Effects of Trigger Point Dry Needling on Strength Measurements and Activation Levels of the Gluteus Medius: A Quasi-Experimental Randomized Control Study.

Background: Latent trigger points have been identified as a source of impaired muscle function giving rise to a reduction in force production and alterations in muscle activation patterns and movement efficiency. There is limited investigation into the effectiveness of a treatment in reducing these clinical manifestations. Purpose: To investigate whether the application of trigger point dry needling (TDN) to latent trigger points within the gluteus medius musculature affected strength measurements and muscle activation levels immediately following intervention. Design: Quasi experimental, single group, pretest-posttest, randomized control study. Methods: A control and an intervention side were randomly assigned for each participant (N = 39). Hand held dynamometer (HHD) force measurements and raw surface electromyography (sEMG) amplitude readings were recorded during maximal volitional isometric contractions of the gluteus medius in two separate positions before and after application of TDN. Comparison of within and between group data were conducted. Results: A statistically significant interaction between time (pre-TDN to post-TDN) and groups (intervention side and control side), p < 0.001 was found for HHD measurements in both positions. Post hoc analysis revealed a statistically significant difference (p < 0.001) for all comparisons in the side lying neutral (SL0) position, while statistically significant differences (p < 0.001) were found for pre and post-TDN measurements within intervention side as well as between the intervention and control side for post-TDN measurements in the side lying internal rotation (SLIR) position. For sEMG amplitude measurements, statistically significant differences were found only in the SL0 position for within group comparisons on the intervention side (p = 0.009) and for between group comparisons for post-TDN measurements (p = 0.002). Conclusion: Application of TDN to latent trigger points within the gluteus medius can significantly increase gluteus muscle force production immediately following intervention while reducing the level of muscle activation required during contraction. Level of Evidence: Level 2.

The impact of internet addiction on depression, physical activity level and trigger point sensitivity in Turkish university students.

BACKGROUND AND OBJECTIVES: Internet addiction (IA), defined as excessive, time consuming, uncontrollable use of the internet, has become a widespread problem. In this study, we investigated the impact of internet addiction on depression, physical activity level, and latent trigger point sensitivity in Turkish university students. METHODS: A total of 215 university students (155 females and 60 males) who were between 18-25 years of age participated in the study. Using the Addiction Profile Index Internet Addiction Form (APIINT), we identified 51 people as non-internet-addicted (non-IA) (Group 1: 10 male/41 female) and 51 as internet-addicted (IA) (Group 2: 7 male/44 female). APIINT, International Physical Activity Questionnaire-Short-Form (IPAQ), Beck Depression Inventory (BDI), and Neck Disability Index (NDI) were administered to both groups, and the pressure-pain threshold (PPT) in upper/middle trapezius latent trigger points area was measured. RESULTS: The internet addiction rate was 24.3% in our students. Compared with the non-IA group, the daily internet use time and BDI and NDI scores were higher (all p< 0.05), while the IPAQ walking (p< 0.01), IPAQ total (p< 0.05), and PPT values (p< 0.05) were lower in the IA group. CONCLUSIONS: IA is a growing problem. This addiction may lead to musculoskeletal problems and can have consequences involving the level of physical activity, depression, and musculoskeletal disorders, particularly in the neck.

Relationship between Alexithymia and latent trigger points in the upper Trapezius.

