title: Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial.
abstract: 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 ∗ 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.
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain ; Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain ; Grupo de Excelencia Investigadora URJC-Banco de Santander: Investigación Traslacional en el Proceso de Salud-Enfermedad (ITPSE), Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Salom-Moreno
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Ayuso-Casado
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Tamaral-Costa
authors.affiliation: Centro de Fisioterapia CRENE, Caunedo 24, 28037 Madrid, Spain.
authors.forename: Zacarías
authors.initials: Z
authors.lastname: Sánchez-Milá
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain ; Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain ; Grupo de Excelencia Investigadora URJC-Banco de Santander: Investigación Traslacional en el Proceso de Salud-Enfermedad (ITPSE), Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain.
authors.forename: César
authors.initials: C
authors.lastname: Fernández-de-Las-Peñas
authors.affiliation: Department of Physical Therapy, Universidad de Salamanca, Avenida Donante de Sangre s/n, 37007 Salamanca, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Alburquerque-Sendín