• Jaime Salom-Moreno, Laura Jiménez-Gómez, Victoria Gómez-Ahufinger, María Palacios-Ceña, José L Arias-Buría, Shane L Koppenhaver, and César Fernández-de-Las-Peñas.
• Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine and Cátedra de Investigación y Docencia en Fisioterapia, Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain(∗).
• PM R. 2017 Dec 1; 9 (12): 1208-1216.

BackgroundThe application of dry needling usually is associated with postneedling-induced pain. A postneedling intervention to reduce this adverse event is needed.ObjectiveTo 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.DesignA 72-hour follow-up, single-blind randomized controlled trial.SettingUrban hospitals.ParticipantsIndividuals with subacromial pain syndrome (n = 90, 52% female, mean age: 35 ± 13 years) with active TrPs in the infraspinatus muscle.InterventionsAll individuals received dry needling into the infraspinatus active TrP. Then, they were divided randomly into an experimental group, which received a single bout of low-load exercise of shoulder muscles; a placebo group, which received inactive ultrasound for 10 minutes; and a control group, which did not receive any intervention.Outcome MeasuresNumerical Pain Rating Scale (0-10 point) was administered postneedling, immediately postintervention (2 minutes), and 24, 48, and 72 hours after needling. Shoulder pain (Numerical Pain Rating Scale, 0-10) and disability (Disabilities of the Arm, Shoulder and Hand; Shoulder Pain and Disability Index) were assessed before and 72 hour after needling.ResultsThe 5 × 3 analysis of covariance showed that the exercise group demonstrated a larger decrease in postneedling-induced pain immediately after (P = .001), 24 hours (P = .001), and 48 hours after (P = .006) than placebo or control groups. No differences were found at 72 hours (P = .03). Similar improvements in shoulder pain (P < .001) and related disability (Disabilities of the Arm, Shoulder and Hand: P < .001; Shoulder Pain and Disability Index: P < .001) were observed 72 hours after needling, irrespective of the treatment group.ConclusionsLow-load exercise was effective for reducing postneedling-induced pain on active TrPs in the infraspinatus muscle 24 and 48 hours after needling. The application of a postneedling intervention did not influence short-term pain and disability changes.Level Of EvidenceI.Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

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