Investigating the Effects of Dry Needling on Hamstring Muscles Flexibility: A Randomized Controlled Tria
Abstract
Introduction: Flexibility or the ability of a muscle to increase in length is an integral part of musculoskeletal characteristics and is essential in preventing musculoskeletal injuries and increasing functional levels. Hamstring muscles rupture is a common injury. One of the important factors in the occurrence of this injury is poor hamstring muscle flexibility, which because of its stiffened structure, has less ability to quickly increase in length. Some researchers have recently suggested that the dry needling technique could reduce the number of treatment sessions for hamstring muscle tightness and bring faster and more effective results. Accordingly, this study aims to investigate the effect of the application of dry needling through an acupuncture technique on hamstring muscle flexibility.
Materials and Methods: The present study is a single-blinded randomized controlled trial in which 16 individuals with bilateral hamstring muscle shortness were randomly allocated into dry-needling and sham-needling groups. The sampling method was non-probability convenience. The outcome measures were the right and left active knee extension range of motion, assessed before and after the first, third, and fifth sessions of intervention. A 2-factor mixed analysis of variance was applied to determine the differences between and within the two groups.
Results: Except for the group main effect, time main effect and interaction effect were statistically significant for the right and left active knee extension range of motion (P<0.001). There were differences in behavioral patterns in groups; accordingly, in the real dry-needling group, a significant difference was detected across times. However, in the sham dry-needling group, no significant difference was observed.
Conclusion: The application of dry needling into motor points of hamstring muscles in individuals with bilateral hamstring muscles shortness could improve flexibility and increase the range of knee extension after 3 and 5 sessions of intervention because of the therapeutic effects of the dry needling technique in improving the muscle flexibility.
2. Clark RA. Hamstring injuries: risk assessment and injury prevention. Annals Academy of Medicine Singapore. 2008;37(4):341.
3. Henderson G, Barnes CA, Portas MD. Factors associated with increased propensity for hamstring injury in English Premier League soccer players. Journal of Science and Medicine in Sport. 2010;13(4):397-402.
4. Reis FJJ, Macedo AR. Influence of hamstring tightness in pelvic, lumbar and trunk range of motion in low back pain and asymptomatic volunteers during forward bending. Asian spine journal. 2015;9(4):535.
5. Decoster LC, Cleland J, Altieri C, Russell P. The effects of hamstring stretching on range of motion: a systematic literature review. Journal of Orthopaedic & Sports Physical Therapy. 2005;35(6):377-87.
6. Dommerholt J. Dry needling in orthopedic physical therapy practice. Orthop Phys Ther Pract. 2004;16(3):15-20.
7. Simons DG. Understanding effective treatments of myofascial trigger points. Journal of Bodywork and movement therapies. 2002;6(2):81-8.
8. Ma Y-t. Biomedical Acupuncture for Sports and Trauma Rehabilitation E-Book: Dry Needling Techniques: Elsevier Health Sciences; 2010.
9. Cagnie B, Barbe T, De Ridder E, Van Oosterwijck J, Cools A, Danneels L. The influence of dry needling of the trapezius muscle on muscle blood flow and oxygenation. Journal of manipulative and physiological therapeutics. 2012;35(9):685-91.
10. Cagnie B, Dewitte V, Barbe T, Timmermans F, Delrue N, Meeus M. Physiologic effects of dry needling. Current pain and headache reports. 2013;17(8):348.
11. Jafri MS. Mechanisms of myofascial pain. International scholarly research notices. 2014;2014.
12. Pelham TW, Holt LE, Stalker R. Acupuncture in human performance. The Journal of Strength & Conditioning Research. 2001;15(2):266-71.
13. AAlaei P. Dry Needling for Hamstring Flexibility: A Single-Blind Randomized Controlled Trial. Journal of sport rehabilitation. 2020;30(3):452-7.
14. Mead AC, McGlynn ML, Slivka DR. Acute Effects of Functional Dry Needling on Skeletal Muscle Function. Journal of Bodywork and Movement Therapies. 2020.
15. Sadat, A., Otadi, K., Fakhari, Z., Nakhostin, A. N., Bagheri, H., & Ghorbanpour, A. (2020). The effects of dry needling on flexibility & electrophysiological indices in healthy men with hamstring tightness: double-blind, randomized, placebo-controlled trial.
