https://orcid.org/0000-0002-6873-3310
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ABSTRACT
Objectives: The purpose of this study was to compare the effects of deep dry needling (DN) with and without needle manipulation on pressure pain thresholds (PPTs) and electromyographic (EMG) amplitude of the lumbosacral multifidus (LM) in adults with low back pain (LBP).
Methods: Participants were randomized into two treatment groups: with needle manipulation (n = 21) and without needle manipulation (n = 21). All participants received a single session of the assigned DN intervention. PPTs and EMG amplitude of the LM muscle were collected three times: before DN, immediately after DN, and one week after DN.
Results: The needle manipulation group had a significantly greater increase in PPT immediately after the intervention and at the one-week follow-up as compared to the no needle manipulation group. The increase of PPT in the needle manipulation group was significant immediately after the intervention, and the increase remained significant at the one-week follow-up. However, there was no significant difference in EMG amplitude of the LM muscle between groups across the three time points.
Discussion: Deep DN with needle manipulation appeared to reduce mechanical pressure sensitivity more than DN without manipulation for patients with LBP. Although a single session of DN could reduce pressure pain sensitivity, it may not be sufficient to improve LM muscle function. Level of Evidence: 1b. Trial registration numbers: NCT03970486.
Acknowledgments
The authors would like to acknowledge Paige Allen and Stefan Lloyd for their assistance in data collection.
Data Sharing
The data that support the findings of this study are available on request from the corresponding author, SWP. The data is not publicly available due to their containing information that could compromise the privacy of research participants.
Disclosure statement
No potential conflict of interest was reported by the authors.
SUPPLEMENTAL DATA
Supplemental data for this article can be accessed here.
Additional information
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Notes on contributors
Sharon Wang-Price
Sharon Wang-Price, PT, PhD is a Professor in the School of Physical Therapy at Texas Woman’s University in Dallas, Texas. Dr. Wang-Price graduated from National Taiwan University in 1987 with a Bachelor of Science degree in Physical Therapy. She received her Master of Science degree in Sports Physical Therapy from University of Pittsburgh in 1991 and her Doctor of Philosophy degree in Physical Therapy from Texas Woman’s University – Houston in 1999. She became board certified in orthopedics through the American Board of Physical Therapy Specialties in 1999 and became a fellow of the American Academy of Orthopaedic Manual Physical Therapists in 2009 after she completed her fellowship in manual therapy from the North American Institute of Orthopaedic Manual Therapy. She maintains her clinical practice with Baylor Scott & White Institute for Rehabilitation.
Jason Zafereo
Jason Zafereo, PT, PhD is an Associate Professor in the Department of Physical Therapy at the University of Texas (UT) Southwestern Medical Center in Dallas, Texas, and also is a faculty member in the UT Southwestern Orthopedic Physical Therapy Residency program. Dr. Zafereo graduated from Baylor University in 1999 with a Bachelor of Arts degree in Biology. He received his Master of Physical Therapy degree from UT Southwestern in 2001, and his Doctor of Philosophy degree in Physical Therapy from Texas Woman’s University – Dallas in 2015. Dr. Zafereo became board certified in orthopedics through the American Board of Physical Therapy Specialties in 2007 and became a fellow of the American Academy of Orthopaedic Manual Physical Therapists in 2007 after he completed his fellowship in manual therapy from the Manual Therapy Institute. He maintains a clinical practice in an interdisciplinary pain program at the Eugene McDermott Center for Pain Management at UT Southwestern Medical Center.
Zach Couch
Zach Couch, PT, MPT is a clinical director for Texas Physical Therapy Specialist - Dallas and an adjunct faculty in the School of Physical Therapy at the Texas Woman’s University in Dallas, Texas. Mr. Couch received his Bachelor of Science degree in Physical Therapy and his Master of Physical Therapy degree in 2002 from the University of Evansville. Mr. Couch became board certified in orthopedics through the American Board of Physical Therapy Specialties in 2007 and became a fellow of the American Academy of Orthopaedic Manual Physical Therapists in 2011 after he completed his fellowship in manual therapy from the North American Institute of Orthopaedic Manual Therapy.
Kelli Brizzolara
Kelli Brizzolara, PT, PhD PT, PhD is an Assistant Professor in the School of Physical Therapy at the Texas Woman’s University in Dallas, Texas. Dr. Brizzolara graduated from Texas A&M University in 2001 with a Bachelor of Science degree in Exercise Technology. She received her Master of Science degree in Physical Therapy from Texas Woman’s University - Houston in 2003, and her Doctor of Philosophy degree in Physical Therapy from Texas Woman’s University – Dallas in 2013. She became board certified in orthopedics through the American Board of Physical Therapy Specialties in 2006. She maintains her clinical practice with Texas Health Resources.
Taylor Heins
Taylor Heins, BS is a physical therapy student in the School of Physical Therapy at Texas Woman’s University in Dallas, TX. Taylor graduated from Emporia State University in Emporia, Kansas with a Bachelor of Science degree in Health & Human Performance in 2017. Taylor will graduate from Texas Woman’s University - Dallas with a Doctor of Physical Therapy degree in 2020. After graduation, she plans to return to her hometown of Emporia, Kansas to begin her clinical practice.
Lindsey Smith
Lindsey Smith, BS is a physical therapy student in the School of Physical Therapy at Texas Woman’s University in Dallas, TX. Lindsey graduated from Cameron University, Oklahoma with a Bachelor of Science degree in Interdisciplinary Studies with a concentration in Biology and Sports and Exercise Science in 2017. Lindsey will graduate from Texas Woman’s University - Dallas with a Doctor of Physical Therapy degree in 2020. After graduation, Lindsey plans to move to Wichita Falls, Texas to begin her clinical practice.