The effect on handgrip strength of low-frequency percutaneous electric stimulation applied to the median and cubital nerves: A randomized, double-blind controlled trial.

Percutaneous electrical nerve stimulation (PENS) consists of applying an electric current of <1,000 Hz to different neuromuscular structures through acupuncture needles. Currently, there is controversy surrounding the effect of PENS on muscle strength in the scientific literature. The main objective was to assess the effect of PENS applied to the median and cubital nerves on the maximum handgrip strength (MHS) compared to sham stimulation, as well as to determine the safety of the intervention.

Challenges Affecting Access to Health and Social Care Resources and Time Management among Parents of Children with Rett Syndrome: A Qualitative Case Study.

Rare diseases face serious sustainability challenges regarding the distribution of resources geared at health and social needs. Our aim was to describe the barriers experienced by parents of children with Rett Syndrome for accessing care resources. A qualitative case study was conducted among 31 parents of children with Rett syndrome.

"Living an Obstacle Course": A Qualitative Study Examining the Experiences of Caregivers of Children with Rett Syndrome.

: Rett syndrome has considerable effects on the quality of life of affected children, impairing everyday activities and potentially impacting the life of both the caregivers and the family. Our aim was to explore the experiences of a group of caregivers of children with Rett syndrome with regards to living and caring for their children. : We conducted a qualitative case study to examine how 31 caregivers of children with Rett syndrome perceived living with their children.

Cost-Effectiveness Evaluation of Manual Physical Therapy Versus Surgery for Carpal Tunnel Syndrome: Evidence From a Randomized Clinical Trial.

Background: Carpal tunnel syndrome (CTS) results in substantial societal costs and can be treated either by nonsurgical or surgical approaches.

Objective: To evaluate differences in cost-effectiveness of manual physical therapy versus surgery in women with CTS.

Methods: In this randomized clinical trial, 120 women with a clinical and an electromyographic diagnosis of CTS were randomized through concealed allocation to either manual physical therapy or surgery.

Effects of dry needling on post-stroke spasticity, motor function and stability limits: a randomised clinical trial.

Objective: To determine the effects of inclusion of deep dry needling into a treatment session following the Bobath concept on spasticity, motor function and postural control after a stroke.

Methods: 26 patients who had suffered a stroke were randomly assigned to one of two treatment groups: Bobath only, or Bobath plus dry needling. Both groups received a session including strengthening, stretching and reconditioning exercises following the principles of the Bobath concept.

Ultrasound-Guided Application of Percutaneous Electrolysis as an Adjunct to Exercise and Manual Therapy for Subacromial Pain Syndrome: A Randomized Clinical Trial.

Unlabelled: This randomized clinical trial compared the effects of adding ultrasound (US)-guided percutaneouselectrolysis into a program consisting of manual therapy and exercise on pain, shoulder-related disability, function, and pressure sensitivity in subacromial pain syndrome. Fifty patients with subacromial pain syndrome were randomized into manual therapy and exercise or percutaneous electrolysis group. All patients received the same manual therapy and exercise program, 1 session per week for 5 consecutive weeks.

Effects of Low-Load Exercise on Postneedling-Induced Pain After Dry Needling of Active Trigger Point in Individuals With Subacromial Pain Syndrome.

Background: The application of dry needling usually is associated with postneedling-induced pain. A postneedling intervention to reduce this adverse event is needed.

Objective: To determine the effectiveness of low-load exercise on reducing postneedling-induced pain after dry needling of active trigger points (TrPs) in the infraspinatus muscle in subacromial pain syndrome.

Exercises and Dry Needling for Subacromial Pain Syndrome: A Randomized Parallel-Group Trial.

Unlabelled: This randomized clinical trial investigated the effectiveness of exercise versus exercise plus trigger point (TrP) dry needling (TrP-DN) in subacromial pain syndrome. A randomized parallel-group trial, with 1-year follow-up was conducted. Fifty subjects with subacromial pain syndrome were randomly allocated to receive exercise alone or exercise plus TrP-DN.

Muscle Trigger Points and Pressure Pain Sensitivity Maps of the Feet in Women with Fibromyalgia Syndrome.

OBJECTIVE : To investigate the presence of trigger points (TrPs) in feet musculature and topographical pressure sensitivity maps of the feet as well as the relationship between TrPs, pressure pain maps, and clinical variables in women with fibromyalgia (FMS). METHODS : Fifty-one FMS women and 24 comparable healthy women participated. TrPs within the flexor hallucis brevis, adductor hallucis, dorsal interossei, extensor digitorum brevis, and quadratus plantae, as well as external and internal gastrocnemius, were explored.

