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The Immediate Effects of Dry Needling on Post-concussion Syndrome

NCT ID: NCT03949998

Last Updated: 2020-11-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2019-05-15

Study Completion Date

2020-11-05

Brief Summary

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In about 15% of adult concussion cases, symptoms last longer than 2 weeks and can largely impact the individual's ability to work, be physically active and participate in everyday life. These symptoms are often partially related to unresolved neck muscle tightness and other neck-related symptoms. Dry needling is a technique that uses acupuncture needles to release muscle knots, decrease neck muscle tightness and decrease neck pain. As far as the investigators are aware, there have been no studies looking at the effects of dry needling on symptoms of chronic concussion. This study will compare the effects of dry needling to traditional hands-on physiotherapy treatment of the neck for concussion-related symptoms. Participants with chronic concussion symptoms will receive either dry needling, hands-on manual physiotherapy or both. Concussion symptoms, symptom severity, neck range of motion and pain with pressure over neck muscles will be compared before and after treatment, and the day after treatment. The investigators expect that the greatest improvement in all of these will be seen in the group receiving both interventions, both immediately after treatment and the following day. If dry needling can immediately improve concussion symptoms, patients may better tolerate therapeutic exercise and experience quicker resolution of chronic symptoms.

Detailed Description

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All participants will be tested in clinic once, for approximately a half hour. For all groups, outcome measures relating to concussion symptoms, cervical range of motion and pain pressure thresholds will be taken prior to and after the intervention.

In the DN group, four muscles (upper fibres trapezius, cervical multifidus, levator scapulae and suboccipitals) will be palpated by a physiotherapist trained in dry needling. If a palpable trigger point is found, the physiotherapist will perform dry needling until a local twitch response is elicited. If a trigger point is not found, no dry needling will take place. In this way, up to 8 total muscles will be needled during the session. The participant will be in prone for the above procedure.

In the MT group, soft tissue release will be performed on the above four muscles bilaterally. Cervical traction (unilateral grade 3 oscillatory distraction technique, any cervical segment between C0/C1 and C7/C7, 3-5 sets of 30 seconds) and mobilization (unilateral inferior-medial-posterior or superior-anterior-lateral, grade 3 oscillatory, any cervical segment between C0/C1 and C7/C7, 3-5 sets of 30 seconds ) will also be performed if the physiotherapist deems it necessary, specific to the spinal level noted to be involved. In the DN+MT group, MT interventions will be performed first, followed by DN, of the four above muscles. Immediately following intervention, the outcome measures will all be re-tested. The participants will also be instructed to fill out the SCAT-5 Step 2 upon waking the next morning. Additionally, if one or more of the cervical motions caused pain during initial testing, they will be asked to repeat the motion and report the current level of pain on the VAS scale.

Conditions

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Post-Concussive Syndrome, Chronic

Keywords

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Dry Needling

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Dry Needling

Participants will receive dry needling of the following muscles as indicated: upper fibres trapezius, levator scapulae, cervical multifidus, suboccipitals.

Group Type EXPERIMENTAL

Dry Needling

Intervention Type DEVICE

Comparison between dry needling and/or manual therapy of the cervical region.

Dry Needling + Manual Therapy

Participants will receive dry needling of the following muscles as indicated: upper fibres trapezius, levator scapulae, cervical multifidus, suboccipitals IN ADDITION TO manual therapy of the above muscles and/or cervical joint traction and/or mobilization as indicated.

Group Type ACTIVE_COMPARATOR

Dry Needling

Intervention Type DEVICE

Comparison between dry needling and/or manual therapy of the cervical region.

Manual Therapy

Intervention Type OTHER

soft tissue release, cervical traction and/or cervical mobilization

Manual Therapy

Participants will receive manual therapy of the following muscles as indicated: upper fibres trapezius, levator scapulae, cervical multifidus, suboccipitals and/or cervical joint traction and/or mobilization as indicated.

Group Type ACTIVE_COMPARATOR

Manual Therapy

Intervention Type OTHER

soft tissue release, cervical traction and/or cervical mobilization

Interventions

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Dry Needling

Comparison between dry needling and/or manual therapy of the cervical region.

Intervention Type DEVICE

Manual Therapy

soft tissue release, cervical traction and/or cervical mobilization

Intervention Type OTHER

Other Intervention Names

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Intramuscular Stimulation (Gunn IMS) Integrated Dry Needling (IDN)

Eligibility Criteria

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Inclusion Criteria

* experiencing concussion symptoms at least 4 weeks following an external impact injury to the head

Exclusion Criteria

* medical diagnoses of depression and/or anxiety
* skull fractures
* subdural or epidural haematomas
* parenchymal bleeds
* recent infection
* vascular anomaly
* hypertension
* current or past smoker
* high cholesterol
* family history of stroke
* migraine
* malignant/inflammatory disease
* osteoporosis
* bleeding disorde
* damaged heart valves
* pacemaker or other electrical implants
* fear of needles
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Guelph

OTHER

Sponsor Role lead

Responsible Party

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Dr. Margo Mountjoy

Adjunct Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Margo Mountjoy, MD

Role: PRINCIPAL_INVESTIGATOR

Adjunct Professor

Locations

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Eramosa Physiotherapy - Elora

Elora, Ontario, Canada

Site Status

Eramosa Physiotherapy - Bullfrog Mall

Guelph, Ontario, Canada

Site Status

Health and Performance Centre

Guelph, Ontario, Canada

Site Status

Countries

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Canada

Other Identifiers

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19-02-035

Identifier Type: -

Identifier Source: org_study_id