Dry needling as an adjunct treatment to multimodal rehabilitation protocol following rotator cuff repair surgery: a preliminary, randomized sham-controlled trial
Abstract Background Rotator cuff repair (RCR) is one of the most prevalent procedures to manage rotator cuff tears (RCT). Postoperative shoulder pain is a common complication following RCR and may be aggravated by activation of myofascial trigger points (MTrP) associated with the injury to the soft...
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BMC
2024-12-01
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| Series: | Chiropractic & Manual Therapies |
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| Online Access: | https://doi.org/10.1186/s12998-024-00555-y |
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| author | Faeze Naseri Mehdi Dadgoo Mohammadreza Pourahmadi Morteza Nakhaei Amroodi Shirin Azizi Amirhossein Shamsi |
| author_facet | Faeze Naseri Mehdi Dadgoo Mohammadreza Pourahmadi Morteza Nakhaei Amroodi Shirin Azizi Amirhossein Shamsi |
| author_sort | Faeze Naseri |
| collection | DOAJ |
| description | Abstract Background Rotator cuff repair (RCR) is one of the most prevalent procedures to manage rotator cuff tears (RCT). Postoperative shoulder pain is a common complication following RCR and may be aggravated by activation of myofascial trigger points (MTrP) associated with the injury to the soft tissues surrounding the surgical incision. This study aimed to describe a preliminary, randomized, sham-controlled trial to evaluate the effectiveness of implementing 4 sessions of myofascial trigger point dry needling (MTrP-DN) as a muscle treatment approach along with 10 sessions of multimodal rehabilitation protocol (MRh) consisting of therapeutic exercise, manual therapy, and electrotherapy on postoperative shoulder pain, range of motion (ROM), strength, and functional outcome scores for patients following RCR surgery. Methods Forty-six patients aged 40–75 following RCR surgery were recruited and randomly allocated into 2 groups: (1) MTrP-DN plus MRh (experimental group), and (2) sham dry needling (S-DN) plus MRh (control group). This trial had a 4-week intervention period. The primary outcome was the Numeric Pain Rating Scale (NPRS) for postoperative shoulder pain. Secondary outcomes were the Shoulder Pain and Disability Index (SPADI), ROM, and strength. The mentioned outcomes were measured at baseline and week 4. In the current study, adverse events were recorded as well. Results No statistically significant differences were observed between groups when adding MTrP-DN to MRh for postoperative shoulder pain after 4 weeks of intervention (mean difference 0.32, [95% CI -0.41,1.05], p = 0.37). However, this trial found a small effect size for postoperative shoulder pain. No significant between-group differences were detected in any of the secondary outcomes (p > 0.05) either. We found significant within-group changes in all studied outcome measures. (p < 0.001). This study also reported minor adverse events. following the needling approach. Conclusion The lack of statistically significant differences in the outcomes and small clinical significance in shoulder pain highlights the complexity of pain management, suggesting that alternative methodologies may be needed for meaningful clinical benefits. Future studies should consider different control groups, long-term follow ups, larger sample sizes, and more MTrP-DN sessions to better understand their potential impact. Trial registration This trial was registered at ( https://www.irct.ir ), (IRCT20211005052677N1) on 19/02/2022. |
| format | Article |
| id | doaj-art-d9523271631e4f1dac576e5dc90c7fdb |
| institution | Kabale University |
| issn | 2045-709X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
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| series | Chiropractic & Manual Therapies |
| spelling | doaj-art-d9523271631e4f1dac576e5dc90c7fdb2024-12-08T12:38:10ZengBMCChiropractic & Manual Therapies2045-709X2024-12-0132111210.1186/s12998-024-00555-yDry needling as an adjunct treatment to multimodal rehabilitation protocol following rotator cuff repair surgery: a preliminary, randomized sham-controlled trialFaeze Naseri0Mehdi Dadgoo1Mohammadreza Pourahmadi2Morteza Nakhaei Amroodi3Shirin Azizi4Amirhossein Shamsi5Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical SciencesIranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical SciencesIranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical SciencesBone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical SciencesIranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical SciencesDepartment of Physiotherapy, School of Rehabilitation, Tehran University of Medical SciencesAbstract Background Rotator cuff repair (RCR) is one of the most prevalent procedures to manage rotator cuff tears (RCT). Postoperative shoulder pain is a common complication following RCR and may be aggravated by activation of myofascial trigger points (MTrP) associated with the injury to the soft tissues surrounding the surgical incision. This study aimed to describe a preliminary, randomized, sham-controlled trial to evaluate the effectiveness of implementing 4 sessions of myofascial trigger point dry needling (MTrP-DN) as a muscle treatment approach along with 10 sessions of multimodal rehabilitation protocol (MRh) consisting of therapeutic exercise, manual therapy, and electrotherapy on postoperative shoulder pain, range of motion (ROM), strength, and functional outcome scores for patients following RCR surgery. Methods Forty-six patients aged 40–75 following RCR surgery were recruited and randomly allocated into 2 groups: (1) MTrP-DN plus MRh (experimental group), and (2) sham dry needling (S-DN) plus MRh (control group). This trial had a 4-week intervention period. The primary outcome was the Numeric Pain Rating Scale (NPRS) for postoperative shoulder pain. Secondary outcomes were the Shoulder Pain and Disability Index (SPADI), ROM, and strength. The mentioned outcomes were measured at baseline and week 4. In the current study, adverse events were recorded as well. Results No statistically significant differences were observed between groups when adding MTrP-DN to MRh for postoperative shoulder pain after 4 weeks of intervention (mean difference 0.32, [95% CI -0.41,1.05], p = 0.37). However, this trial found a small effect size for postoperative shoulder pain. No significant between-group differences were detected in any of the secondary outcomes (p > 0.05) either. We found significant within-group changes in all studied outcome measures. (p < 0.001). This study also reported minor adverse events. following the needling approach. Conclusion The lack of statistically significant differences in the outcomes and small clinical significance in shoulder pain highlights the complexity of pain management, suggesting that alternative methodologies may be needed for meaningful clinical benefits. Future studies should consider different control groups, long-term follow ups, larger sample sizes, and more MTrP-DN sessions to better understand their potential impact. Trial registration This trial was registered at ( https://www.irct.ir ), (IRCT20211005052677N1) on 19/02/2022.https://doi.org/10.1186/s12998-024-00555-yDry needlingPostoperative shoulder PainTrigger pointRotator cuff tearRotator Cuff repairShoulder rehabilitation |
| spellingShingle | Faeze Naseri Mehdi Dadgoo Mohammadreza Pourahmadi Morteza Nakhaei Amroodi Shirin Azizi Amirhossein Shamsi Dry needling as an adjunct treatment to multimodal rehabilitation protocol following rotator cuff repair surgery: a preliminary, randomized sham-controlled trial Chiropractic & Manual Therapies Dry needling Postoperative shoulder Pain Trigger point Rotator cuff tear Rotator Cuff repair Shoulder rehabilitation |
| title | Dry needling as an adjunct treatment to multimodal rehabilitation protocol following rotator cuff repair surgery: a preliminary, randomized sham-controlled trial |
| title_full | Dry needling as an adjunct treatment to multimodal rehabilitation protocol following rotator cuff repair surgery: a preliminary, randomized sham-controlled trial |
| title_fullStr | Dry needling as an adjunct treatment to multimodal rehabilitation protocol following rotator cuff repair surgery: a preliminary, randomized sham-controlled trial |
| title_full_unstemmed | Dry needling as an adjunct treatment to multimodal rehabilitation protocol following rotator cuff repair surgery: a preliminary, randomized sham-controlled trial |
| title_short | Dry needling as an adjunct treatment to multimodal rehabilitation protocol following rotator cuff repair surgery: a preliminary, randomized sham-controlled trial |
| title_sort | dry needling as an adjunct treatment to multimodal rehabilitation protocol following rotator cuff repair surgery a preliminary randomized sham controlled trial |
| topic | Dry needling Postoperative shoulder Pain Trigger point Rotator cuff tear Rotator Cuff repair Shoulder rehabilitation |
| url | https://doi.org/10.1186/s12998-024-00555-y |
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