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干针疗法对轻中度髋骨关节炎患者疼痛、压痛阈和心理困扰的影响:一项随机对照试验的二次分析。

Effects of dry needling on pain, pressure pain threshold and psychological distress in patients with mild to moderate hip osteoarthritis: Secondary analysis of a randomized controlled trial.

机构信息

Department of Surgery, Ophtalmology and Physiotherapy, University of Valladolid.c/Universidad s/n 42004, Soria, Spain.

ID_ERGO Research group, I3A, Department: Design and Manufacturing Engineering. University of Zaragoza, Spain.

出版信息

Complement Ther Med. 2020 Jun;51:102443. doi: 10.1016/j.ctim.2020.102443. Epub 2020 May 18.

DOI:10.1016/j.ctim.2020.102443
PMID:32507443
Abstract

OBJECTIVE

To determine the changes produced by dry needling in active myofascial trigger points in hip muscles compared to a sham needling on pain intensity, main pain area, pressure pain threshold and psychological distress in patients with hip osteoarthritis.

DESIGN

Secondary analysis of a single-centre, randomized, double-blinded, clinical trial.

INTERVENTION

30 participants with mild to moderate hip osteoarthritis were randomly assigned to DN group (n = 15) or sham DN group (n = 15). DN group received three sessions of penetrating DN, and sham DN group received three sessions of non-penetrating DN in hip muscles.

MAIN OUTCOME MEASURES

Pain intensity (Visual Analogue Scale), main pain area (body chart), pressure pain threshold (algometry), psychological distress (Hospital Anxiety and Depression Scale) and self-reported improvement (Global Rate of Change) were measured before and after treatment.

RESULTS

DN group showed statistically significant improvements with large effect sizes for pain intensity (p < 0.001; E.S: 2.7), pressure pain thresholds (p < 0.05; E.S: 1.3-1.8) and psychological distress (p = 0.002; E.S: 1.5) compared to sham DN group. The DN group described a self-reported improvement categorised as quite a bit, great or very great deal better (n = 12, 80%). No statistically significant differences were found between baseline and postintervention in the sham DN group in any variable (p > 0.05).

CONCLUSIONS

Three sessions of dry needling were more effective than sham dry needling for improving pain intensity, pressure pain threshold and psychological distress in patients with mild to moderate hip osteoarthritis in the short term.

摘要

目的

比较干针治疗髋关节肌肉活动性肌筋膜触发点与假针刺治疗对髋骨关节炎患者疼痛强度、主要疼痛区域、压痛阈值和心理困扰的影响。

设计

单中心、随机、双盲、临床试验的二次分析。

干预措施

30 名轻度至中度髋骨关节炎患者被随机分为 DN 组(n=15)或 sham DN 组(n=15)。DN 组接受三次穿透性 DN 治疗,而 sham DN 组接受三次非穿透性 DN 治疗。

主要观察指标

治疗前后疼痛强度(视觉模拟量表)、主要疼痛区域(身体图表)、压痛阈值(测压法)、心理困扰(医院焦虑和抑郁量表)和自我报告的改善(总体变化率)。

结果

DN 组在疼痛强度(p<0.001;ES:2.7)、压痛阈值(p<0.05;ES:1.3-1.8)和心理困扰(p=0.002;ES:1.5)方面的改善具有统计学意义,且具有较大的效应量,与 sham DN 组相比。DN 组报告自我报告的改善程度为相当大、非常大或极大(n=12,80%)。在 sham DN 组中,任何变量在基线和干预后均无统计学差异(p>0.05)。

结论

在短期内,三次干针治疗比 sham 干针治疗更能有效改善轻度至中度髋骨关节炎患者的疼痛强度、压痛阈值和心理困扰。

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