title: Inclusion of trigger point dry needling in a multimodal physical therapy program for postoperative shoulder pain: a randomized clinical trial.
abstract: 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.
  
  
  RESULTS
  Analysis of variance showed that subjects receiving TrP-DN plus physical therapy exhibited greater improvement in the Constant-Murley total score (P < .001) and also activities of daily living (P < .001) and strength (P = .019) subscales than those receiving physical therapy alone. Between-group effect sizes were large in favor of the TrP-DN group (0.97 < SMD < 1.45). Both groups experienced similar improvements in pain (P < .001) and range of motion (P < .001).
  
  
  CONCLUSIONS
  Our results suggest that including a single session of TrP-DN in the first week of a multimodal physical therapy approach may assist with faster increases in function in individuals with postoperative shoulder pain.
authors: Clinician, Department of Physical Therapy, Hospital Universitario Gregorio Marañón, Madrid, Spain; Professor, Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
authors: José L
authors: JL
authors: Arias-Buría
authors: Professor, Department of Physical Therapy, Universidad Complutense de Madrid, Madrid, Spain.
authors: Raquel
authors: R
authors: Valero-Alcaide
authors: Professor, Department of Physical Therapy, Rehabilitation Services, Concord Hospital, Concord, NH.
authors: Joshua Aland
authors: JA
authors: Cleland
authors: Professor, Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Professor, Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation of Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
authors: Jaime
authors: J
authors: Salom-Moreno
authors: Professor, Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Professor, Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation of Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
authors: Ricardo
authors: R
authors: Ortega-Santiago
authors: Professor, Department of Physical Therapy, Universidad Complutense de Madrid, Madrid, Spain.
authors: María A
authors: MA
authors: Atín-Arratibel
authors: Professor, Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Professor, Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation of Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. Electronic address: cesar.fernandez@urjc.es.
authors: César
authors: C
authors: Fernández-de-las-Peñas
mesh_terms: D015669:Acupuncture Points; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000628:therapy*; D026741:Physical Therapy Modalities; D020069:Shoulder Pain / Q000601:surgery*; D061028:Trigger Points
keywords: Fracture; Rehabilitation; Shoulder Pain; Trigger Point