Abstract
Objective. To compare the effects of combined trigger point dry needling (TrP-DN) and proprioceptive/strengthening exercises to proprioceptive/strengthening exercises on pain and function in ankle instability. Methods. Twenty-seven (44% female, mean age: 33 ± 3 years) individuals with unilateral ankle instability were randomly assigned to an experimental group who received proprioceptive/strengthening exercises combined with TrP-DN into the lateral peroneus muscle and a comparison group receiving the same proprioceptive/strengthening exercise program alone. Outcome included function assessed with the Foot and Ankle Ability Measure (FAAM) and ankle pain intensity assessed with a numerical pain rate scale (NPRS). They were captured at baseline and 1-month follow-up after the intervention. Results. The ANOVAs found significant Group ∗ Time Interactions for both subscales of the FAAM (ADL: F = 8.211; P = 0.008; SPORTS: F = 13.943; P < 0.001) and for pain (F = 44.420; P < 0.001): patients receiving TrP-DN plus proprioceptive/strengthening exercises experienced greater improvements in function and pain than those receiving the exercise program alone. Between-groups effect sizes were large in all outcomes (SMD > 2.1) in favor of the TrP-DN group. Conclusions. This study provides evidence that the inclusion of TrP-DN within the lateral peroneus muscle into a proprioceptive/strengthening exercise program resulted in better outcomes in pain and function 1 month after the therapy in ankle instability.
Highlights
Lateral ankle sprain is the most common form of ankle sprain experienced by subjects participating in athletic activities and results in substantial societal burden [1]
This study provides evidence that the inclusion of trigger point dry needling (TrP-DN) within the lateral peroneus muscle into a proprioceptive/strengthening exercise program resulted in better outcomes in pain and function 1 month after the therapy in ankle instability
trigger points (TrPs)-DN posttreatment soreness resolved spontaneously within 24–36 hours without any intervention. The results of this randomized clinical trial suggest that the combination of TrP-DN plus proprioceptive/strengthening exercise program resulted in better outcomes 1 month after the end of therapy than when only proprioceptive/strengthening exercises were applied in individuals with chronic ankle instability
Summary
Lateral ankle sprain is the most common form of ankle sprain experienced by subjects participating in athletic activities and results in substantial societal burden [1]. Lateral ankle sprain can be a single injury event or part of an ongoing process that leads to functional ankle instability. Up to 40% of ankle sprains can result in chronic ankle instability [2, 3]. An overall prevalence of chronic ankle instability of 1.1% has been recently reported in males and 0.7% in females in a large general population study [4]. Tanen et al found a prevalence rate of 23% of ankle instability in high school athletes [5].
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