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| Trigger point dry needling and proprioceptive exercises for the management of chronic ankle instability: a randomized clinical trial |
| Salom-Moreno J, Ayuso-Casado B, Tamaral-Costa B, Sanchez-Mila Z, Fernandez-de-las-Penas C, Alburquerque-Sendin F |
| Evidence-Based Complementary and Alternative Medicine 2015;(790209):Epub |
| clinical trial |
| 7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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OBJECTIVE: To compare the effects of combined trigger point dry needling (TrP-DN) and proprioceptive/strengthening exercises to proprioceptive/strengthening exercises on pain and function in ankle instability. METHODS: Twenty-seven (44% female, mean age 33 +/- 3 years) individuals with unilateral ankle instability were randomly assigned to an experimental group who received proprioceptive/strengthening exercises combined with TrP-DN into the lateral peroneus muscle and a comparison group receiving the same proprioceptive/strengthening exercise program alone. Outcome included function assessed with the Foot and Ankle Ability Measure (FAAM) and ankle pain intensity assessed with a numerical pain rate scale (NPRS). They were captured at baseline and 1-month follow-up after the intervention. RESULTS: The ANOVAs found significant group x time Interactions for both subscales of the FAAM (ADL F = 8.211; p = 0.008; SPORTS F = 13.943; p < 0.001) and for pain (F = 44.420; p < 0.001): patients receiving TrP-DN plus proprioceptive/strengthening exercises experienced greater improvements in function and pain than those receiving the exercise program alone. Between-groups effect sizes were large in all outcomes (SMD > 2.1) in favor of the TrP-DN group. CONCLUSIONS: This study provides evidence that the inclusion of TrP-DN within the lateral peroneus muscle into a proprioceptive/strengthening exercise program resulted in better outcomes in pain and function 1 month after the therapy in ankle instability.
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