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J Orthop Sports Phys Ther. 2018 Nov 30:1-38. doi: 10.2519/jospt.2019.8270. [Epub ahead of print]

The Effects of Needling Therapies on Muscle Force Production: A Systematic Review and Meta-Analysis.

Author information

1
Orthopaedic Manual Physical Therapy Fellowship, OSU Sports Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.
2
School of Health & Rehabilitation Sciences, The Ohio State University, Columbus, OH.
3
OSU Sports Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.
4
School of Physical Therapy and Movement Sciences, University of Montana, Missoula, MT.
5
Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH.
6
Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH.
7
College of Medicine, Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH.

Abstract

STUDY DESIGN:

Systematic review with meta-analysis.

BACKGROUND:

Needling has been shown to decrease pain in the short-term; however, its effects on muscle force production are unclear.

OBJECTIVE:

Evaluate the evidence regarding the comparative effects of needling on muscle force production.

METHODS:

An electronic search was performed using keywords related to needling. Methodological quality of articles was appraised and effect sizes calculated. The strength of evidence was determined and meta-analysis performed when similar methods were used in studies for similar conditions.

RESULTS:

Twenty-one studies were included in the review with 9 deemed high quality (>6/10 on the PEDro scale), 11 fair quality (5-6/10), and 1 deemed poor quality (<5/10). Three meta-analyses were performed. There was moderate strength of evidence with medium effect sizes for needling therapy to enhance force production in those with neck pain, and very low strength of evidence of no effect for individuals with non-specific and post-operative shoulder pain and those with lateral epicondylalgia. Other studies not included in the 3 meta-analyses demonstrated no significant effect of needling on force production. These studies included individuals with carpal tunnel syndrome, knee osteoarthritis, ankle sprains, knee arthroscopy, or delayed onset muscle soreness.

CONCLUSION:

The majority of studies suggest no effect of dry-needling on force production. High-quality studies with adequate power that control for the placebo effect and follow accepted reporting standards could make valuable contributions to this literature.

LEVEL OF EVIDENCE:

Therapy, level 1a. J Orthop Sports Phys Ther, Epub 30 Nov 2018. doi:10.2519/jospt.2019.8270.

KEYWORDS:

acupuncture; dry needling; neck; strength; trigger points

PMID:
30501386
DOI:
10.2519/jospt.2019.8270

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