This study aimed to compare the effects of dry needling (DN) versus placebo DN applied to the peroneus longus (PL) and tibialis anterior (TA) on neuromuscular control and static postural control in basketball players with chronic ankle instability (CAI). A single-blinded randomized controlled trial was conducted. Thirty-two male and female basketball players with CAI were randomly assigned to receive either DN (n = 16) or placebo DN (n = 16). Pre-activation amplitudes of PL and TA were assessed with surface electromyography (EMG) during a dynamic landing test. Center of pressure (CoP) displacement and sway variability in anterior-posterior (AP) and medio-lateral (ML) directions were measured with a force platform during a single leg balance test (SLBT). Measures were obtained prior to a single DN intervention, immediately after, at 48 h, and 1 month after. The DN group displayed a significant increase in PL and TA pre-activation values, which were maintained 1 month later. Significant reductions in the ML and AP displacements and sway variability of CoP were found for the DN group. These results showed improvements in feedback/feed-forward strategies following DN, including enhanced neuromuscular control and static postural control, with the potential to become a convenient and accessible preventive treatment in CAI subjects.

Background: Dry needling (DN) is often used for the treatment of muscle pain among physiotherapists. However, little is known about the mechanisms of action by which its effects are generated. The aim of this randomized controlled trial was to determine if the use of DN in healthy subjects activates the sympathetic nervous system, thus resulting in a decrease in pain caused by stress. Methods: Sixty-five healthy volunteer subjects were recruited from the University of Alcala, Madrid, Spain, with an age of 27.78 (SD = 8.41) years. The participants were randomly assigned to participate in a group with deep DN in the adductor pollicis muscle or a placebo needling group. The autonomic nervous system was evaluated, in addition to local and remote mechanical hyperalgesia. Results: In a comparison of the moment at which the needling intervention was carried out with the baseline, the heart rate of the dry needling group significantly increased by 20.60% (SE = 2.88), whereas that of the placebo group increased by 5.33% (SE = 2.32) (p = 0.001, d = 1.02). The pressure pain threshold showed significant differences between both groups, being significantly higher in the needling group (adductor muscle p = 0.001; d = 0.85; anterior tibialis muscle p = 0.022, d = 0.58). Conclusions: This work appears to indicate that dry needling produces an immediate activation in the sympathetic nervous system, improving local and distant mechanical hyperalgesia.

The Scapula Reposition Test (SRT) is proposed to determine if a relationship exists between scapular dyskinesis and shoulder pathology. The purpose of this study was to evaluate intra-rater and inter-rater reliability of the SRT in subjects with rotator cuff tendinopathy and scapular dyskinesis. In addition, we compared subjective strength findings from the test to an objective measure made by dynamometry. The SRT was independently and randomly performed by two physical therapists in 42 subjects. The percent agreement, Cohen’s kappa (κ), maximum attainable κ, prevalence and bias indexes, and prevalence-adjusted-bias-adjusted kappa were used as intra- and inter-rater reliability estimates. Finally, the point-biserial correlation coefficient (r_pb) was used for correlation analysis of objective and subjective strength findings. A moderate intra-rater (κ = 0.43; CI 95%, 0.14 to 0.73; p = 0.004) and poor inter-rater (κ = 0.08; CI 95%, −0.22 to 0.38; p = 0.61) agreement was found. Subjective strength changes during SRT and dynamometry were poorly correlated (r_pb = 0.137; CI 95%, −0.175 to 0.423; p = 0.389). The SRT cannot be recommended for clinical practice. More studies evaluating its reliability are needed as well as further research on the capability of a rater to manually detect strength changes.