Motor effects of movement representation techniques and cross-education: a systematic review and meta-analysis.

INTRODUCTION: The objective was to assess the impact of movement representation techniques (MRT) through motor imagery (MI), action observation (AO) and visual mirror feedback (VMF) and cross-education training (CE) on strength, range of motion (ROM), speed, functional state and balance during experimental immobilization processes in healthy individuals, in patients with injuries that did not require surgery and in those with surgical processes that did or did not require immobilization. EVIDENCE ACQUISITION: MEDLINE, EMBASE, CINAHL and Google Scholar were searched. Thirteen meta-analyses were conducted. EVIDENCE SYNTHESIS: Regarding the immobilized participants, in the healthy individuals, MI showed significant results regarding maintenance of strength and ROM, with low-quality evidence. Regarding the process with no immobilization, VMF and MI techniques showed significant changes in maintaining ROM in patients with injury without surgery, with very low-quality evidence. Results had shown that MI demonstrated significantly higher maintenance of strength and speed in patients undergoing surgery, with low-quality evidence. No significant results were found in ROM. Low-quality evidence showed better results in AO plus usual care compared with usual treatment in isolation with respect to maintenance of functional state and balance. CE training demonstrated maintenance of strength in patients undergoing surgery, with moderate evidence; however, not in healthy experimentally immobilized individuals. VMF did not show significant results in maintaining ROM after surgery without immobilization, nor did MI in maintaining strength after surgery and immobilization. CONCLUSIONS: MRT and CE training have been shown to have a significant impact on the improvement of various motor variables and on physical maintenance in general.

Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain

ABSTRACT Background Dry needling (DN) and percutaneous electrical nerve stimulation (PENS) are widely used techniques in the treatment of myofascial pain. Objective To investigate the immediate and short-term effects of the combination of DN and PENS compared to DN alone on the upper trapezius muscle. Method This is a 72-hour follow-up single-blinded randomized controlled trial. Sixty-two volunteer patients with chronic myofascial neck pain with active Myofascial Trigger Points (MTrPs) in the upper trapezius muscle were recruited. Randomization was performed, and 31 patients received DN treatment (DN group) and 31 received DN and PENS (DN+PENS group). The primary outcomes were neck disability index (NDI) and visual analog scale for pain for both post-needling soreness (PNS) and neck pain intensity (NPI). Pressure pain threshold (PPT) and cervical range of motion (CROM) were the secondary outcomes. Results We detected between-group differences in NPI and PNS in favor of the DN+PENS group immediately after treatment. No between-group differences in NDI were observed. Conclusion PENS application after dry needling treatment is more effective than dry needling alone for decreasing soreness in the short term and improving neck pain intensity immediately in patients with myofascial chronic neck pain.

Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain.

BACKGROUND: Dry needling (DN) and percutaneous electrical nerve stimulation (PENS) are widely used techniques in the treatment of myofascial pain. OBJECTIVE: To investigate the immediate and short-term effects of the combination of DN and PENS compared to DN alone on the upper trapezius muscle. METHOD: This is a 72-hour follow-up single-blinded randomized controlled trial. Sixty-two volunteer patients with chronic myofascial neck pain with active Myofascial Trigger Points (MTrPs) in the upper trapezius muscle were recruited. Randomization was performed, and 31 patients received DN treatment (DN group) and 31 received DN and PENS (DN+PENS group). The primary outcomes were neck disability index (NDI) and visual analog scale for pain for both post-needling soreness (PNS) and neck pain intensity (NPI). Pressure pain threshold (PPT) and cervical range of motion (CROM) were the secondary outcomes. RESULTS: We detected between-group differences in NPI and PNS in favor of the DN+PENS group immediately after treatment. No between-group differences in NDI were observed. CONCLUSION: PENS application after dry needling treatment is more effective than dry needling alone for decreasing soreness in the short term and improving neck pain intensity immediately in patients with myofascial chronic neck pain.