Halle Rob, Crowell Michael, Goss Donald
US Army Baylor University KACH Division 1 Sports Physical Therapy Fellowship, West Point, NY.
Int J Sports Phys Ther. 2020 Feb;15(1):81-102.
Post-operative range of motion (ROM) loss and pain can limit quality of life, prolong functional return to activity, and may be sport/career threatening. Dry needling (DN) is intended assist in the treatment of these complaints.
To determine if the addition of upper quarter DN to a rehabilitation protocol is more effective in improving ROM, pain, and functional outcome scores when compared to a rehabilitation protocol alone after shoulder stabilization surgery.
Single-Blind Randomized Clinical Trial.
Thirty-nine post-operative shoulder patients were randomly allocated into two groups: (1) standard of care rehabilitation (control group) (2) standard of care rehabilitation plus dry needling (experimental group). Patient's pain, ROM, and functional outcome scores were assessed at baseline (4 weeks post-operative), and at 8 weeks, 12 weeks, and 6 months post-operative.
Of 39 enrolled patients, 20 were allocated to the control group and 19 to the experimental group. At six-month follow up, there was a statistically significant improvement in shoulder flexion ROM in the control group. Aside from this, there were no significant differences in outcomes between the two treatment groups. Both groups showed improvement over time. No adverse events were reported.
Dry needling of the shoulder girdle in addition to standard of care rehabilitation after shoulder stabilization surgery did not significantly improve shoulder ROM, pain, or functional outcome scores when compared with standard of care rehabilitation alone. Both group's improvement was largely equal over time. The significant difference in flexion at the six-month follow up may be explained by additional time spent receiving passive range of motion (PROM) in the control group. These results provide preliminary evidence that dry needling in a post-surgical population is safe and without significant risk of iatrogenic infection or other adverse events.
Therapy, Level 2.
术后活动范围（ROM）受限和疼痛会影响生活质量，延长功能恢复至正常活动的时间，甚至可能对运动/职业构成威胁。干针疗法（DN）旨在辅助治疗这些问题。
确定在肩部稳定手术后，与单纯康复方案相比，在康复方案中增加上肢干针疗法是否能更有效地改善活动范围、疼痛和功能结局评分。
单盲随机临床试验。
39例肩部手术后患者被随机分为两组：（1）标准护理康复组（对照组）（2）标准护理康复加干针疗法组（试验组）。在基线（术后4周）、术后8周、12周和6个月时评估患者的疼痛、活动范围和功能结局评分。
39例入组患者中，20例被分配到对照组，19例被分配到试验组。在六个月的随访中，对照组的肩部前屈活动范围有统计学意义的改善。除此之外，两个治疗组的结局没有显著差异。两组均随时间推移有所改善。未报告不良事件。
与单纯标准护理康复相比，肩部稳定手术后在标准护理康复基础上加用肩部干针疗法并未显著改善肩部活动范围、疼痛或功能结局评分。两组随时间的改善大致相当。六个月随访时前屈的显著差异可能是由于对照组接受被动活动范围（PROM）的时间更长。这些结果提供了初步证据，表明手术人群中的干针疗法是安全的，且没有医源性感染或其他不良事件的重大风险。
治疗，2级。
