Seif Gretchen, Phipps Alan M, Donnelly Joseph M, Dellenbach Blair H S, Thompson Aiko K
Department of Health Professions, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina, United States.
Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina, United States.
J Neurophysiol. 2025 Jan 1;133(1):288-298. doi: 10.1152/jn.00366.2024. Epub 2024 Dec 20.
Deep dry needling (DDN) is a method to treat muscle trigger points (TrPs) often found in persons with neuromuscular pain and spasticity. Currently, its neurophysiological actions are not well established. Thus, to understand how DDN affects spinal cord physiology, we investigated the effects of TrP DDN on spinal reflexes. In 17 adults with latent TrPs in the medial gastrocnemius (MG) without known neurological or orthopedic injuries, the H reflex, M wave, and reciprocal inhibition in the soleus, MG, and lateral gastrocnemius (LG) and passive ankle range of motion (ROM) were measured before and immediately, 90 min, and 72 h after a single bout of DDN at the MG TrPs. The MG maximum M wave (M) amplitude was decreased immediately and 90 min post DDN (by -14% and -18%) and returned to pre-DDN level at 72 h post. LG and soleus M did not change. The maximum H reflex (H) amplitude did not change in any of the triceps surae. Soleus inhibition was increased significantly immediately (+30%) and 72 h (+36%) post DDN. ROM was increased by ≈4° immediately and ≈3° at 72 h post DDN. Temporary reduction of MG (but not soleus or LG) M amplitude after DDN and its recovery at 72 h post indicate temporary and specific effects of DDN in the treated muscle. The immediate and 72 h post increases in the ROM and soleus inhibition with no changes in H suggest complex effects of DDN at the spinal level. In this study, we examined the effects of deep dry needling (DDN) on spinal reflexes in the triceps surae. We found that the H reflex (an excitatory reflex) did not change after DDN but soleus inhibition was increased immediately and 72 h after DDN, corresponding to increases in ankle range of motion. Differential effects of DDN on excitatory and inhibitory reflexes over the first 72 h may reflect its complex neurophysiological effects at the spinal level.
深部干针疗法（DDN）是一种治疗肌肉触发点（TrP）的方法，肌肉触发点常见于患有神经肌肉疼痛和痉挛的人群中。目前，其神经生理作用尚未明确。因此，为了解深部干针疗法如何影响脊髓生理，我们研究了针对触发点的深部干针疗法对脊髓反射的影响。在17名内侧腓肠肌（MG）存在潜在触发点且无已知神经或骨科损伤的成年人中，在针对MG触发点进行单次深部干针治疗前、治疗后即刻、90分钟和72小时，分别测量比目鱼肌、MG和外侧腓肠肌（LG）的H反射、M波、交互抑制以及被动踝关节活动范围（ROM）。MG的最大M波（M）振幅在深部干针治疗后即刻和90分钟时降低（分别降低了14%和18%），并在治疗后72小时恢复到治疗前水平。LG和比目鱼肌的M波未发生变化。任何一块小腿三头肌的最大H反射（H）振幅均未改变。比目鱼肌的抑制作用在深部干针治疗后即刻（增加30%）和72小时（增加36%）时显著增强。ROM在深部干针治疗后即刻增加约4°，在治疗后72小时增加约3°。深部干针治疗后MG（而非比目鱼肌或LG）M波振幅的暂时降低及其在72小时后的恢复表明深部干针疗法对治疗肌肉具有暂时且特定的作用。ROM和比目鱼肌抑制作用在治疗后即刻和72小时的增加，而H反射无变化，提示深部干针疗法在脊髓水平具有复杂的作用。在本研究中，我们研究了深部干针疗法（DDN）对小腿三头肌脊髓反射的影响。我们发现，深部干针治疗后H反射（一种兴奋性反射）未发生变化，但比目鱼肌的抑制作用在深部干针治疗后即刻和72小时增强，这与踝关节活动范围的增加相对应。深部干针疗法在最初72小时内对兴奋性和抑制性反射的不同影响可能反映了其在脊髓水平的复杂神经生理作用。