Effect of Dry Needling on Spasticity, Shoulder Range of Motion, and Pressure Pain Sensitivity in Patients With Stroke: A Crossover Study.

Objective: The purpose of this study was to determine the effects of the inclusion of deep dry needling (DDN) in spastic shoulder muscles into a rehabilitation program on spasticity, pressure pain sensitivity, and shoulder range of motion in subjects who had experienced a stroke.

Methods: A controlled, repeated-measures, crossover, double-blinded, randomized trial was conducted. Twenty patients who have had a stroke were randomly assigned to receive rehabilitation alone or rehabilitation combined with DDN over the upper trapezius, infraspinatus, subscapularis, and pectoralis mayor muscles on the spastic shoulder.

Prediction of Outcome in Women With Carpal Tunnel Syndrome Who Receive Manual Physical Therapy Interventions: A Validation Study.

Study Design Secondary analysis of a randomized trial. Background A clinical prediction rule to identify patients with carpal tunnel syndrome (CTS) most likely to respond to manual physical therapy has been published but requires further testing to determine its validity. Objective To assess the validity of a clinical prediction rule proposed for the management of patients with CTS in a different group of patients with a variety of treating clinicians.

Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial.

Objective. To compare effects of ultrasound- (US-) guided percutaneous electrolysis combined with an eccentric exercise program of the rotator cuff muscles in subacromial pain syndrome. Methods.

Direct and Indirect Effects of Function in Associated Variables Such as Depression and Severity on Pain Intensity in Women with Carpal Tunnel Syndrome.

Objective: To determine the direct and indirect effects of function on clinical variables such as age, pain intensity, years of the disease, severity of symptoms, and depression in women with electrodiagnostic and clinical diagnosis of carpal tunnel syndrome (CTS).

Design: A cross-sectional study.

Setting: Patients from an urban hospital referred to a university clinic.

Neuroscience education in addition to trigger point dry needling for the management of patients with mechanical chronic low back pain: A preliminary clinical trial.

The objective of the current study was to determine the short-term effects of trigger point dry needling (TrP-DN) alone or combined with neuroscience education on pain, disability, kinesiophobia and widespread pressure sensitivity in patients with mechanical low back pain (LBP). Twelve patients with LBP were randomly assigned to receive either TrP-DN (TrP-DN) or TrP-DN plus neuroscience education (TrP-DN + EDU). Pain intensity (Numerical Pain Rating Scale, 0-10), disability (Roland-Morris Disability Questionnaire-RMQ-, Oswestry Low Back Pain Disability Index-ODI), kinesiophobia (Tampa Scale of Kinesiophobia-TSK), and pressure pain thresholds (PPT) over the C5-C6 zygapophyseal joint, transverse process of L3 vertebra, second metacarpal, and tibialis anterior muscle were collected at baseline and 1-week after the intervention.

Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial.

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.

Pain is Associated to Clinical, Psychological, Physical, and Neurophysiological Variables in Women With Carpal Tunnel Syndrome.

Objectives: To investigate potential relationships of clinical (age, function, side of pain, years with pain), physical (cervical range of motion, pinch grip force), psychological (depression), and neurophysiological (pressure and thermal pain thresholds) outcomes and hand pain intensity in carpal tunnel syndrome (CTS).

Methods: Two hundred and forty-four (n=224) women with CTS were recruited. Demographic data, duration of the symptoms, function and severity of the disease, pain intensity, depression, cervical range of motion, pinch tip grip force, heat/cold pain thresholds (HPT/CPT), and pressure pain thresholds (PPT) were collected.

Inclusion of trigger point dry needling in a multimodal physical therapy program for postoperative shoulder pain: a randomized clinical trial.

Objective: The purpose of this study was to evaluate the effects of including 1 session of trigger point dry needling (TrP-DN) into a multimodal physiotherapy treatment on pain and function in postoperative shoulder pain.

Methods: Twenty patients (5 male; 15 female; age, 58 ± 12 years) with postoperative shoulder pain after either open reduction and internal fixation with Proximal Humeral Internal Locking System plate plate or rotator cuff tear repair were randomly divided into 2 groups: physiotherapy group (n = 10) who received best evidence physical therapy interventions and a physical therapy plus TrP-DN group (n = 10) who received the same intervention plus a single session of TrP-DN targeted at active TrPs. The Constant-Murley score was used to determine pain, activities of daily living, range of motion, and strength, which was captured at baseline and 1 week after by an assessor blinded to group assignment.

Has the prevalence of migraine changed over the last decade (2003-2012)? A Spanish population-based survey.

