Effectiveness of Trigger Point Dry Needling on Plantar Fasciitis

NCT ID: NCT05588349

Last Updated: 2023-02-14

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 20 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-02-01
• Study Completion Date: 2023-05-31

Brief Summary

Plantar fasciitis could lead to pain, disability and impaired balance. Dry needling that targets myofascial trigger points (MTrPs) has been shown to be beneficial in reducing pain, improving range of motion and function in patients with musculoskeletal conditions. Previous systematic review suggested a positive effect of dry needling on improving pain intensity and pain-related disability in patients with plantar heel pain (Llurda-Almuzara et al., 2021). However, the generalisability of the result is limited by small number of trials and heterogenicity in the dry needling application. Also, there is currently no evidence on its effect on dynamic balance and ankle dorsiflexion range of motion. This randomized controlled trial is designed to investigate the effectiveness of dry needling on pain, pain-related disability, dynamic balance and ankle dorsiflexion range of motion in patients with plantar fasciitis.

Detailed Description

Twenty participants aged 18 - 65 years with plantar fasciitis will be recruited and randomized to (1) dry needing and stretching exercise group or (2) stretching exercise group, receiving three treatment sessions over three weeks. The primary outcome measure will be numeric pain rating scale (NPRS) and the secondary outcome measures will be Chinese Foot and Ankle Outcome Score (FAOS), modified Star Excursion Balance Test (mSEBT) and weight bearing lunge test (WBLT) measured at baseline and week 4.

Conditions

Plantar Fascitis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Dry needling + stretching exercise

After locating the MTrPs, hand hygiene of the physiotherapist will be done and the needling site will be disinfected with alcohol swab. 0.30 x 50 mm disposable stainless-steel needles (DongBang Acupuncture Inc., Boryeong, Korea) will be used. The needle will be inserted into the muscle and pistoned in an up-and-down fashion using the "fast in and fast out" technique in order to provoke the local twitch response (LTR). This will be repeated until either the LTRs are exhausted, or the participant's tolerance threshold is met. If the participant is sensitive to the needle stimulation, the manipulation will be reduced. The needle will be left in situ for five minutes (Cotchett et al., 2011). Participants will receive dry needling once per week for three weeks. Plantar fascia and calf stretching exercise will be taught

Group Type: EXPERIMENTAL

Dry needling

Intervention Type: OTHER

Dry needling + stretching exercise

Stretching exercise

Plantar fascia stretching exercise:

Participants will be instructed to sit with the affected foot placed on the contralateral thigh with the toes being grasped and pulled into extension until a stretch is felt in the plantar fascia.

Calf stretching exercise:

To focus on stretching the gastrocnemius, participants will be taught to stand with both hands holding onto the wall and keep the affected leg back with knee straightened and heel in contact with the floor. Slowly lean forward to the wall until a stretch is felt in the calf. To focus on stretching the soleus, the same procedures will be taught except with the affected knee being bent.

Group Type: ACTIVE_COMPARATOR

Stretching exercise

Intervention Type: OTHER

Stretching exercise only

Interventions

Dry needling

Dry needling + stretching exercise

Intervention Type: OTHER

Stretching exercise

Stretching exercise only

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age of 18-65 years
• Clinical diagnosis of plantar fasciitis in accordance with the clinical guidelines of the Orthopaedic Section of the American Physical Therapy Association (APTA)
• Pain intensity of a minimum score of 5 on 11-point NPRS
• Presence of trigger points of the gastrocnemius or soleus muscles or both
• History of plantar heel pain for over 1 month

Exclusion Criteria

• Needle allergy or phobia
• Bleeding disorders or severe vascular disease
• Pregnancy
• Cancer
• Fracture or surgery in the foot region or leg
• Infection
• Dermatological disease in the area of needling
• History of injection therapy in the heel during the previous three months
• Cognitive impairment
• Neurological disorders affecting balance

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Chinese University of Hong Kong

OTHER

Sponsor Role: lead

Responsible Party

Wong Wing Sze

Student

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Our Lady of Maryknoll Hospital

Hong Kong, , Hong Kong

Site Status: RECRUITING

Countries

Hong Kong

Central Contacts

Wong

Role: CONTACT

1155168950@link.cuhk.edu.hk

64323868

Facility Contacts

Wong

Role: primary

References

Llurda-Almuzara L, Labata-Lezaun N, Meca-Rivera T, Navarro-Santana MJ, Cleland JA, Fernandez-de-Las-Penas C, Perez-Bellmunt A. Is Dry Needling Effective for the Management of Plantar Heel Pain or Plantar Fasciitis? An Updated Systematic Review and Meta-Analysis. Pain Med. 2021 Jul 25;22(7):1630-1641. doi: 10.1093/pm/pnab114.

Reference Type: BACKGROUND

PMID: 33760098 (View on PubMed)

Cotchett MP, Landorf KB, Munteanu SE, Raspovic AM. Consensus for dry needling for plantar heel pain (plantar fasciitis): a modified Delphi study. Acupunct Med. 2011 Sep;29(3):193-202. doi: 10.1136/aim.2010.003145. Epub 2011 Apr 18.

Reference Type: BACKGROUND

PMID: 21504939 (View on PubMed)

Other Identifiers

ChineseUHK2022

Identifier Type: -

Identifier Source: org_study_id