Effects of Dry Needling on Neuromuscular Control of Ankle Stabilizer Muscles and Center of Pressure Displacement in Basketball Players with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial.

Luis López-González,Deborah Falla,Irene Lázaro-Navas,Daniel Pecos-Martín,Cristina Lorenzo-Sánchez-Aguilera,Tomás Gallego-Izquierdo,Isabel Rodríguez-Costa

doi:10.3390/ijerph18042092

Abstract

This study aimed to compare the effects of dry needling (DN) versus placebo DN applied to the peroneus longus (PL) and tibialis anterior (TA) on neuromuscular control and static postural control in basketball players with chronic ankle instability (CAI). A single-blinded randomized controlled trial was conducted. Thirty-two male and female basketball players with CAI were randomly assigned to receive either DN (n = 16) or placebo DN (n = 16). Pre-activation amplitudes of PL and TA were assessed with surface electromyography (EMG) during a dynamic landing test. Center of pressure (CoP) displacement and sway variability in anterior-posterior (AP) and medio-lateral (ML) directions were measured with a force platform during a single leg balance test (SLBT). Measures were obtained prior to a single DN intervention, immediately after, at 48 h, and 1 month after. The DN group displayed a significant increase in PL and TA pre-activation values, which were maintained 1 month later. Significant reductions in the ML and AP displacements and sway variability of CoP were found for the DN group. These results showed improvements in feedback/feed-forward strategies following DN, including enhanced neuromuscular control and static postural control, with the potential to become a convenient and accessible preventive treatment in CAI subjects.

Highlights

After an initial ankle sprain, anatomical changes such as laxity, impaired arthrokinematics, or synovial changes can lead to joint insufficiencies that predispose to recurrent ankle sprains [1,2,3,4]
chronic ankle instability (CAI) is associated with repetitive lateral ankle instability episodes, where both functional and mechanical insufficiencies predispose to multiple sprains [1,4]
tibialis anterior (TA) = Tibialis Anterior, peroneus longus (PL) = Peroneus Longus, ML = Medial-Lateral, AP = Anterior-Posterior; * Means and Standard Deviations; † Compared to pre-treatment; ‡ Mean Differences (95% Confidence Interval); ~ Statistically significant differences (p < 0.05); § Statistically significant differences (p < 0.001); η2 = Eta squared

Summary

Introduction

After an initial ankle sprain, anatomical changes such as laxity, impaired arthrokinematics, or synovial changes can lead to joint insufficiencies that predispose to recurrent ankle sprains [1,2,3,4]. Given the intrinsic characteristics of basketball practice and its specific physical demands, more than 70% of basketball players who suffer an acute ankle sprain will develop recurrent sprains between 6 weeks and 18 months after the initial injury, with approximately 20–40% developing chronic ankle instability (CAI) [1,5,6,7]. CAI is associated with repetitive lateral ankle instability episodes, where both functional and mechanical insufficiencies predispose to multiple sprains [1,4]. C. The first sprain must have occurred at least 12 months before inclusion in the research study. The first sprain must have occurred at least 12 months before inclusion in the research study It must have developed with signs of inflammation.

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