Neck PainNCT02638987
EMG Activity Before, During and After Dry Needling
A study testing Dry needling in people with Neck Pain, run by University Ghent.
Trial summary
An experimental study will be conducted to evaluate the effect of a single dry needling session on surface EMG activity (primary outcome measure), muscle tone, elasticity, stiffness and pain (secondary outcome measures) of the upper trapezius, in female office workers with trapezius myalgia. Read more about this study
- Who is it for?
- Ages 25 to 55 years, women only
- Conditions the study is for
- Neck Pain
- What is being tested?
- Dry needling
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 24 participants
- Where
- No sites listed yet
- Study dates
- Sep 2015to Jan 2016
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 25 to 55 years
- Women only
- No healthy volunteers
- Adult
Who may be able to join
- Performing office work since at least one year
- Performing computer based tasks for at least 20 hours a week
- NRS > or equal to 3/10
- Clinical diagnosis of trapezius myalgia
- Trapezius myalgia is work-related and thus aggravates during working day/week
- Presence of MTrP2 in the upper trapezius muscle (bilaterally)
Who cannot join
- Being in treatment during the study
- Traumatic injuries/surgery to neck and upper limb region
- Signs of cervical nerve root impingement
- Whiplash injury
- Cardiovascular, neurological, life threatening, systemic and metabolic diseases
- Diagnosis of fibromyalgia/chronic fatigue syndrome
Show all 9Show fewer
- Shoulder pathology
- Coagulation disorders
- Pregnancy
About this study
Official title: EMG Activity, Muscle Tone, Elasticity and Stiffness of the Upper Trapezius Before, During and After Dry Needling
An experimental study will be conducted to evaluate the effect of a single dry needling session on surface EMG activity (primary outcome measure), muscle tone, elasticity, stiffness and pain (secondary outcome measures) of the upper trapezius, in female office workers with trapezius myalgia.
Read the detailed description
Neck-shoulder pain is a frequent problem in office workers . These complaints are often related to myofascial problems of neck and shoulder muscles in which the upper trapezius is frequently involved. Trapezius myalgia (TM) is characterized by pain, palpable stiffness and tenderness of the upper part of the trapezius muscle. Several studies show that myofascial trigger points (MTrP) have an important role in the development and maintenance of myofascial pain.
Trigger points are defined as hyperirritable nodules in a contracture of skeletal muscle fibers.
The pathophysiology of MTrPs is still unclear but several hypothesis exist. The most plausible explanation is that, due to sustained postures or repetitive low-level tasks, a sustained irritation of motor end plates with an excessive release of acetylcholine arises. This may lead to a persistent sarcomere contraction, leading to an impaired blood circulation, a reduced oxygenation and energy depletion, sensitizing nociceptors and causing pain.
Dry needling (DN) is a myofascial treatment technique, in which a thin, solid filiform needle is inserted directly into the MTrP. During dry needling, local twitch responses (LTR) can be elicited. These are involuntary contractions of muscle fibers, leading to muscle relaxation, an increase in blood flow, recovery of the muscle metabolism and thus a reduction of pain and stiffness.
In this experimental study, 25 female office workers with trapezius myalgia are recruited from several work places with predominantly computer based tasks. These subjects have to perform at least 20 hours a week of computer work and this since at least one year. Subjects are included based on online questionnaires, a clinical examination of neck an shoulder and the presence of MTRP 2 in the upper trapezius. All participants will receive information and have to sign an informed consent form.
Participants will be subjected to baseline assessment which involves measuring resting surface EMG activity, muscle tone, stiffness, elasticity and pain. Then, subjects have to perform a computer task during 20 minutes while surface EMG activity will be measured every 5 minutes. After this computer task, all measurements will be repeated. After a resting period of 10 minutes, baseline measurements are repeated, followed by a computer task of 20 minutes and repetition of the same assessment. After this computer task, a single dry needling session of MTrP 2 of the upper trapezius will be performed bilaterally. During this treatment, surface EMG activity will be measured to captivate the EMG activity during local twitch responses.
This is followed by repeating the same measurements 1 and 10 minutes after dry needling.
