Abstract
This study aimed to evaluate changes in neuromuscular function and pain perception in latent trigger points (TrPs) in the gastrocnemius muscle after a single session of dry needling. A randomized within-participant clinical trial was conducted. Fifty volunteers with latent TrPs in the gastrocnemius muscles were explored. Each extremity was randomly assigned to a control or experimental (dry needling) group. Viscoelastic parameters and contractile properties were analyzed by tensiomyography. Ankle dorsiflexion range of motion was assessed with the lunge test. Pressure pain thresholds (PPT) and pain perceived were also analyzed. The results observed that three viscoelastic proprieties (myotonometry) showed significant differences in favor of the experimental extremity in the lateral gastrocnemius: stiffness (p = 0.02), relaxation (p = 0.045), and creep (p = 0.03), but not in the medial gastrocnemius. No changes in tensiomyography outcomes were found. The control extremity showed a higher increase in PPTs (i.e., decrease in pressure pain sensitivity) than the experimental extremity (p = 0.03). No significant effects for range of motion or strength were observed. In general, gender did not influence the effects of dry needling over latent TrPs in the gastrocnemius muscle. In conclusion, a single session of dry needling was able to change some parameters of neuromuscular function, such as muscle tone, relaxation, pressure pain sensitivity, and creep in the lateral (but not medial) gastrocnemius but did not improve strength or range of motion.
Highlights
The clinical difference between active and latent trigger points (TrPs) is that active TrPs reproduce the pain symptoms experienced by an individual [2], while latent TrPs can be present without spontaneous symptoms, and when elicited, they do not reproduce the symptoms of an individual [1]
The medial gastrocnemius was needled in 55%, whereas the lateral gastrocnemius was needled in 45% of participants
The analysis of covariance (ANCOVA) revealed a significant group × time (F = 6.259; p = 0.016), without an effect of gender (F = 0.082; p = 0.776): the control extremity experienced a significant decrease in ankle strength when compared with the needle extremity (p = 0.003). The objective of this clinical trial was to evaluate the effects of a single session of dry needling over latent TrPs on neuromuscular function, sensitivity to pressure pain, range of motion, and strength in a sample of asymptomatic subjects
Summary
It has been observed that latent TrPs can induce motor dysfunctions, such as stiffness, restriction of range of motion, and muscle fatigue, supporting their clinical relevance [3]. Latent TrPs in the gastrocnemius muscles are common [4,5], and their presence may increase the risk of injury in the lower extremity, in individuals with a moderate level of activity and genetic predisposition [6]. Proper evaluation and treatment of latent TrPs could be essential for the prevention of muscle injuries. In such a scenario, a small number of trials have shown that the treatment of gastrocnemius muscle TrPs reduces pain, improves health-related quality of life, and increases range of motion [8]. Few studies have assessed the changes in neuromuscular function by using myotonometry after the treatment of latent TrPs in the gastrocnemius muscle [9,10]
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