissionais clínicos de terapia ocupacional devido à pandemia de COVID-19 na Colômbia. Métodos: Estudo transversal que aplicou um questionário online em janeiro-fevereiro de 2021 a terapeutas ocupacionais colombianos em ambientes clínicos/hospitalares. Foram analisadas variáveis ​​sociodemográficas, prática profissional clínica e o impacto da COVID-19 em termos de perda de emprego, modificações e adaptações para a intervenção. As análises descritivas são realizadas por variável e um teste de independência Qui-quadrado para associações entre as variáveis. Resultados Participaram 382 terapeutas ocupacionais colombianos. O tempo médio de exercício profissional foi de 10,8 anos. Do total, 89% trabalhavam antes da pandemia e continuaram seu trabalho, pelo menos 64% afirmaram que perderam o emprego devido ao COVID-19. Dos que continuaram a trabalhar, 20.5% o fizeram virtualmente e 79.5% em clínica presencial. Em nível virtual, 89% o fizeram por exigência de trabalho e pelo menos 53% o fizeram sem treinamento em telessaúde. Presencialmente, 68% relataram restrições nas ações praticadas e diminuição dos encaminhamentos para terapia. Conclusão A pandemia redimensionou as ações do terapeuta ocupacional, modificando os meios e formas de intervenção e permitindo a reinvenção do seu trabalho.

Abstract Introduction A series of restrictive health care measures emerged limiting actions that include the work of occupational therapists and proposing adaptations to provide care to people who require it. Objective To identify the impact and adaptations in the care of Occupational Therapy clinical professionals due to the COVID-19 pandemic in Colombia. Methods Cross-sectional study that applies an online questionnaire in January-February 2021 to Colombian occupational therapists in clinical/hospital settings. Sociodemographic variables, clinical professional practice, and the impact of COVID-19 in terms of job loss, modifications, and adaptations for the intervention were analyzed. Descriptive analyzes are performed by variable and a Chi-square test of independence is applied for associations between variables. Results 382 Colombian occupational therapists participated. The average time of professional practice was 10.8 years. Of the total, 89% worked before the pandemic and continued their work, and at least 64% claimed that they lost their job due to COVID-19. Of those who continued to work, 20.5% did so virtually and 79.5% in a face-to-face clinic. On a virtual level, 89% did it due to a job requirement and at least 53% did it without training in telehealth. In face-to-face, 68% reported restrictions in the actions practiced and decreased referrals to therapy. Conclusions The pandemic has resized the actions of the occupational therapist, has modified the means and forms of intervention, allowing the reinvention of their work.

Fingering instability in spreading epithelial monolayers: roles of cell polarisation, substrate friction and contractile stresses.

Collective cell migration plays a crucial role in many developmental processes that underlie morphogenesis, wound healing, or cancer progression. In such coordinated behaviours, cells are organised in coherent structures and actively migrate to serve different biological purposes. In some contexts, namely during epithelial wound healing, it is well known that a migrating free-edge monolayer develops finger-like instabilities, yet the onset is still under debate. Here, by means of theory and numerical simulations, we shed light on the main mechanisms driving the instability process, analysing the linear and nonlinear dynamics of a continuum compressible polar fluid. In particular, we assess the role of cell polarisation, substrate friction, and contractile stresses. Linear theory shows that it is crucial to analyse the perturbation transient dynamics, since we unravel a plethora of crossovers between different exponential growth rates during the linear regime. Numerical simulations suggest that cell-substrate friction could be the mechanism responsible for the formation of complex finger-like structures at the edge, since it triggers secondary fingering instabilities and tip-splitting phenomena. Finally, we obtain a critical contractile stress that depends on cell-substrate friction and the initial-to-nematic length ratio, characterising an active wetting-dewetting transition. In the dewetting scenario, the monolayer retracts and becomes stable without developing finger-like structures.

Evans Syndrome in a Jehovah's Witness.

Evans syndrome (ES) is a rare hematologic disorder characterized by the development of autoimmune hemolytic anemia (AIHA), idiopathic thrombocytopenia, and occasionally immune-mediated neutropenia. Jehovah's Witnesses (JW) often decline blood product transfusion on the grounds of a scriptural stand based on biblical texts. The acute management of ES often consists of blood product transfusion in addition to high-dose steroids and intravenous immunoglobulin. We describe the case of a JW female presenting with new-onset, acutely worsening AIHA and thrombocytopenia with concern for hemodynamic compromise who was successfully treated with erythropoietin-stimulating agents, parenteral iron, folic acid, and high-dose steroids.

Wearable sensors in the diagnosis and study of Parkinson's disease symptoms: a systematic review.

Nowadays, there are several diseases which affect different systems of the body, producing changes in the correct functioning of the organism and the people lifestyles. One of them is Parkinson's disease (PD), which is defined as a neurodegenerative disorder provoked by the destruction of dopaminergic neurons in the brain, resulting in a set of motor and non-motor symptoms. As this disease affects principally to ancient people, several researchers have studied different treatments and therapies for stopping neurodegeneration and diminishing symptoms, to improve the quality patients' lives. The most common therapies created for PD are based on pharmacological treatment for controlling the degeneration advance and the physical ones which do not reveal the progress of patients. For this reason, this review paper opens the possibility for using wearable motion capture systems as an option for the control and study of PD. Therefore, it aims to (1) study the different wearable systems used for capture the movements of PD patients and (2) determine which of them bring better results for monitoring and assess PD people. For the analysis, it uses papers based on experiments that prove the functioning of several motion systems in different aspects as monitoring, treatment and diagnose of the disease. As a result, it works with 30 papers which describe the factors mentioned before. Additionally, the paper uses journals and literature review about the pathology, its characteristics and the function of wearable sensors for the correct understanding of the topic.