- Conditions
- Neck Pain
- Being tested
- Dry needling
- Keywords
- Dry needling, office workers, myofascial pain, electromyography
- Medical subject headings
- Neck Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Dry needlingProcedure or surgery
Dry needling (DN) is a myofascial treatment technique, in which a thin, solid filiform needle is inserted directly into the MTrP. During dry needling, local twitch responses (LTR) can be elicited. These are involuntary contractions of muscle fibers, leading to muscle relaxation, an increase in blood flow,recovery of the muscle metabolism and thus a reduction of pain and stiffness.
| Study group | Role | What they receive |
|---|---|---|
| Dry needling | Experimental | After the second computer task, a single dry needling session will be performed with the subject lying on the non painful side. After palpation of a taut band and detection of MTrP 2 in the upper trapezius muscle, a trained physiotherapist will penetrate the needle into the MTrP and will move the needle up and down in multiple directions. When local twitch responses are elicited, this will be repeated until the local twitch responses are extinct. Receives: Procedure: Dry needling |
| Rest | No intervention | After the first computer task, participants will rest in sidelying position for 10 minutes. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Changes in surface resting EMG activity of the upper trapezius after dry needling as assessed by the EMG DTS device
Device: Noraxon USA Desktop Direct Transmission System (DTS) for EMG
Changes in resting EMG activity of the upper trapezius immediately after dry needling and 10 minutes after dry needling, compared to resting EMG activity after a typing task, will be measured by using surface electrodes placed bilaterally at the MTrP 2 location of the upper trapezius (halfway between C7 and the posterolateral edge of the acromion). The change in EMG activity after dry needling will be compared with the change in EMG activity after rest.
Resting EMG activity will be expressed as a percentage of submaximal reference contractions of the upper trapezius (% reference contractions).
Measured: Immediately after a typing task of 20 minutes, one minute after dry needling, 10 minutes after dry needling
Secondary outcomes (12)
Changes in surface resting EMG activity of the upper trapezius after rest as assessed by the EMG DTS device
Device: Noraxon USA Desktop Direct Transmission System (DTS) for EMG
Changes in resting EMG activity of the upper trapezius after a resting pause of 10 minutes (in sidelying position), compared to resting EMG activity after a typing task, will be measured by using surface electrodes placed bilaterally at the MTrP 2 location of the upper trapezius (halfway between C7 and the posterolateral edge of the acromion).
Resting EMG activity will be expressed as a percentage of submaximal reference contractions of the upper trapezius (% reference contractions).
Measured: Immediately after a typing task of 20 minutes, immediately after a resting pause of 10 minutes
Changes in surface resting EMG activity of the upper trapezius during a fatiguing typing task of 20 minutes as assessed by the EMG DTS device
Device: Noraxon USA Desktop Direct Transmission System (DTS) for EMG
Changes in EMG activity of the upper trapezius during a typing task of 20 minutes, will be measured by using surface electrodes placed bilaterally at the MTrP 2 location of the upper trapezius (halfway between C7 and the posterolateral edge of the acromion).
EMG activity during this typing task will be expressed as a percentage of submaximal reference contractions of the upper trapezius (% reference contractions).
Measured: During the typing task, every five minutes EMG activity will be measured for 30 seconds
Differences in active muscle tension of the upper trapezius (ratio between resting EMG activity in upright and lying position) between the (dominant) painful and heterolateral side, as assessed by the EMG DTS device
Device: Noraxon USA Desktop Direct Transmission System (DTS) for EMG
Resting EMG activity will be measured by using surface electrodes placed bilaterally at the MTrP 2 location of the upper trapezius (halfway between C7 and the posterolateral edge of the acromion).
Resting EMG activity will be measured during 30 seconds with the subject lying supine, then resting EMG activity will be measured during 30 seconds with the subject seated in upright position. A ratio of both measurements will be calculated to compare active muscle tension the (dominant) painful and heterolateral side.
Resting EMG activity will be expressed as a percentage of submaximal reference contractions of the upper trapezius (% reference contractions).
Measured: At baseline
Differences in muscle fatigue of the upper trapezius (ratio between resting EMG activity before and after a typing task of 20 minutes) between the (dominant) painful and heterolateral side, as assessed by the EMG DTS device
Device: Noraxon USA Desktop Direct Transmission System (DTS) for EMG
Resting EMG activity will be measured by using surface electrodes placed bilaterally at the MTrP 2 location of the upper trapezius (halfway between C7 and the posterolateral edge of the acromion).
Resting EMG activity will be measured during 30 seconds before starting the typing task and immediately after the typing task of 20 minutes. A ratio of both measurements will be calculated to compare muscle fatigue between the (dominant) painful and heterolateral side.
