The Journal of Orthopedics Research and Rehabilitation welcomes scholarly papers inorthopaedic surgery, physical therapy and rehabilitation, neurosurgery, neurology and clinic anesthesiology and reanimation.

EndNote Style
Original Article
Comparison of the effects of dry needling technique and combination of different manual therapy techniques on electrophysiological and psychological status in patients with myofascial pain syndrome - randomized, controlled, single blind, a pilot study
Aims: Our aim was to compare the electrophysiological and psychometric properties of the effects of the dry needling technique, graston technique, and muscle energy technique in treating myofascial pain syndrome.
Methods: The study included 21 patients diagnosed with myofascial pain syndrome (MPS) and an active trigger point in the upper trapezius muscle. The patients were randomly divided into three groups of 7 each. The first group received only exercise and dry needling technique (DNT), the second group received graston technique (GT), muscle energy technique (MET) and exercise, and the third group received only exercise. Evaluations were conducted before and after treatment. The trigger point detected with an algometer in the upper trapezius muscle was evaluated with needle electromyography (EMG). The study used the Beck Depression Inventory (BDI) to determine its effects on psychological state.
Results: The change in EMG variable over time was significant in each treatment group (p<0.05). The improvement in EMG change was more pronounced in the DNT group compared to the other groups. There was also a significant decrease in BDI scores before and after treatment (p<0.05). Pairwise comparison analysis revealed an improvement in the BDI scores of all groups, except the control (exercise) group, after treatment, when compared to pre-treatment.
Conclusion: During the trigger point needle EMG examination of all subjects in the study, we detected spontaneous muscle activity (SMA) in addition to entry activity. After treatment, we observed improvement in SMA. These results suggest that the applied techniques are effective in treating trigger points.The effectiveness of the applied techniques can be evaluated in terms of creating alternatives.

1. Fern&aacute;ndez-de-Las-Pe&ntilde;as C, Dommerholt J. International Consensuson Diagnostic Criteria and Clinical Considerations of MyofascialTrigger Points: A Delphi Study. Pain Med. 2018;19(1):142-150.doi:10.1093/pm/pnx207
2. Barbero M, Schneebeli A, Koetsier E, Maino P. Myofascial painsyndrome and trigger points: evaluation and treatment in patients withmusculoskeletal pain. Curr Opin Support Palliat Care. 2019;13(3):270-276. doi:10.1097/SPC.0000000000000445
3. Bron C, Franssen J, Wensing M, Oostendorp RA. Interrater reliabilityof palpation of myofascial trigger points in three shoulder muscles. JMan Manip Ther. 2007;15(4):203-215. doi:10.1179/106698107790819477
4. Simons DG. Understanding effective treatments of myofascial triggerpoints. J Bodyw Mov Ther. 2002;6:81-88. doi: 10.1054/jbmt.2002.0271.
5. Meleger AL, Krivickas LS. Neck and back pain: musculoskeletaldisorders. Neurol Clin. 2007;25(2):419-438. doi:10.1016/j.ncl.2007.01.006
6. Ariji Y, Kimura Y, Gotoh M, Sakuma S, Zhao YP, Ariji E. Blood flowin and around the masseter muscle: normal and pathologic featuresdemonstrated by color Doppler sonography. Oral Surg Oral MedOral Pathol Oral Radiol Endod. 2001;91(4):472-482. doi:10.1067/moe.2001.111760
7. Cojocaru MC, Cojocaru IM, Voiculescu VM, Cojan-Carlea NA,Dumitru VL, Berteanu M. Trigger points--ultrasound and thermalfindings. J Med Life. 2015;8(3):315-318.
