title: Quantification of dry needling on myofascial trigger points using a novel ultrasound method: A study protocol.
abstract: BACKGROUND
  Myofascial pain syndrome (MPS) is a neuromuscular dysfunction consisting of both motor and sensory abnormalities. Considering the high prevalence of MPS and its related disabilities and costs, this study was designed to determine the reliability of new ultrasonographic indexes of the upper trapezius muscle as well as the sensitivity and specificity of 2D ultrasound imaging for diagnostic purposes. Furthermore, we sought to evaluate the effectiveness of dry needling (DN) on studied ultrasonographic indexes.
  
  
  METHODS
  This study will be performed in two steps with two different designs. The first is a pilot study and was designed as a semi-experimental study to determine the sensitivity and specificity of ultrasonography for the diagnosis of MPS and the reliability of ultrasonographic measurements like muscle thickness, area of myofascial trigger points (MTrPs) in longitudinal view, echogenicity of MTrPs in longitudinal view, echogenicity of muscle with MTrPs in longitudinal and transverse views, and pennation angle of upper trapezius muscle. The second study is an interventional study which was designed to investigate the effectiveness of DN on ultrasonographic measurements, for which the reliability was determined in the first study.
  
  
  CONCLUSIONS
  we will quantify the effectiveness of DN on MTrPs and muscle tissue by using novel ultrasonographic indexes. The results of the current study will provide baseline information to design more interventional studies to improve the evaluation of other treatments of MPS.
authors.affiliation: Physiotherapy Research Centre, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Navid
authors.initials: N
authors.lastname: Taheri
authors.affiliation: Physiotherapy Research Centre, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: a_rezasoltani@sbmu.ac.ir.
authors.forename: Asghar
authors.initials: A
authors.lastname: Rezasoltani
authors.affiliation: Physiotherapy Research Centre, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Farshad
authors.initials: F
authors.lastname: Okhovatian
authors.affiliation: Radiology Department, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Karami
authors.affiliation: Department of Bio-statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran; Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Sayed Mohsen
authors.initials: SM
authors.lastname: Hosseini
authors.affiliation: Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Hosein
authors.initials: H
authors.lastname: Kouhzad Mohammadi
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D006801:Humans; D009209:Myofascial Pain Syndromes / Q000000981:diagnostic imaging* / Q000628:therapy*; D009339:Needles; D010865:Pilot Projects; D015203:Reproducibility of Results; D012107:Research Design; D012680:Sensitivity and Specificity; D064171:Superficial Back Muscles / Q000503:physiopathology; D061028:Trigger Points / Q000503:physiopathology*
keywords: Dry needling; Myofascial pain syndrome; Myofascial trigger points; Ultrasonography