Mason John S, Tansey Kimberly A, Westrick Richard B
Physical Therapy Department, McDonald Army Health Center, Fort Eustis, VA.
Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA.
Int J Sports Phys Ther. 2014 Feb;9(1):116-24.
Case Report.
Dry needling (DN) is an increasingly popular intervention used by clinicians as a treatment of regional neuromusculoskeletal pain. DN is an invasive procedure that involves insertion of a thin monofilament needle directly into a muscle trigger point (MTP) with the intent of stimulating a local twitch response. Current evidence is somewhat limited, but recent literature supports the use of this intervention in specific neuromusculoskeletal conditions. The purpose of this case report is to present the outcomes of DN as a primary treatment intervention in an adolescent subject with subacute posterior knee pain.
The subject was a 16-year-old female competitive ballet dancer referred to physical therapy with a two month history of right posterior knee pain. Palpation identified MTPs which reproduced the patient's primary symptoms. In addition to an exercise program promoting lower extremity flexibility and hip stability, the subject was treated with DN to the right gastrocnemius, soleus, and popliteus muscles.
The subject reported being pain free on the Numerical Pain Scale and a +7 improvement in perceived change in recovery on the Global Rating of Change at final follow-up. Physical examination demonstrated no observed impairments or functional limitations, including normal mobility, full strength, and unrestricted execution of dance maneuvers.
The patient was able to return to high level dance training and competition without physical limitations and resumed pre-injury dynamic movement activities including dancing, running, jumping, and pivoting without pain. DN can be an effective and efficient intervention to assist patients in decreasing pain and returning to high intensity physical activity. Additional research is needed to determine if DN is effective for other body regions and has long-term positive outcomes.
Level 4.
病例报告。
干针疗法（DN）是临床医生越来越常用的一种干预手段，用于治疗局部神经肌肉骨骼疼痛。DN是一种侵入性操作，需要将一根细的单丝针直接插入肌肉触发点（MTP），目的是激发局部抽搐反应。目前的证据在一定程度上有限，但最近的文献支持在特定的神经肌肉骨骼疾病中使用这种干预措施。本病例报告的目的是展示DN作为主要治疗干预手段，对一名患有亚急性后膝疼痛的青少年患者的治疗效果。
该患者是一名16岁的女性竞技芭蕾舞演员，因右后膝疼痛两个月前来接受物理治疗。触诊发现了能再现患者主要症状的MTP。除了进行促进下肢灵活性和髋关节稳定性的锻炼计划外，还对该患者右侧腓肠肌、比目鱼肌和腘肌进行了干针治疗。
在最后一次随访时，患者报告在数字疼痛量表上无痛，在总体变化评定量表上恢复感知变化改善了7分。体格检查未发现任何损伤或功能受限，包括正常的活动度、完全的力量以及舞蹈动作的无限制执行。
患者能够不受身体限制地恢复高水平舞蹈训练和比赛，并恢复了受伤前的动态运动活动，包括跳舞、跑步、跳跃和旋转，且无疼痛。干针疗法可以是一种有效且高效的干预措施，帮助患者减轻疼痛并恢复高强度体育活动。需要进一步的研究来确定干针疗法对其他身体部位是否有效以及是否具有长期的积极效果。
4级。