Resting EMG activity will be expressed as a percentage of submaximal reference contractions of the upper trapezius (% reference contractions).
Measured: Before and after a typing task of 20 minutes
Changes in muscle tone, stiffness and elasticity of the upper trapezius after dry needling as assessed by the MyotonPRO ®
Device: MyotonPRO ®
Changes in muscle tone, stiffness and elasticity of the upper trapezius immediately after dry needling and 10 minutes after dry needling, compared to muscle tone, stiffness and elasticity after a typing task, will be measured by using the MyotonPRO ® device. This is placed on the upper trapezius halfway between C7 and the posterolateral part of the acromion.
Muscle tone is expressed in Hertz (Hz) and characterizes muscle tone in resting state Muscle elasticity is the logarithmic decrement of the natural oscillation of the muscle Muscle stiffness is expressed in N/m (Newton per meter) and represents the resistance of the muscle to contraction.
Measured: Immediately after a typing task of 20 minutes, one minute after dry needling, 10 minutes after dry needling
Changes in muscle tone, stiffness and elasticity of the upper trapezius after rest as assessed by the MyotonPRO ®
Device: MyotonPRO ®
Changes in muscle tone, stiffness and elasticity of the upper trapezius immediately after dry needling and 10 minutes after dry needling, compared to muscle tone, stiffness and elasticity will be measured by using the MyotonPRO ® device, which is placed on the upper trapezius halfway between C7 and the posterolateral part of the acromion
Muscle tone is expressed in Hertz (Hz) and characterizes muscle tone in resting state Muscle elasticity is the logarithmic decrement of the natural oscillation of the muscle Muscle stiffness is expressed in N/m (Newton per meter) and represents the resistance of the muscle to contraction.
Measured: Immediately after a typing task of 20 minutes, immediately after 10 minutes of rest
Changes in muscle tone, stiffness and elasticity of the upper trapezius after a typing task, compared to baseline, as assessed by the MyotonPRO ®
Device: MyotonPRO ®
Changes in muscle tone, stiffness and elasticity of the upper trapezius after a typing task of 20 minutes, compared to baseline will be measured by using the MyotonPRO ® device, which is placed on the upper trapezius halfway between C7 and the posterolateral part of the acromion
Muscle tone is expressed in Hertz (Hz) and characterizes muscle tone in resting state Muscle elasticity is the logarithmic decrement of the natural oscillation of the muscle Muscle stiffness is expressed in N/m (Newton per meter) and represents the resistance of the muscle to contraction.
Measured: Before and immediately after a typing task of 20 minutes
Differences in muscle tone, stiffness and elasticity of the upper trapezius between the (dominant) painful and heterolateral side, as assessed by the MyotonPRO ®
Device: MyotonPRO ®
Differences in muscle tone, stiffness and elasticity of the upper trapezius between the (dominant) painful and heterolateral side will be measured by using the MyotonPRO ®, which is placed on the upper trapezius halfway between C7 and the posterolateral part of the acromion
Muscle tone is expressed in Hertz (Hz) and characterizes muscle tone in resting state Muscle elasticity is the logarithmic decrement of the natural oscillation of the muscle Muscle stiffness is expressed in N/m (Newton per meter) and represents the resistance of the muscle to contraction.
Measured: At baseline
Changes in pain score after dry needling as assessed by the numeric rating scale
Subjects will have to report their actual pain complaints on a numeric rating scale (NRS) ranging from 0 (no pain) to 10 (worst pain) after a typing task, one minute after dry needling and 10 minutes after dry needling.
Measured: Immediately after a typing task of 20 minutes, one minute after dry needling, 10 minutes after dry needling
Changes in pain score after rest as assessed by the numeric rating scale
Subjects will have to report their actual pain complaints on a numeric rating scale (NRS) ranging from 0 (no pain) to 10 (worst pain) after a typing task of 20 minutes and after a resting pause of 10 minutes.
Measured: Immediately after a typing task of 20 minutes, immediately after 10 minutes of rest
Changes in pain score after a typing task of 20 minutes as assessed by the numeric rating scale
Subjects will have to report their actual pain complaints on a numeric rating scale (NRS) ranging from 0 (no pain) to 10 (worst pain) before and after a typing task of 20 minutes.