FisB relies on homo-oligomerization and lipid binding to catalyze membrane fission in bacteria.

Little is known about mechanisms of membrane fission in bacteria despite their requirement for cytokinesis. The only known dedicated membrane fission machinery in bacteria, fission protein B (FisB), is expressed during sporulation in Bacillus subtilis and is required to release the developing spore into the mother cell cytoplasm. Here, we characterized the requirements for FisB-mediated membrane fission. FisB forms mobile clusters of approximately 12 molecules that give way to an immobile cluster at the engulfment pole containing approximately 40 proteins at the time of membrane fission. Analysis of FisB mutants revealed that binding to acidic lipids and homo-oligomerization are both critical for targeting FisB to the engulfment pole and membrane fission. Experiments using artificial membranes and filamentous cells suggest that FisB does not have an intrinsic ability to sense or induce membrane curvature but can bridge membranes. Finally, modeling suggests that homo-oligomerization and trans-interactions with membranes are sufficient to explain FisB accumulation at the membrane neck that connects the engulfment membrane to the rest of the mother cell membrane during late stages of engulfment. Together, our results show that FisB is a robust and unusual membrane fission protein that relies on homo-oligomerization, lipid binding, and the unique membrane topology generated during engulfment for localization and membrane scission, but surprisingly, not on lipid microdomains, negative-curvature lipids, or curvature sensing.

Effectiveness of Dry Needling Therapy on Pain, Hip Muscle Strength, and Physical Function in Patients With Hip Osteoarthritis: A Randomized Controlled Trial.

OBJECTIVE: To investigate the short-term effects of dry needling (DN) on physical function, pain, and hip muscle strength in patients with hip osteoarthritis (OA). DESIGN: A double-blind, placebo-control, randomized controlled trial. SETTING: Private practice physiotherapy clinic. PARTICIPANTS: Patients with unilateral hip OA (N=45) were randomly allocated to a DN group, sham DN group, or control group. INTERVENTIONS: Patients in the DN and sham groups received 3 treatment sessions. Three active myofascial trigger points (MTrPs) were treated in each session with DN or a sham needle procedure. The treatment was applied in active MTrPs of the iliopsoas, rectus femoris, tensor fasciae latae, and gluteus minimus muscles. MAIN OUTCOME MEASURES: Physical function was assessed with the Western Ontario and McMaster Universities (WOMAC) physical function subscale, the timed Up and Go test, and the 40-meter self-paced walk test. Intensity of hip pain related to physical function was evaluated using the visual analog scale and WOMAC pain subscale. The maximal isometric force of hip muscles was recorded with a handheld dynamometer. RESULTS: Significant group by time interactions were shown for physical function, pain, and hip muscle force variables. Post hoc tests revealed a significant reduction in hip pain and significant improvements in physical function and hip muscle strength in the DN group compared with the sham and control groups. The DN group showed within- and between-groups large effect sizes (d>0.8). CONCLUSIONS: DN therapy in active MTrPs of the hip muscles reduced pain and improved hip muscle strength and physical function in patients with hip OA. DN in active MTrPs of the hip muscles should be considered for the management of hip OA.

Effects of dry needling on pain, pressure pain threshold and psychological distress in patients with mild to moderate hip osteoarthritis: Secondary analysis of a randomized controlled trial.

OBJECTIVE: To determine the changes produced by dry needling in active myofascial trigger points in hip muscles compared to a sham needling on pain intensity, main pain area, pressure pain threshold and psychological distress in patients with hip osteoarthritis. DESIGN: Secondary analysis of a single-centre, randomized, double-blinded, clinical trial. INTERVENTION: 30 participants with mild to moderate hip osteoarthritis were randomly assigned to DN group (n = 15) or sham DN group (n = 15). DN group received three sessions of penetrating DN, and sham DN group received three sessions of non-penetrating DN in hip muscles. MAIN OUTCOME MEASURES: Pain intensity (Visual Analogue Scale), main pain area (body chart), pressure pain threshold (algometry), psychological distress (Hospital Anxiety and Depression Scale) and self-reported improvement (Global Rate of Change) were measured before and after treatment. RESULTS: DN group showed statistically significant improvements with large effect sizes for pain intensity (p < 0.001; E.S: 2.7), pressure pain thresholds (p < 0.05; E.S: 1.3-1.8) and psychological distress (p = 0.002; E.S: 1.5) compared to sham DN group. The DN group described a self-reported improvement categorised as quite a bit, great or very great deal better (n = 12, 80%). No statistically significant differences were found between baseline and postintervention in the sham DN group in any variable (p > 0.05). CONCLUSIONS: Three sessions of dry needling were more effective than sham dry needling for improving pain intensity, pressure pain threshold and psychological distress in patients with mild to moderate hip osteoarthritis in the short term.