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Randomized Controlled Trial
. 2025 Apr 14;33(1):14.
doi: 10.1186/s12998-024-00567-8.

A comparative study of sonographic and clinical parameters in patient with upper trapezius muscle trigger point following dry needling and intramuscular electrical stimulation: a randomized control trial

Monavar Hadizadeh  1 , Abbas Rahimi  2 , Meysam Velayati  3 , Mohammad Javaherian  4 , Farokh Naderi  5 , Abbasali Keshtkar  6 , Jan Dommerholt  7   8   9
Affiliations
Randomized Controlled Trial

A comparative study of sonographic and clinical parameters in patient with upper trapezius muscle trigger point following dry needling and intramuscular electrical stimulation: a randomized control trial

Monavar Hadizadeh et al. Chiropr Man Therap. .

Abstract

Background: The most common cause of muscle pain is myofascial pain syndrome. Myofascial pain syndrome caused by sensitive areas called trigger points (TrP). Some physiotherapy modalities have acceptable effects for this disorder, but it is necessary to check the effects of placebo, appropriate dose, and long-term effects for each intervention. The aim of this study is to investigate the effect of intramuscular electrical stimulation (IMES) compared to dry needling (DN) on sonographic and clinical parameters in upper trapezius muscle TrP.

Methods: This is a randomized, single-blind control trial. The study period was from December 2, 2020, to April 10, 2021. Thirty volunteer patients with active upper trapezius TrP were randomly allocated into two groups: (1) IMES, (2) DN. Participants received interventions in three sessions. Primary outcome measurements were neck range of motion (ROM) and TrP circumference. Secondary outcome measurements were pain by visual analog scale (VAS), pain pressure threshold (PPT), disability, TrP longitudinal and transverse diameter, TrP stiffness, and muscle blood flow by vascular resistance index (RI). All outcome measurements were evaluated before, after, and one month after the intervention. If the data were normal, the repeated measure ANOVA test was used; if data were not normal, the Friedman test and the Kruskal-Wallis test was used. A significance level of 0.05 has considered.

Results: ROM increment was significantly more in the IMES group. TrP circumference decrement was significantly more in the IMES group. VAS changes did not show significant difference between two groups. The PPT improvement was significantly more in the IMES group. Disability changes were not significant. Longitudinal diameter changes were significantly more in the IMES group. TrP stiffness changes were not significant. The vascular RI decreased significantly in IMES group.

Conclusion: It seems that both IMES and DN have promising effects for improving upper trapezius TrPs. However, IMES is more effective in some clinical and ultrasound parameters. In order to investigate the effects of this intervention more precisely more studies are necessary.

Trial registration: This study was prospectively registered at Iranian registry of clinical trials (IRCT: IRCT20170616034567N2).

Keywords: Dry needling; Intramuscular electrical stimulation; Myofascial pain; Trigger point; Ultrasound imaging; Upper trapezius.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study design was approved by the Shahid Beheshti University of Medical science Ethics Committee (IR.SBMU.RETECH.REC.1399.480, dated: August 9, 2020). Consent for publication: Subjects signed a written informed consent for publication and use their blind picture. Competing interests: The authors declare that they have no competing interests. Suppliers: Digital algometer. (FG-8020 -Taiwan). Dry needle (Dong Bang 30*50). Electrical stimulation (ES-160. by ITO (Japan)). Goniometer Sonography device. (Aixplorer Supersonic Imagine, France, 2017).

Figures

Fig. 1
Fig. 1
IMES intervention procedure
Fig. 2
Fig. 2
DN intervention procedure
Fig. 3
Fig. 3
(a) participants position during sonography; (b) TrP CIR in UT muscle gray scale image
Fig. 4
Fig. 4
TrP stiffness in UT muscle gray scale image
Fig. 5
Fig. 5
RI measurement in the TrP vicinity
Fig. 6
Fig. 6
CONSORT flow diagram
Fig. 7
Fig. 7
Neck lateral flexion ROM changes in both group
Fig. 8
Fig. 8
TrP CIR changes in both group
See this image and copyright information in PMC

References

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