Physical Therapy Department, Life Care Clinics, Taif, 26311, Saudi Arabia.
Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, 21944, Saudi Arabia.
Musculoskelet Sci Pract. 2024 Nov;74:103155. doi: 10.1016/j.msksp.2024.103155. Epub 2024 Aug 18.
BACKGROUND: Myofascial pain syndrome (MPS) is a chronic condition caused by sensitive pressure regions within the muscles known as myofascial trigger points (MTrPs). OBJECTIVE: The purpose of this randomized controlled trial (RCT) was to assess the effectiveness of adding dry needling (DN) to activate MTrPs in the upper trapezius muscle compared with usual physiotherapy among individuals with chronic neck pain. METHODS: Thirty participants were recruited from a private clinic in Saudi Arabia. Their mean age was 29.7 ± 4.4 years. The subjects were randomized into two groups: the experimental group (application of DN to the MTrPs coupled with usual physiotherapy (n = 15)) and the control group (usual physiotherapy alone (n = 15)). The primary outcomes were pain (assessed using the visual analog scale) and disability (Neck Disability Index), and the secondary outcomes were neck active range of motion (AROM; assessed using cervical ROM) and depression (Beck's Depression Inventory). RESULTS: Significant between-group difference in pain intensity was observed immediately post-intervention. Participants in the experimental group had significantly higher pain (mean difference = 1.27, 95% confidence interval [CI] 0.20, 2.33, p = 0.022, Cohen's d = 0.889) than those in the control group. There was no significant difference between both groups in pain intensity during the follow-up. There were no between-group differences in disability immediately post-intervention. However, there was a between-group difference in disability at follow-up; participants in the experimental group had significantly lower disability (mean difference = -3.13, 95%CI -5.07, -1.20, p = 0.003, Cohen's d = 1.211) than those in the control group. Immediately post-intervention, the experimental group showed greater flexion AROM compared to the control group, with no differences in other AROM measures. At follow-up, the experimental group exhibited significantly higher neck AROM in extension, flexion, right and left side bending, and lower depression, while no differences were observed in right- and left-rotation AROMs between groups. CONCLUSIONS: The addition of DN to standard physiotherapy effectively improved disability, AROM (extension, flexion, and side bending), and depression among patients with chronic neck pain.
背景：肌筋膜疼痛综合征（MPS）是一种由肌肉中称为肌筋膜触发点（MTrP）的敏感压力区域引起的慢性疾病。 目的：本随机对照试验（RCT）的目的是评估在慢性颈痛患者中，与常规物理治疗相比，在斜方肌上部肌筋膜触发点（MTrP）上添加干针（DN）激活 MTrP 的效果。 方法：从沙特阿拉伯的一家私人诊所招募了 30 名参与者。他们的平均年龄为 29.7±4.4 岁。受试者被随机分为两组：实验组（DN 应用于 MTrP 结合常规物理治疗（n=15））和对照组（仅常规物理治疗（n=15））。主要结局是疼痛（使用视觉模拟量表评估）和残疾（颈椎残疾指数），次要结局是颈部主动活动范围（ROM；使用颈椎 ROM 评估）和抑郁（贝克抑郁量表）。 结果：干预后即刻观察到组间疼痛强度存在显著差异。实验组参与者的疼痛明显更高（平均差异=1.27，95%置信区间[CI]0.20，2.33，p=0.022，Cohen's d=0.889），比对照组参与者高。在随访期间，两组之间的疼痛强度没有差异。干预后即刻，两组之间的残疾无差异。然而，在随访时存在残疾方面的组间差异；实验组参与者的残疾明显较低（平均差异=-3.13，95%CI-5.07，-1.20，p=0.003，Cohen's d=1.211），比对照组参与者低。干预后即刻，实验组的前屈 ROM 明显大于对照组，其他 ROM 测量值无差异。在随访时，实验组在伸展、前屈、右侧和左侧侧屈以及抑郁方面表现出更高的颈部 ROM，而在右侧和左侧旋转 ROM 方面，两组之间没有差异。 结论：在标准物理治疗的基础上添加 DN 可有效改善慢性颈痛患者的残疾、ROM（伸展、前屈和侧屈）和抑郁。
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