Measured: Immediately before and after a typing task of 20 minutes
Differences in pain score at baseline between the (dominant) painful side and heterolateral side
Subjects will have to report their actual pain complaints on a numeric rating scale (NRS) ranging from 0 (no pain) to 10 (worst pain) for the (dominant) painful and heterolateral side.
Measured: At baseline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Dec 2015 (estimated)
- Study startSep 2015
- Primary completionJan 2016
- Study completionJan 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Neck PainStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Non-randomised
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 24 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Ghent
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Barbara Cagnie, PhD, Principal investigator, University Ghent
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02638987
- Sponsor's protocol ID
- 2015/0740
- Status last verified
- Nov 2022
- First submitted
- 9 Dec 2015
- Last updated
- 5 Dec 2022
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 5 Dec 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- EMG Activity, Muscle Tone, Elasticity and Stiffness of the Upper Trapezius Before, During and After Dry Needling
- ClinicalTrials.gov ID
- NCT02638987
- Acronym / sponsor ID
- 2015/0740
- Conditions
- Neck Pain
- Keywords
- Dry needling, office workers, myofascial pain, electromyography
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 24 participants (actual)
- Lead sponsor
- University GhentUniversity, hospital or other
- Study start
- Sep 2015
- Primary completion
- Jan 2016 (actual)
- Study completion
- Jan 2016 (actual)
- First posted
- 23 Dec 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
An experimental study will be conducted to evaluate the effect of a single dry needling session on surface EMG activity (primary outcome measure), muscle tone, elasticity, stiffness and pain (secondary outcome measures) of the upper trapezius, in female office workers with trapezius myalgia.
Detailed description
Neck-shoulder pain is a frequent problem in office workers . These complaints are often related to myofascial problems of neck and shoulder muscles in which the upper trapezius is frequently involved. Trapezius myalgia (TM) is characterized by pain, palpable stiffness and tenderness of the upper part of the trapezius muscle. Several studies show that myofascial trigger points (MTrP) have an important role in the development and maintenance of myofascial pain.
Trigger points are defined as hyperirritable nodules in a contracture of skeletal muscle fibers.
The pathophysiology of MTrPs is still unclear but several hypothesis exist. The most plausible explanation is that, due to sustained postures or repetitive low-level tasks, a sustained irritation of motor end plates with an excessive release of acetylcholine arises. This may lead to a persistent sarcomere contraction, leading to an impaired blood circulation, a reduced oxygenation and energy depletion, sensitizing nociceptors and causing pain.
Dry needling (DN) is a myofascial treatment technique, in which a thin, solid filiform needle is inserted directly into the MTrP. During dry needling, local twitch responses (LTR) can be elicited. These are involuntary contractions of muscle fibers, leading to muscle relaxation, an increase in blood flow, recovery of the muscle metabolism and thus a reduction of pain and stiffness.
In this experimental study, 25 female office workers with trapezius myalgia are recruited from several work places with predominantly computer based tasks. These subjects have to perform at least 20 hours a week of computer work and this since at least one year. Subjects are included based on online questionnaires, a clinical examination of neck an shoulder and the presence of MTRP 2 in the upper trapezius. All participants will receive information and have to sign an informed consent form.
Participants will be subjected to baseline assessment which involves measuring resting surface EMG activity, muscle tone, stiffness, elasticity and pain. Then, subjects have to perform a computer task during 20 minutes while surface EMG activity will be measured every 5 minutes. After this computer task, all measurements will be repeated. After a resting period of 10 minutes, baseline measurements are repeated, followed by a computer task of 20 minutes and repetition of the same assessment. After this computer task, a single dry needling session of MTrP 2 of the upper trapezius will be performed bilaterally. During this treatment, surface EMG activity will be measured to captivate the EMG activity during local twitch responses.
This is followed by repeating the same measurements 1 and 10 minutes after dry needling.
