ABSTRACT
BACKGROUND: Dry needling (DN) has been established as an effective treatment for myofascial pain, however, there are no studies thus far investigating the benefit to movement and motor control. PURPOSE: The primary purpose of this study was to compare differences in a series of outcomes between dry needling, dry needling and stretching, and stretching only in a sample of healthy males. A secondary purpose was to compare change over time. DESIGN: Blinded, randomized controlled trial. METHODS: Thirty healthy male subjects were randomly assigned to one of three intervention groups: DN, stretching, or combination DN +stretching. Subjects in the DN group and DN+stretch group received DN to a palpated trigger point (TrP) in the triceps surae to elicit local twitch response. Subjects in the stretch group and DN+stretch group were instructed in a home stretching program for gastrocnemius and soleus muscles. All groups were tested for dorsiflexion range of motion and performed functional tasks (overhead deep squat, and Y-Balance test, Lower Quarter) prior to intervention, directly after intervention, and four days post intervention. Group comparisons were performed using a repeated measure Analysis of Variance and a partial eta squared calculation for effect size. For all measures a p-value of < 0.05 was used to determine significance. Cohen's criteria were used to categorize strength of effect size. RESULTS: There were no statistically significant differences among groups for range of motion nor functional measures, with the exception of the deep squat. Proportionally, the DN group improved significantly in deep squat performance (p<0.01) compared to the other groups. Time oriented improvements were seen for the YBT posterior-lateral reach (p = 0.02) only. Between groups effect sizes ranged from 0.02 (small) to 0.17 (large). CONCLUSIONS: Including DN did not markedly influence range of motion nor functional assessment measures, excluding those seen during the overhead deep squat. Effect measures suggest the lack of significant findings may be an issue of statistical power. LEVEL OF EVIDENCE: 1b.
ABSTRACT
CONTEXT: Currently, hip-rotation range of motion (ROM) is clinically measured in an open kinetic chain in either seated or prone position using passive or active ROM. However, during activities of daily living and during sports participation the hip must be able to rotate in a loaded position, and there is no standard measurement for this. OBJECTIVE: To determine if a novel method for measuring hip rotation in weight bearing will result in good to very good reliability as demonstrated by an intraclass correlation coefficient (ICC) of >.80 and to investigate if weight-bearing hip measurements will result in significantly reduced hip ROM compared with non-weight-bearing methods. DESIGN: Repeated measures. SETTING: Outpatient sports physical therapy clinic. PARTICIPANTS: 20 healthy participants (10 men, 10 women) recruited for hip-rotation measurements. METHODS: Three trials of both internal and external rotation were measured in sitting, prone, and weight bearing. Two therapists independently measured each participant on the same day. The participants returned the following day to repeat the same measurements with the same 2 therapists. MAIN OUTCOME MEASURES: Degrees of hip internal and external rotation measured in prone, sitting, and loaded positions. RESULTS: In general, the measurement of hip ROM across the different conditions was reliable. The intrarater reliability was .67-.95, while interrater reliability was .59-.96. Interrater reliability was improved when values were averaged across the measures (.75-.97). ICCs for active loaded ROM were .67-.81, while interrater ICCs were .53-.87. In general, prone hip ROM was greater than supine and supine was greater than loaded. CONCLUSIONS: Loaded hip rotation can be measured in a clinical setting with moderate to good reliability. The rotation ROM of a loaded hip can be significantly decreased compared with unloaded motion.