Dry needling latent upper trapezius myofascial trigger points and the immediate effects on cervical motor performance: a randomized controlled pre-post clinical trial

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Date
2024-08-22
Authors
Bone, Robin
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Abstract
Background: Dry needling (DN) is an efficacious intervention for recurrent cervical pain. However, there is a paucity of research on the impact of DN on motor performance using quantitative objective outcome measures. Objective: The purpose of this study was to investigate the efficacy of DN compared to a sham needling procedure on latent upper trapezius (UT) myofascial trigger points (MTrPs) in participants with a recurrent history of neck pain. Method: A blinded pre-post clinical trial was performed. Thirty-six volunteers (mean age 35) with recurrent neck pain and latent MTrPs in UT were randomly assigned to a DN or a penetrating sham group. A single needling intervention was performed. Clinical outcomes included active range of motion (ROM), pain with the visual analogue scale (VAS), Neck Disability Index (NDI) and pain pressure thresholds (PPT). A Fitts’ Law-based head turning task assessed motor outcomes. Results: Immediately following treatment both groups showed no change in pain (p > 0.05) or ROM (p > 0.05) while PPT was increased (p < 0.001). Pain was reduced at the one-week follow up (p < 0.001). Movement time (MT) was reduced in both groups after the intervention (p < 0.001). Both constant and variable error were also reduced post-intervention (p < 0.001, p = 0.002; respectively). An interesting trend was found with movement initiation (peak velocity and peak acceleration), where after the DN intervention participants’ initial movement was faster; this trend was not seen in participants in the sham procedure group. Conclusions: Needling interventions can impact central pain processing resulting in decreased pain perception, with subsequent reductions in MTs. These data suggest that DN triggered a sensorimotor response that altered or reset muscle activation patterns leading to different movement strategies.
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Keywords
Myofascial Trigger Points, Dry needling, Motor performance, Fitts' task
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