8. Crema MD, Yamada AF, Guermazi A, Roemer FW, Skaf AY. Imagingtechniques for muscle injury in sports medicine and clinical relevance.Curr Rev Musculoskelet Med. 2015;8(2):154-161. doi:10.1007/s12178-015-9260-4
9. Evans V, Behr M, Gangwar A, Noseworthy MD, Kumbhare D. PotentialRole of MRI Imaging for Myofascial Pain: A Scoping Review for theClinicians and Theoretical Considerations. J Pain Res. 2021;14:1505-1514. Published 2021 May 27. doi:10.2147/JPR.S302683
10. Hubbard DR, Berkoff GM. Myofascial trigger points show spontaneousneedle EMG activity. Spine (Phila Pa 1976). 1993;18(13):1803-1807.doi:10.1097/00007632-199310000-00015
11. Simons DG, Hong CZ, Simons LS. Prevalence of spontaneous electricalactivity at trigger points and at control sites in rabbit skeletal muscle. JMusculoskel Pain. 1995;3(1):35-48.
12. De Meulemeester KE, Castelein B, Coppieters I, Barbe T, CoolsA, Cagnie B. Comparing Trigger Point Dry Needling and ManualPressure Technique for the Management of Myofascial Neck/ShoulderPain: A Randomized Clinical Trial. J Manipulative Physiol Ther.2017;40(1):11-20. doi:10.1016/j.jmpt.2016.10.008
13. Baker RT, Nasypany A, Seegmiller JG, et al. Instrumentassisted softtissue mobilization treatment for tissue extensibility dysfunction. Int JAthl Ther Training. 2013;18(5):16-21. doi:10.1123/ijatt.18.5.16
14. Ballantyne F, Fryer G, McLaunghlin P. The effect of muscle energytechnique on hamstring extensibility: the mechanism of alteredflexibility. J Osteopathic Med. 2003; 6 (2), 59-63.
15. Chila A, Foundation of Osteopathic Medicine. Medicine; 2010: 682-695.
16. Chaitlow L, Liebenson C (Ed) In: Muscle Energy Technicques. 2001:2nd Edition, Donald R Murphy, London. 95-106.
17. Simons DG, Travell JG, Simons LS. Myofascial pain anddysfunction:the trigger point manual. 2nd ed. Baltimore: Williams &amp;Wilkins;1999.
18. Ulusoy M, Şahin N, Erkmen H. Turkish version of Beck Anxietyinventory: Psychometric properties. Int J Cogn Ther. 1998;12(2):163-72.
19. Chiarotto A, Clijsen R, Fernandez-de-Las-Penas C, Barbero M.Prevalence of Myofascial Trigger Points in Spinal Disorders: ASystematic Review and Meta-Analysis. Arch Phys Med Rehabil.2016;97(2):316-337. doi:10.1016/j.apmr.2015.09.021
20. G&uuml;l K, Onal SA. Miyofasiyal ağri sendromlu hastalarin tedavisindenon-invazif ve invazif tekniklerin karşilaştirilmasi [Comparison ofnon-invasive and invasive techniques in the treatment of patients withmyofascial pain syndrome]. Agri. 2009;21(3):104-112.
21. Mata Diz JB, de Souza JR, Leopoldino AA, Oliveira VC. Exercise,especially combined stretching and strengthening exercise, reducesmyofascial pain: a systematic review. J Physiother. 2017;63(1):17-22.doi:10.1016/j.jphys.2016.11.008
22. Hou CR, Tsai LC, Cheng KF, Chung KC, Hong CZ. Immediate effectsof various physical therapeutic modalities on cervical myofascial painand trigger-point sensitivity. Arch Phys Med Rehabil. 2002;83(10):1406-1414. doi:10.1053/apmr.2002.34834
23. Galasso A, Urits I, An D, et al. A Comprehensive Review of theTreatment and Management of Myofascial Pain Syndrome. Curr PainHeadache Rep. 2020;24(8):43. doi:10.1007/s11916-020-00877-5
24. Urits I, Charipova K, Gress K, et al. Treatment and managementof myofascial pain syndrome. Best Pract Res Clin Anaesthesiol.2020;34(3):427-448. doi:10.1016/j.bpa.2020.08.003
