Ultrasound-Guided Percutaneous Needle Electrolysis in Dancers with Chronic Soleus Injury: A Randomized Clinical Trial.

Damage to intramuscular tendons is very common in sports injuries, specifically in soleus muscle injuries. This study sought to compare the effects of applying ultrasound- (US-) guided percutaneous needle electrolysis (PNE) in combination with an eccentric exercise program on pain and functionality in dancers with chronic soleus injury, located in the central tendon. Thirty dancers with injured central tendon of the soleus muscle were randomly allocated to a PNE group (n = 10), an eccentric exercise group (n = 10), or a combined group (n = 10). Pain, ankle dorsiflexion range of motion (DROM), endurance, the heel raise test, the DFOS questionnaire, and the minimal clinically important difference (MCID) were analyzed at baseline and after treatment (four weeks). Over half (52%) of the dancers had a chronic soleus muscle injury. Variables for pain, DROM, the heel rise test, ADL, technique, DFOS total, and DFOS-subjective variables showed significant differences (P < 0.05) in pretreatment and posttreatment in all groups, whereas no significant differences were observed between intervention groups. However, the combined group showed a higher percentage of changes compared to the other groups, and these dancers had greater perceived changes (MCID = 4.70 ± 1.42). The conclusion of the study was that dancers with chronic soleus injury, located in the central tendon, treated with a combination of US-guided PNE and an eccentric exercise program displayed improved outcomes compared to the application of PNE therapy or eccentric exercise alone. The US-guided PNE, combined with an eccentric exercise program, is a useful therapeutic tool for the treatment of chronic soleus injury, located in the central tendon. The trial is registered with NCT04042012.

Efectos sobre la tensión neural adversa medida mediante test de Slump tras punción seca de punto gatillo miofascial del músculo gastrocnemio / Effects on adverse neural tension by slump test after dry needling of myofascial trigger point of the gastrocnemius muscle

Objetivo: Conocer el efecto de la punción seca (PS) en puntos gatillo miofasciales (PGM) del músculo gastrocnemio sobre la tensión neural adversa (TNA) y el dolor percibido. Material y métodos: Cincuenta adultos se prestaron al estudio. Tras aplicar criterios de inclusión y exclusión, obtuvimos una muestra final de 45. Fueron asignados aleatoriamente al grupo 1 o experimental (n = 23, edad media: 22,41 ± 1,53) y al grupo 2 o control (n = 22, edad media: 21,15 ± 1,34). Una vez localizado y confirmado el PGM por el evaluador ciego, se aplicó la técnica de PS profunda. Para el grupo 2 se utilizó la misma aguja, diferenciándose en la capacidad de retracción de la misma, sin llegar a perforar la piel. La TNA fue valorada mediante el test neurodinámico de Slump y el dolor percibido mediante escala visual analógica (EVA) justo antes (pretest) y en 2 momentos posteriores (inmediato y a 48 h). Los datos fueron tratados con el paquete estadístico SPSS versión 19.0. Resultados: Se observaron diferencias estadísticamente significativas (p < 0,05) en el grupo 1 entre pretest y postest inmediato y entre postest inmediato y tardío (48 h) para la variable TNA. El dolor percibido mostró diferencias estadísticamente significativas entre el pretest y los 2 momentos de valoración posterior (p < 0,001), mientras el grupo 2 no evidenció mejoras. Se observaron diferencias entre grupos en el postest inmediato del dolor percibido. Conclusiones: La PS sobre PGM latentes del músculo gastrocnemio disminuye el dolor percibido al menos 48 h, no obteniendo cambios significativos sobre la TNA medida mediante test de Slump

Objective: To determine the effect of dry needling (DN) in the myofascial trigger points (MTrP) of the gastrocnemius muscle on adverse neural tension (ANT) and perceived pain. Material and methods: 50 adults were selected for the study. After applying inclusion and exclusion criteria, we obtained a final sample of 45. They were randomly assigned to group 1 or experimental (n = 23, mean age: 22.41 ± 1.53) and group 2 or control (n = 22, mean age: 21.15 ± 1.34). Once allocated and confirmed by the blind assessor, deep dry needling technique on the MTrP was applied. For group 2 the same needle was used, differing in shrinkage capacity therefore without perforating the skin. The ANT was assessed using the Slump neurodynamic test and perceived pain by visual analogue scale (VAS) just before (pre-test) and in two subsequent times (immediately and 48hours). The data were processed with SPSS version 19.0. Results: We observed statistically significant differences (P < .05) in group 1 between pretest and immediate posttest and between immediate and delayed post-test (48 hours) for the variable ANT. The perceived pain showed statistically significant differences between the pretest and the two later time points (P < .001), while group 2 showed no improvement. Differences between groups were observed in the immediate posttest perceived pain. Conclusions: The dry needling in the MTrP latent on gastrocnemius muscle decreases perceived pain at least 48 hours, not getting on the ANT significant changes measured by Slump test

Analysis of heart rate variability at rest and during aerobic exercise: a study in healthy people and cardiac patients.

OBJECTIVE: To analyse HRV at rest in healthy people and in patients with acute myocardial infarction (AMI) and how it changes during aerobic exercise. METHODS: The heartbeat signal was recorded beat to beat for 15 minutes at rest and 15 minutes while pedalling in 10 healthy and active men (H group) and 10 cardiac patients (C group). The statistical parameters in the time domain were calculated as well as the spectral analysis applying the Fast Fourier Transform (FFT) and Poincare's graphic analysis (PGA). RESULTS: At rest, H group have an average SDRR (standard deviation of RR intervals) of 71.24 msec, a pRR50 (percentage of differences higher than 50 msec in RR intervals) of 9.97% and a PGA called "comet-type". The C group have a SDRR of 36.69 msec, a pRR50 of 1.69%, and a PGA "torpedo-type". These data show a low or moderate risk for healthy people and a high risk for patients. The FFT analysis lies in the very-low-frequency (VLF) zone in both groups. During exercise, H group shows a significant decrease in all parameters; the PGA turns to "torpedo-type" and the FFT remains in the VLF zone. However, C group is characterised by the maintenance of pRR50, no change in PGA and a second peak in FFT in the high-frequency zone. CONCLUSION: The HRV at rest and during aerobic exercise follows a different pattern in healthy people and in patients and it provides further information about performance during exercise.