Introduction: Information on temporal trends can identify groups of people at risk for any particular condition; however information on temporal trends on migraine headache at population levels is scarce. Our aim was to estimate the time trends in the prevalence of migraine from 2003 to 2012 in Spain.

Methods: A population-based national study was conducted.

Changes in spasticity, widespread pressure pain sensitivity, and baropodometry after the application of dry needling in patients who have had a stroke: a randomized controlled trial.

Objective: The purpose of this study was to determine the effects of deep dry needling (DDN) on spasticity, pressure sensitivity, and plantar pressure in patients who have had stroke.

Methods: A randomized controlled trial was conducted. Thirty-four patients who previously had a stroke were randomly assigned either an experimental group that received a single session of DDN over the gastrocnemius and tibialis anterior muscles on the spastic leg or a control group that received no intervention.

Activation in the hypothalamic-pituitary-adrenocortical axis and sympathetic nervous system in women with carpal tunnel syndrome.

Objective: The aim of this study is to investigate the differences in salivary cortisol (hypothalamic-pituitary-adrenocortical [HPA] axis), α-amylase activity (sympathetic nervous system [SNS]), and immunoglobulin A (IgA; immune system) concentrations between women with carpal tunnel syndrome (CTS) and healthy women.

Design: A cross-sectional study.

Setting: Activation of HPA, SNS, and immune system in CTS has not been clearly determined.

Immediate changes in neck pain intensity and widespread pressure pain sensitivity in patients with bilateral chronic mechanical neck pain: a randomized controlled trial of thoracic thrust manipulation vs non-thrust mobilization.

Objective: The purpose of this study was to compare the effects of thoracic thrust manipulation vs thoracic non-thrust mobilization in patients with bilateral chronic mechanical neck pain on pressure pain sensitivity and neck pain intensity.

Methods: Fifty-two patients (58% were female) were randomly assigned to a thoracic spine thrust manipulation group or of thoracic non-thrust mobilization group. Pressure pain thresholds (PPTs) over C5-C6 zygapophyseal joint, second metacarpal, and tibialis anterior muscle and neck pain intensity (11-point Numerical Pain Rate Scale) were collected at baseline and 10 minutes after the intervention by an assessor blinded to group allocation.

Trigger points and pressure pain hypersensitivity in people with postmeniscectomy pain.

Objectives: The objectives of this study are (1) to assess the presence of myofascial trigger points (TrPs) and widespread pressure hyperalgesia; and (2) to assess the relationship between the presence of active TrPs, pain intensity, and widespread pressure hypersensitivity in individuals with postmeniscectomy pain.

Methods: Thirty-three patients with postmeniscectomy pain, 46 to 60 years of age, and 33 matched controls participated. TrPs were explored bilaterally within the tensor fasciae latae, rectus femoris, vastus lateralis, vastus medialis, adductor magnus, adductor longus, semitendinosus, biceps femoris, and gastrocnemius muscles in a blinded manner.

Short-term changes in neck pain, widespread pressure pain sensitivity, and cervical range of motion after the application of trigger point dry needling in patients with acute mechanical neck pain: a randomized clinical trial.

Study Design: Randomized clinical trial.

Objectives: To determine the effects of trigger point dry needling (TrPDN) on neck pain, widespread pressure pain sensitivity, and cervical range of motion in patients with acute mechanical neck pain and active trigger points in the upper trapezius muscle.

Background: TrPDN seems to be effective for decreasing pain in individuals with upper-quadrant pain syndromes.

Widespread pressure pain hypersensitivity in patients with multiple sclerosis with and without pain as sign of central sensitization.

Objective: To determine the presence of widespread pressure hyperalgesia in multiple sclerosis (MS) patients with and without pain and its association with pain and fatigue.

Methods: A total of 108 individuals with definite MS, 49 men and 59 women (mean age, 44±8 y) and 108 age-matched and sex-matched pain-free controls (mean age, 44±9 y) were included. Fifty patients (n=58, 54%) reported pain and 50 (46%) did not.

Manual treatment for cervicogenic headache and active trigger point in the sternocleidomastoid muscle: a pilot randomized clinical trial.

Objective: The purpose of this preliminary study was to determine feasibility of a clinical trial to measure the effects of manual therapy on sternocleidomastoid active trigger points (TrPs) in patients with cervicogenic headache (CeH).

Methods: Twenty patients, 7 males and 13 females (mean ± SD age, 39 ± 13 years), with a clinical diagnosis of CeH and active TrPs in the sternocleidomastoid muscle were randomly divided into 2 groups. One group received TrP therapy (manual pressure applied to taut bands and passive stretching), and the other group received simulated TrP therapy (after TrP localization no additional pressure was added, and inclusion of longitudinal stroking but no additional stretching).