25. Ay S, Konak HE, Evcik D, Kibar S. The effectiveness of Kinesio Tapingon pain and disability in cervical myofascial pain syndrome. Rev BrasReumatol Engl Ed. 2017;57(2):93-99. doi:10.1016/j.rbre.2016.03.012
26. Navarro-Santana MJ, Sanchez-Infante J, Fern&aacute;ndez-de-Las-Pe&ntilde;as C,Cleland JA, Mart&iacute;n-Casas P, Plaza-Manzano G. Effectiveness of DryNeedling for Myofascial Trigger Points Associated with Neck PainSymptoms: An Updated Systematic Review and Meta-Analysis. J ClinMed. 2020;9(10):3300. Published 2020 Oct 14. doi:10.3390/jcm9103300
27. Lew J, Kim J, Nair P. Comparison of dry needling and trigger pointmanual therapy in patients with neck and upper back myofascial painsyndrome: a systematic review and meta-analysis. J Man Manip Ther.2021;29(3):136-146. doi:10.1080/10669817.2020.1822618
28. Sbardella S, La Russa C, Bernetti A, et al. Muscle Energy Techniquein the Rehabilitative Treatment for Acute and Chronic Non-SpecificNeck Pain: A Systematic Review. Healthcare (Basel). 2021;9(6):746.Published 2021 Jun 17. doi:10.3390/healthcare9060746
29. Kashyap R, Iqbal A, Alghadir AH. Controlled intervention to comparethe efficacies of manual pressure release and the muscle energytechnique for treating mechanical neck pain due to upper trapeziustrigger points. J Pain Res. 2018;11:3151-3160. doi:10.2147/JPR.S172711
30. Basak T, Pal TK, Sasi MM, Agarwal S. A Comparative study on theefficacy of ischaemic compression and dry needling with muscleenergy technique in patients with upper trapezius myofascial triggerpoints. Int J Health Sci Res. 2018;8:74-81.
31. Shah NA, Shah N. Comparison of two treatment techniques: Muscleenergy technique and Ischemic compression on upper trapezius triggerpoint in subjects with non- specific neck pain. Int J Ther Rehabil.2015;4:260-264. doi: 10.5455/ijtrr.000000100.
32. Aggarwal A, Saxena K, Palekar TJ, Rathi M. Instrument assisted softtissue mobilization in adhesive capsulitis: A randomized clinical trial.J Bodyw Mov Ther. 2021;26:435-442. doi:10.1016/j.jbmt.2020.12.039
33. Lee J, Young A, Erb NJ, Herzog VW. Acute and Residual Effects ofIASTM and Roller Massage Stick on Hamstring Range of Motion. JAllied Health. 2020;49(1):e51-e55.
34. Ahmadpour Emshi Z, Okhovatian F, Mohammadi Kojidi M,Akbarzadeh Baghban A, Azimi H. Comparison of the effects ofinstrument assisted soft tissue mobilization and dry needling on activemyofascial trigger points of upper trapezius muscle. Med J Islam RepubIran. 2021;35:59. Published 2021 May 8. doi:10.47176/mjiri.35.59
35. Turo D, Otto P, Hossain M, et al. Novel Use of Ultrasound Elastographyto Quantify Muscle Tissue Changes After Dry Needling of MyofascialTrigger Points in Patients With Chronic Myofascial Pain. J UltrasoundMed. 2015;34(12):2149-2161. doi:10.7863/ultra.14.08033
36. Hakimeh A, Azadeh S, Ebrahimi E, Asghar R, Naderi F. B mode,Doppler and ultrasound elastography imaging on active triggerpoint in women with myofascial pain syndrome treated by dryneedling. Muscle Ligaments and Tendons J. 2019;09:417. Doi:10.32098/mltj.03.2019.16.
37. Coupp&eacute; C, Midttun A, Hilden J, Jorgensen U, Oxholm P, Fuglsang-Frederiksen A. Spontaneous needle electromyographic activity inmyofascial trigger points in the infraspinatus muscle: a blindedassessment. J Musculoskeletal Pain. 2001;9:7-16. doi: 10.1300/J094v09n03_02.
Volume 1, Issue 2, 2023
Page : 21-25