Study design
- Primary purpose
- Other
- Allocation
- Non-randomised
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Dry needling | Experimental | Procedure: Dry needlingAfter the second computer task, a single dry needling session will be performed with the subject lying on the non painful side. After palpation of a taut band and detection of MTrP 2 in the upper trapezius muscle, a trained physiotherapist will penetrate the needle into the MTrP and will move the needle up and down in multiple directions. When local twitch responses are elicited, this will be repeated until the local twitch responses are extinct. |
| Rest | No intervention | –After the first computer task, participants will rest in sidelying position for 10 minutes. |
Who may qualify
- Ages
- 25 to 55 years
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (6 listed)
- Performing office work since at least one year
- Performing computer based tasks for at least 20 hours a week
- NRS > or equal to 3/10
- Clinical diagnosis of trapezius myalgia
- Trapezius myalgia is work-related and thus aggravates during working day/week
Key exclusion criteria (9 listed)
- Being in treatment during the study
- Traumatic injuries/surgery to neck and upper limb region
- Signs of cervical nerve root impingement
- Whiplash injury
- Cardiovascular, neurological, life threatening, systemic and metabolic diseases
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Dry needlingDry needling (DN) is a myofascial treatment technique, in which a thin, solid filiform needle is inserted directly into the MTrP. During dry needling, local twitch responses (LTR) can be elicited. These are involuntary contractions of muscle fibers, leading to muscle relaxation, an increase in blood flow,recovery of the muscle metabolism and thus a reduction of pain and stiffness. | Procedure or surgery | Dry needling |
Primary outcome
Changes in surface resting EMG activity of the upper trapezius after dry needling as assessed by the EMG DTS device
Time frame: Immediately after a typing task of 20 minutes, one minute after dry needling, 10 minutes after dry needling
Device: Noraxon USA Desktop Direct Transmission System (DTS) for EMG Changes in resting EMG activity of the upper trapezius immediately after dry needling and 10 minutes after dry needling, compared to resting EMG activity after a typing task, will be measured by using surface electrodes placed bilaterally at the MTrP 2 location of the upper trapezius (halfway between C7 and the posterolateral edge of the acromion). The change in EMG activity after dry needling will be compared with the change in EMG activity after rest. Resting EMG activity will be expressed as a percentage of submaximal reference contractions of the upper trapezius (% reference contractions).
12 secondary outcomes
Changes in surface resting EMG activity of the upper trapezius after rest as assessed by the EMG DTS device
Time frame: Immediately after a typing task of 20 minutes, immediately after a resting pause of 10 minutes
Changes in surface resting EMG activity of the upper trapezius during a fatiguing typing task of 20 minutes as assessed by the EMG DTS device
Time frame: During the typing task, every five minutes EMG activity will be measured for 30 seconds
Differences in active muscle tension of the upper trapezius (ratio between resting EMG activity in upright and lying position) between the (dominant) painful and heterolateral side, as assessed by the EMG DTS device
Time frame: At baseline
Differences in muscle fatigue of the upper trapezius (ratio between resting EMG activity before and after a typing task of 20 minutes) between the (dominant) painful and heterolateral side, as assessed by the EMG DTS device
Time frame: Before and after a typing task of 20 minutes
Changes in muscle tone, stiffness and elasticity of the upper trapezius after dry needling as assessed by the MyotonPRO ®
Time frame: Immediately after a typing task of 20 minutes, one minute after dry needling, 10 minutes after dry needling
Changes in muscle tone, stiffness and elasticity of the upper trapezius after rest as assessed by the MyotonPRO ®
Time frame: Immediately after a typing task of 20 minutes, immediately after 10 minutes of rest
Changes in muscle tone, stiffness and elasticity of the upper trapezius after a typing task, compared to baseline, as assessed by the MyotonPRO ®
Time frame: Before and immediately after a typing task of 20 minutes
Differences in muscle tone, stiffness and elasticity of the upper trapezius between the (dominant) painful and heterolateral side, as assessed by the MyotonPRO ®
Time frame: At baseline
Changes in pain score after dry needling as assessed by the numeric rating scale
Time frame: Immediately after a typing task of 20 minutes, one minute after dry needling, 10 minutes after dry needling
Changes in pain score after rest as assessed by the numeric rating scale
Time frame: Immediately after a typing task of 20 minutes, immediately after 10 minutes of rest
Changes in pain score after a typing task of 20 minutes as assessed by the numeric rating scale
Time frame: Immediately before and after a typing task of 20 minutes
Differences in pain score at baseline between the (dominant) painful side and heterolateral side
Time frame: At baseline
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Dec 2022.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Barbara Cagnie, PhD principal investigator
University Ghent
Questions about this trial
What is this clinical trial studying?
A study testing Dry needling in people with Neck Pain, run by University Ghent.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 5 Dec 2022. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Changes in surface resting EMG activity of the upper trapezius after dry needling as assessed by the EMG DTS device (time frame: Immediately after a typing task of 20 minutes, one minute after dry needling, 10 minutes after dry needling). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Dec 2022.