BACKGROUND: Latent trigger points (LTrPs) can be activated by future events, leading to pain. Few studies have reported LTrP risk factors. It has been suggested that alexithymia is associated with myofascial pain and diminished awareness of physical sensation. This study was designed to evaluate the relation between alexithymia and LTrPs found the upper trapezius of healthy individuals. METHODS: The correlation between LTrPs and alexithymia, and between LTrPs and depression was analyzed in 160 healthy participants (80 male, mean age: 40.5 years [20 to 66 years]). Each participant was evaluated for potential LTrPs by careful manual examination and completed the Toronto Alexithymia Scale-20 (TAS-20) and the Beck Depression Inventory (BDI) to assess potential alexithymia and depressive symptoms, respectively. RESULTS: LTrPs were observed in the upper trapezius of 76 participants (47.5%). TAS-20 scores were significantly higher in subjects with LTrPs than without LTrPs (p < 0.001); in contrast, there was no significant BDI score difference between these groups (p = 0.451). The LTrP risk for alexithymia was 2.74 (95% confidence interval [95% CI]: 2.10-3.58). There was no correlation between the TAS-20 and BDI scores (correlation coefficient: -0.04). Significant risk factors associated with LTrPs included the TAS-20 score (odds ratio [OR]: 1.11, 95% CI: 1.07-1.15) and age (OR: 1.05, 95% CI: 1.01-1.09). CONCLUSIONS: Alexithymia was associated with LTrPs in the upper trapezius of healthy individuals, suggesting that it may serve as a useful predictive factor. TRIAL REGISTRATION: UMIN000027468. Registered 23 May 2017(retrospectively registered).

A comparison of the effect of the active release and muscle energy techniques on the latent trigger points of the upper trapezius.

BACKGROUND/AIM: The increasing use of computer in daily life has brought about numerous musculoskeletal problems. Impairments in the head, neck and shoulders are more common compared with the other parts of the body. The aim of this study was to compare the effect of two manual treatments in two separate groups, i.e., active release technique (ART) and muscle energy technique (MET) on the latent trigger points (LTrPs) in the upper trapezius muscle. The set criteria in the study included the active range of cervical lateral flexion, pain intensity on the visual analog scale (VAS), and the upper trapezius muscle thickness. SUBJECTS AND METHODS: This clinical trial study assessed the outcome measures within and between groups before and after the intervention. The target population were 64 (32 males, 32 females) participants who had been selected from among the staff members and the students of a rehabilitation school, and the employees of an engineering company who had LTrPs in their upper trapezius muscle and were from 18 to 50 years old. RESULTS: The immediate effects of MET and ART on the patients of each groups with LTrPs in their upper trapezius muscle were increased active range of cervical lateral flexion (P < 0.001), decreased pain intensity on VAS (P < 0.05) and decreased thickness of the upper trapezius muscle (P < 0.01). CONCLUSION: Both manual techniques of ART and MET reduced the symptoms of LTrPs in the upper trapezius in the two groups equally, neither technique being superior to the other.

Diagnosis of myofascial pain syndrome.

Myofascial pain is one of the most common causes of pain. The diagnosis of myofascial pain syndrome (MPS) is made by muscle palpation. The source of the pain in MPS is the myofascial trigger point, a very localized region of tender, contracted muscle that is readily identified by palpation. The trigger point has well-described electrophysiologic properties and is associated with a derangement of the local biochemical milieu of the muscle. A proper diagnosis of MPS includes evaluation of muscle as a cause of pain, and assessment of associated conditions that have an impact on MPS.

The immediate effect of triceps surae myofascial trigger point therapy on restricted active ankle joint dorsiflexion in recreational runners: a crossover randomised controlled trial.

OBJECTIVES: To investigate the immediate effect on restricted active ankle joint dorsiflexion range of motion (ROM), after a single intervention of myofascial trigger point (MTrP) therapy on latent triceps surae MTrPs in recreational runners. DESIGN: A crossover randomised controlled trial. PARTICIPANTS: Twenty-two recreational runners (11 men and 11 women; mean age 24.57; ±8.7 years) with a restricted active ankle joint dorsiflexion and presence of latent MTrPs. INTERVENTION: Participants were screened for a restriction in active ankle dorsiflexion in either knee flexion (soleus) or knee extension (gastrocnemius) and the presence of latent MTrPs. Participants were randomly allocated a week apart to both the intervention (combined pressure release and 10 s passive stretch) and the control condition. RESULTS: A clinically meaningful (large effect size) and statistically significant increase in ankle ROM in the intervention compared to the control group was achieved, for the soleus (p = 0.004) and the gastrocnemius (p = 0.026). CONCLUSION: Apart from the statistical significance (p < 0.05), these results are clinically relevant due to the immediate increase in ankle dorsiflexion. These results must be viewed in caution due to the carry-over effect in the RCT crossover design and the combined MTrP therapy approach.