Vicente-Mampel J, Bautista I J, Salvat I, Maroto-Izquierdo S, Lluch Girbés E, Ros Bernal F
School of Medicine and Health Science, Department of Physiotherapy, Catholic University of Valencia, Valencia, Spain.
Faculty of Medicine and Health Sciences, Department of Medicine and Surgery, Rovira i Virgili, Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain.
PM R. 2025 Apr;17(4):419-430. doi: 10.1002/pmrj.13289. Epub 2024 Dec 6.
BACKGROUND: Dry needling (DN) has been demonstrated as an effective treatment for patients with fibromyalgia (FM). It is crucial to take into consideration catastrophizing, a psychological construct that could potentially undermine the short-term efficacy of DN. OBJECTIVE: To analyze the effects of DN in the infraspinatus muscle on both local and remote pressure pain thresholds (PPTs) and its relationship with baseline levels of pain catastrophizing in patients with FM. DESIGN: Randomized controlled trial. METHODS: All participants were randomly assigned to one of three interventions: DN, sham DN, and no intervention. Hong's fast-in and fast-out technique was implemented during the DN intervention. MAIN OUTCOMES MEASURES: The primary study outcome pain sensitivity (local and remote PPTs) was assessed at baseline, immediately post, and 24 h post intervention to evaluate short-term effect. Pain catastrophizing was measured at baseline in all participants using the Pain Catastrophizing Scale. To analyze the effect of DN on local and remote PPTs, an analysis of covariance was performed using catastrophism as covariate. Additionally, to examine the possible influence of catastrophism on local PPTs ratings in the subsequent assessment we performed a moderation analysis. PATIENTS: A total of 120 women diagnosed with FM. However, during the follow-up period, 24 participants discontinued their involvement, leaving a final cohort of 96 patients who successfully concluded the study. RESULTS: DN showed significant differences in both local PPTs immediately post intervention and 24 h post intervention (MD [95% confidence interval] = 3.21 [0.40-6.02] kg/cm, p = .019; and 2.84 [0.10-5.58] kg/cm, p = .039, respectively) compared to sham and no-intervention groups. In addition, DN group results suggest that moderate values of catastrophizing (<35) diminish the effect of DN immediately postintervention. CONCLUSIONS: The infraspinatus DN led to a notable reduction in local PPTs among individuals with FM. Additionally, the effectiveness of the DN treatment was influenced by pain catastrophizing.
背景：干针疗法（DN）已被证明是治疗纤维肌痛（FM）患者的有效方法。考虑灾难化思维这一可能会削弱DN短期疗效的心理因素至关重要。 目的：分析对冈下肌进行DN治疗对局部和远处压力疼痛阈值（PPT）的影响，以及其与FM患者疼痛灾难化思维基线水平的关系。 设计：随机对照试验。 方法：所有参与者被随机分配到三种干预措施之一：DN、假DN和不干预。在DN干预期间采用洪氏快速进针和快速出针技术。 主要结局指标：在基线、干预后即刻和干预后24小时评估主要研究结局疼痛敏感性（局部和远处PPT），以评估短期效果。使用疼痛灾难化量表在基线时测量所有参与者的疼痛灾难化思维。为了分析DN对局部和远处PPT的影响，以灾难化思维为协变量进行协方差分析。此外，为了检查灾难化思维在后续评估中对局部PPT评分的可能影响，我们进行了调节分析。 患者：共有120名被诊断为FM的女性。然而，在随访期间，24名参与者退出，最终有96名患者成功完成研究。 结果：与假干预组和不干预组相比，DN在干预后即刻和干预后24小时的局部PPT均有显著差异（平均差[95%置信区间]=3.21[0.40 - 6.02]kg/cm，p = 0.019；和2.84[0.10 - 5.58]kg/cm，p = 0.039）。此外，DN组的结果表明，灾难化思维程度中等（<35）会削弱干预后即刻DN的效果。 结论：对冈下肌进行DN治疗可使FM患者的局部PPT显著降低。此外，DN治疗的有效性受疼痛灾难化思维的影响。
Pain Physician. 2020-7
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