Journal of Rehabilitation Sciences & Research

The effect of dry needling of trigger points in forearm’s extensor muscles on the grip force, pain and function of athletes with chronic tennis elbow

Zahra Etminan; Mohsen Razeghi; Farahnaz Ghafarinejad

Volume 6, Issue 1 , March 2019, , Pages 27-33

Abstract

Background: Tennis elbow syndrome (TES) is mainly known by having pain in the external side of the elbow. Physiotherapy plays an effective role in the treatment of this syndrome. Dry ... Read More Background: Tennis elbow syndrome (TES) is mainly known by having pain in the external side of the elbow. Physiotherapy plays an effective role in the treatment of this syndrome. Dry needling is a less invasive, novel, and inexpensive method that shows its therapeutic effects in a shorter time in comparison with the other physiotherapy methods. Effect on tough bands, circulation, and environmental and central neurophysiological effects are some mechanisms by which dry needling poses its effects. The aim of this study was to study the effect of adding dry needling to routine physiotherapy methods in order to improve grip strength and function and reduce pain, as well as to decrease costs and treatment duration for treating tennis elbow syndrome. Methods: Forty four athletes aged 18 to 40 years old who had exercise or match for at least 3 sessions per week (for a sum of 6 hours per week), and were detected to have tennis elbow syndrome lasting more than 3 months were recognized and classified into two groups. The first group received physiotherapy including ultrasound, deep friction massage, and muscle stretching and strengthening exercises. The second group received dry needling in addition to physiotherapy treatment. Therapeutic duration was 3 weeks in each group and 3 sessions in each week. The patient rate elbow evaluation questionnaire (PREE) was completed at the beginning of treatment and the beginning of the second and third weeks, as well as at the end of the third week; grip strength was measured at the mentioned times as well. One week after the end of the therapeutic period, patients were re-evaluated for the reliability rate of the treatment outcomes. For analysis of data obtained for the study, repeated measure test, Mixed ANOVA, and Paired T-test statistical tests were used. Results: Results showed that all evaluated variables (including pain, function, and grip strength) were improved in the patients of both groups after completion of the therapeutic period (P<0.0001). Comparison of the two groups showed a significant difference in the pain variable at the seventh session with P<0.0001, the ninth session with P=0.006, and one week after the end of treatment with P<0.001, and the performance variable at seventh sessions with P<0.0001, ninth sessions with P=0.006, and one week after the end of treatment with P<0.0001, respectively. The pain reduction and function increase rates were higher in the group that received dry needling in addition to physiotherapy in comparison with the group that received physiotherapy after the seventh session. Regarding grip strength variable, the mean of groups was different, though the effect of these two methods in the enhancement of grip strength was not statistically significant (P=0.09). Moreover, regarding the results obtained for the group that received physiotherapy in addition to dry needling, the pain variable reduced in a shorter time in comparison with the other group. Conclusion: With regard to the results mentioned above, both therapeutic methods resulted in an improvement in the studied variables in a comparison that was performed before and after treatment. Moreover, in comparison with the single physiotherapy, using dry needling in addition to physiotherapy had a more powerful effect in improving the studied variables. Therefore, it could be said that using dry needling in addition to other therapeutic methods results in the facilitation of treatment process in the patients, and can reduce their therapeutic costs.

The Effect of Dry Needling of the Trigger Points of Shoulder Muscles on Pain and Grip Strength in Patients with Lateral Epicondylitis: A Pilot Study

Alireza Kheradmandi; Maryam Ebrahimian; Farahnaz Ghafarinejad; Venous Ehyaii; Mohammadreza Farazdaghi

Volume 2, Issue 3 , September 2015, , Pages 58-62

Abstract

Background: Lateral epicondylitis, also known as tennis elbow, is the most common overuse syndrome of the elbow. The severity of pain may not be directly caused by tendinopathy of wrist ... Read More Background: Lateral epicondylitis, also known as tennis elbow, is the most common overuse syndrome of the elbow. The severity of pain may not be directly caused by tendinopathy of wrist extensors since trigger points of the shoulder muscles have a referral zone in the arm and elbow. Therefore the aim of this study was to evaluate the effect of dry needling of shoulder myofascial trigger points on wrist extensors muscles pain and function.Methods: Fourteen female patients with tennis elbow (aged 20 - 45 years old) were recruited after primary evaluation by an orthopedist. They entered the study if they had pain in the lateral aspect of elbow of the dominant hand for more than 3 months along with the presence of myofascial trigger points in any muscles of supra spinatus, infra spinatus, sub scapularis or scalenes. Pain pressure threshold, maximal grip force and pain intensity of the hand extensors on lateral epicondyle of elbow were measured before and after treatment. Pain intensity was measured on a one to ten scale of visual analogue scale (VAS). A hand dynamometer used to measure the maximal grip force value of the affected hand in 0˚shoulder flexion/abduction, 90˚ elbow extension and mid-poison of forearm in sitting position .A pressure algometer was applied on hand extensor muscles to define their trigger point sensitivity. For the control group, treatment regimens consisted of routine physical therapy of tennis elbow. This regime was accompanied by dry needling of mentioned muscles for the intervention group. Wilcoxon and Mann-Whitney non-parametric tests were used for statistical analysis.Results: Comparison of the results after intervention showed that the patients’ pain significantly decreased in both groups (P <0.001); but the patient’s PPT and grip force significantly increased solely in the intervention group (P <0.05). Mann Whitney test showed significant pain differences in both groups (P = 0.001).The comparison of differences showed that the grip force and PPT statistically improved in the intervention group (P <0.05).Conclusion: Dry needling of affected shoulder muscles along with routine physical therapy has a more significant effect on improvement of pain, sensitivity and grip power of patient’s with tennis elbow syndrome.

Evaluation of Ankle Joint Proprioception and Balance in Patients with Type 2 Diabetes and Healthy Subjects

Farzaneh Moslemi Haghighi; Farahnaz Ghafarinejad; Ladan Hemmati; Zahra Saadat; Zeinab Oorangi; Somayeh Torabi; Mohammad amin Mohammadzadeh

Volume 2, Issue 1 , March 2015, , Pages 17-19

Abstract

Background: Joint proprioception plays an important role in limb movement and awareness of position sense. Diabetes has a lot of complications such as lossof sensoryfunction, which ... Read More

Effects of Massage in Prone Position on Blood Pressure and Heart Rate in Healthy Women

Narges Meftahi; Soha Bervis; Shohreh Taghizadeh; Farahnaz Ghafarinejad

Volume 1, Issue 2 , June 2014, , Pages 40-43

Abstract

Background: At the present time, massage has become a popular therapy employed in complementary medicine. There is evidence showing that back massage might have many positive psychological ... Read More

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Author = Ghafarinejad, Farahnaz

The effect of dry needling of trigger points in forearm’s extensor muscles on the grip force, pain and function of athletes with chronic tennis elbow

Abstract

The Effect of Dry Needling of the Trigger Points of Shoulder Muscles on Pain and Grip Strength in Patients with Lateral Epicondylitis: A Pilot Study

Abstract

Evaluation of Ankle Joint Proprioception and Balance in Patients with Type 2 Diabetes and Healthy Subjects

Abstract

Effects of Massage in Prone Position on Blood Pressure and Heart Rate in Healthy Women

Abstract