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Effectiveness of Dry Needling Therapy on Pain, Hip Muscle Strength, and Physical Function in Patients With Hip Osteoarthritis: A Randomized Controlled Trial

Published:February 07, 2021DOI:https://doi.org/10.1016/j.apmr.2021.01.077

      Abstract

      Objective

      To investigate the short-term effects of dry needling (DN) on physical function, pain, and hip muscle strength in patients with hip osteoarthritis (OA).

      Design

      A double-blind, placebo-control, randomized controlled trial.

      Setting

      Private practice physiotherapy clinic.

      Participants

      Patients with unilateral hip OA (N=45) were randomly allocated to a DN group, sham DN group, or control group.

      Interventions

      Patients in the DN and sham groups received 3 treatment sessions. Three active myofascial trigger points (MTrPs) were treated in each session with DN or a sham needle procedure. The treatment was applied in active MTrPs of the iliopsoas, rectus femoris, tensor fasciae latae, and gluteus minimus muscles.

      Main Outcome Measures

      Physical function was assessed with the Western Ontario and McMaster Universities (WOMAC) physical function subscale, the timed Up and Go test, and the 40-meter self-paced walk test. Intensity of hip pain related to physical function was evaluated using the visual analog scale and WOMAC pain subscale. The maximal isometric force of hip muscles was recorded with a handheld dynamometer.

      Results

      Significant group by time interactions were shown for physical function, pain, and hip muscle force variables. Post hoc tests revealed a significant reduction in hip pain and significant improvements in physical function and hip muscle strength in the DN group compared with the sham and control groups. The DN group showed within- and between-groups large effect sizes (d>0.8).

      Conclusions

      DN therapy in active MTrPs of the hip muscles reduced pain and improved hip muscle strength and physical function in patients with hip OA. DN in active MTrPs of the hip muscles should be considered for the management of hip OA.

      Keywords

      List of abbreviations:

      40-m SPW (40-meter self-paced walk), ADL (activities of daily living), ANOVA (analysis of variance), CI (confidence interval), DN (dry needling), ICC (intraclass correlation coefficient), MCID (minimal clinically important difference), MTrP (myofascial trigger point), OA (osteoarthritis), TUG (timed Up and Go), VAS (visual analog scale), WOMAC (Western Ontario and McMaster Universities), WOMAC-P (Western Ontario and McMaster Universities physical pain subscale), WOMAC-PF (Western Ontario and McMaster Universities physical function subscale)
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