16. Sim H, Shin B-C, Lee MS, Jung A, Lee H, Ernst E. Acupuncture for carpal tunnel syndrome: a systematic review of randomized controlled trials. The Journal of Pain. 2011;12(3):307-14.
17. Zhen H, Dongyu L, Chengwei L, editors. Implementation of reinforcement and reduction of traditional acupuncture and moxibustion. 2008 International Conference on BioMedical Engineering and Informatics; 2008: IEEE.
18. Fernández-Carnero J, La Touche R, Ortega-Santiago R, Galan-del-Rio F, Pesquera J, Ge H-Y, et al. Short-term effects of dry needling of active myofascial trigger points in the masseter muscle in patients with temporomandibular disorders. Journal of orofacial pain. 2010;24(1):106.
19. Lucas KR, Rich PA, Polus BI. Muscle activation patterns in the scapular positioning muscles during loaded scapular plane elevation: the effects of latent myofascial trigger points. Clinical Biomechanics. 2010;25(8):765-70.
20. Lucas KR, Polus BI, Rich PA. Latent myofascial trigger points: their effects on muscle activation and movement efficiency. Journal of bodywork and movement therapies. 2004;8(3):160-6.
21. Aronson PA. Medial collateral ligament stiffness in males and females: University of Virginia; 2005.
22. Yıldırım MŞ, Tuna F, Kabayel DD, Süt N. The cut-off values for the diagnosis of hamstring shortness and related factors. Balkan medical journal. 2018;35(5):388.
23. Azmi M, Junidah R, Mariam AS, Safiah M, Fatimah S, Norimah A, et al. Body Mass Index (BMI) of Adults: Findings of the Malaysian Adult Nutrition Survey (MANS). Malaysian Journal of Nutrition. 2009;15(2).
24. Seidenberg PH, Beutler AI. The sports medicine resource manual: Elsevier; 2008.
25. Shrader JA, Popovich Jr JM, Gracey GC, Danoff JV. Navicular drop measurement in people with rheumatoid arthritis: interrater and intrarater reliability. Physical therapy. 2005;85(7):656-64.
26. Kuilart KE, Woollam M, Barling E, Lucas N. The active knee extension test and Slump test in subjects with perceived hamstring tightness. International journal of osteopathic medicine. 2005;8(3):89-97.
27. Gajdosik R, Lusin G. Hamstring muscle tightness: reliability of an active-knee-extension test. Physical therapy. 1983;63(7):1085-8.
28. Lee Y-S, Jung W-M, Lee I-S, Lee H, Park H-J, Chae Y. Visualizing Motion Patterns in Acupuncture Manipulation: MyJoVE Corporation; 2016.
29. Solomons L, Lee JJ, Bruce M, White LD, Scott A. Intramuscular stimulation vs sham needling for the treatment of chronic midportion Achilles tendinopathy: A randomized controlled clinical trial. PloS one. 2020;15(9):e0238579.
30. Geist K, Bradley C, Hofman A, Koester R, Roche F, Shields A, et al. Clinical effects of dry needling among asymptomatic individuals with hamstring tightness: a randomized controlled trial. Journal of sport rehabilitation. 2017;26(6):507-17.
31. Anandkumar S, Manivasagam M. Effect of fascia dry needling on non-specific thoracic pain–A proposed dry needling grading system. Physiotherapy theory and practice. 2017;33(5):420-8.
32. Langevin HM. Acupuncture, connective tissue, and peripheral sensory modulation. Critical Reviews™ in Eukaryotic Gene Expression. 2014;24(3).
33. Weppler CH, Magnusson SP. Increasing muscle extensibility: a matter of increasing length or modifying sensation? Physical therapy. 2010;90(3):438-49.
34. Langevin HM, Churchill DL, Cipolla MJ. Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture. The FASEB journal. 2001;15(12):2275-82.
35. Langevin HM, Churchill DL, Wu J, Badger GJ, Yandow JA, Fox JR, et al. Evidence of connective tissue involvement in acupuncture. The FASEB journal. 2002;16(8):872-4.
Files | ||
Issue | Vol 17 No 4 (2023) | |
Section | Research Article(s) | |
DOI | https://doi.org/10.18502/jmr.v17i4.13888 | |
Keywords | ||
Dry needling Hamstring muscles tightness Flexibility Range of motion Knee joint |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |