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Efficacy of quadriceps vastus medialis dry needling in a rehabilitation protocol after surgical reconstruction of complete anterior cruciate ligament rupture

BACKGROUND: Several new rehabilitation modalities have been proposed after anterior cruciate ligament (ACL) reconstruction. Among these, trigger point dry needling (TrP-DN) might be useful in the treatment of myofascial pain syndrome associated with ACL reconstruction to reduce pain intensity, incre...

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Autores principales: Velázquez-Saornil, Jorge, Ruíz-Ruíz, Beatriz, Rodríguez-Sanz, David, Romero-Morales, Carlos, López-López, Daniel, Calvo-Lobo, Cesar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413255/
https://www.ncbi.nlm.nih.gov/pubmed/28445290
http://dx.doi.org/10.1097/MD.0000000000006726
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author Velázquez-Saornil, Jorge
Ruíz-Ruíz, Beatriz
Rodríguez-Sanz, David
Romero-Morales, Carlos
López-López, Daniel
Calvo-Lobo, Cesar
author_facet Velázquez-Saornil, Jorge
Ruíz-Ruíz, Beatriz
Rodríguez-Sanz, David
Romero-Morales, Carlos
López-López, Daniel
Calvo-Lobo, Cesar
author_sort Velázquez-Saornil, Jorge
collection PubMed
description BACKGROUND: Several new rehabilitation modalities have been proposed after anterior cruciate ligament (ACL) reconstruction. Among these, trigger point dry needling (TrP-DN) might be useful in the treatment of myofascial pain syndrome associated with ACL reconstruction to reduce pain intensity, increase knee flexion range and modify the mechanical properties of the quadriceps muscle during late-stage rehabilitation. To date, this is the first randomized clinical trial to support the use of TrP-DN in the early rehabilitation process after ACL reconstruction. The aim of this study was to determine the pain intensity, range of motion (ROM), stability, and functionality improvements by adding quadriceps vastus medialis TrP-DN to the rehabilitation protocol (Rh) provided to subacute ACL reconstructed patients. METHODS: This randomized, single-blinded, clinical trial (NCT02699411) included 44 subacute patients with surgical reconstruction of complete ACL rupture. The patients were randomized into 2 intervention groups: Rh (n = 22) or Rh + TrP-DN (n = 22). Pain intensity, ROM, stability, and functionality were measured at baseline (A(0)) and immediately (A(1)), 24 hours (A(2)), 1 week (A(3)), and 5 weeks (A(4)) after the first treatment. RESULTS: Comparing statistically significant differences (P ≤ .001; Eta(2) = 0.198–0.360) between both groups, pain intensity (at A(1)), ROM (at A(1), A(2,) and A(3)), and functionality (at A(2), A(3,) and A(4)) were increased. Nevertheless, the rest of measurements did not show significant differences (P > .05). CONCLUSION: Quadriceps vastus medialis TrP-DN in conjunction with a rehabilitation protocol in subacute patients with surgical reconstruction of complete ACL rupture increases ROM (short-term) and functionality (short- to mid-term). Although there was an increase in pain intensity with the addition of TrP-DN, this was not detected beyond immediately after the first treatment. Furthermore, stability does not seem to be modified after TrP-DN.
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spelling pubmed-54132552017-05-05 Efficacy of quadriceps vastus medialis dry needling in a rehabilitation protocol after surgical reconstruction of complete anterior cruciate ligament rupture Velázquez-Saornil, Jorge Ruíz-Ruíz, Beatriz Rodríguez-Sanz, David Romero-Morales, Carlos López-López, Daniel Calvo-Lobo, Cesar Medicine (Baltimore) 6300 BACKGROUND: Several new rehabilitation modalities have been proposed after anterior cruciate ligament (ACL) reconstruction. Among these, trigger point dry needling (TrP-DN) might be useful in the treatment of myofascial pain syndrome associated with ACL reconstruction to reduce pain intensity, increase knee flexion range and modify the mechanical properties of the quadriceps muscle during late-stage rehabilitation. To date, this is the first randomized clinical trial to support the use of TrP-DN in the early rehabilitation process after ACL reconstruction. The aim of this study was to determine the pain intensity, range of motion (ROM), stability, and functionality improvements by adding quadriceps vastus medialis TrP-DN to the rehabilitation protocol (Rh) provided to subacute ACL reconstructed patients. METHODS: This randomized, single-blinded, clinical trial (NCT02699411) included 44 subacute patients with surgical reconstruction of complete ACL rupture. The patients were randomized into 2 intervention groups: Rh (n = 22) or Rh + TrP-DN (n = 22). Pain intensity, ROM, stability, and functionality were measured at baseline (A(0)) and immediately (A(1)), 24 hours (A(2)), 1 week (A(3)), and 5 weeks (A(4)) after the first treatment. RESULTS: Comparing statistically significant differences (P ≤ .001; Eta(2) = 0.198–0.360) between both groups, pain intensity (at A(1)), ROM (at A(1), A(2,) and A(3)), and functionality (at A(2), A(3,) and A(4)) were increased. Nevertheless, the rest of measurements did not show significant differences (P > .05). CONCLUSION: Quadriceps vastus medialis TrP-DN in conjunction with a rehabilitation protocol in subacute patients with surgical reconstruction of complete ACL rupture increases ROM (short-term) and functionality (short- to mid-term). Although there was an increase in pain intensity with the addition of TrP-DN, this was not detected beyond immediately after the first treatment. Furthermore, stability does not seem to be modified after TrP-DN. Wolters Kluwer Health 2017-04-28 /pmc/articles/PMC5413255/ /pubmed/28445290 http://dx.doi.org/10.1097/MD.0000000000006726 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 6300
Velázquez-Saornil, Jorge
Ruíz-Ruíz, Beatriz
Rodríguez-Sanz, David
Romero-Morales, Carlos
López-López, Daniel
Calvo-Lobo, Cesar
Efficacy of quadriceps vastus medialis dry needling in a rehabilitation protocol after surgical reconstruction of complete anterior cruciate ligament rupture
title Efficacy of quadriceps vastus medialis dry needling in a rehabilitation protocol after surgical reconstruction of complete anterior cruciate ligament rupture
title_full Efficacy of quadriceps vastus medialis dry needling in a rehabilitation protocol after surgical reconstruction of complete anterior cruciate ligament rupture
title_fullStr Efficacy of quadriceps vastus medialis dry needling in a rehabilitation protocol after surgical reconstruction of complete anterior cruciate ligament rupture
title_full_unstemmed Efficacy of quadriceps vastus medialis dry needling in a rehabilitation protocol after surgical reconstruction of complete anterior cruciate ligament rupture
title_short Efficacy of quadriceps vastus medialis dry needling in a rehabilitation protocol after surgical reconstruction of complete anterior cruciate ligament rupture
title_sort efficacy of quadriceps vastus medialis dry needling in a rehabilitation protocol after surgical reconstruction of complete anterior cruciate ligament rupture
topic 6300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413255/
https://www.ncbi.nlm.nih.gov/pubmed/28445290
http://dx.doi.org/10.1097/MD.0000000000006726
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