Anterior Cruciate Ligament Reconstruction Rehabilitation, Dry Needling, Strength
Conditions
Brief summary
Dry needling is a skilled intervention provided by trained physical therapists to treat pain, myofascial dysfunction, and a variety of other diagnosis. While there is research demonstrating the benefits of dry needling in reduction of pain and improvement in strength, research in regards the pediatric population is very limited. A recent retrospective chart review regarding dry needling trends and outcomes in the pediatric orthopedic population showed the pediatric population is tolerating this treatment and seeing benefits. Physical therapists are already pushing the boundaries and finding additional benefits in the use of dry needling with current patients. A diagnosis frequently seen in sports medicine is surgical reconstruction of the anterior cruciate ligament (ACL). Over the last couple of years, therapists have seen an increase in the use of quadriceps tendon autograft for reconstruction following ACL tears due to lower incidence rate of retears. Patients have been struggling to regain strength of the quadriceps to meet desired outcomes. The quadricep muscles are one of the major stabilizers of the knee and with a reduction in strength places the patient at a significant increase of retear. Subjects will be categorized into an experimental group (dry needling intervention + physical therapy) or the control group (physical therapy only) with a N of 20 in each group. The goal for this research is to determine if dry needling use in the subacute phase of post-operative ACLR following quadriceps autograft can assist with increasing quad strength and improve post-surgical outcomes.
Interventions
PROCEDUREDry Needling
Dry needling is defined as a skilled intervention that utilizes a thin filiform needle to stimulate underlying myofascial trigger points, muscular, and connective tissue in managing pain and movement dysfunction. For the Intervention Group, dry needling will be completed to the quadriceps as stated below. Two sessions of dry needling will be done once per week starting in week 6 and finishing by end of week 7. The patient will be laying in supine. Needles will be placed in the quadriceps muscle. Placement will be at identified trigger points or in mid muscle belly if no trigger point is identified. Electrical stimulation will be applied and increased to an intensity of the patient's tolerance with a visual contraction noted. Electrical stimulation will remain on for 5 minutes.
Sponsors
Children's Mercy Hospital Kansas City
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
10 Years to 20 Years
Healthy volunteers
No
Inclusion criteria
* Status post subacute quadriceps autograft 6 weeks or less * Ages 10-20 years * English and/or Spanish speaking
Exclusion criteria
* History of surgery on the knee or hip on the testing lower extremity. * Any surgical intervention to other ligamentous or meniscus structures during time of ACLR * Any post-surgical complications such as infection * Current pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Quadriceps Muscle Strength | Muscle strength measurements taken at post-operative week 6, 7, and 9. | Muscle strength measurement will be taken with use of the handheld dynamometer and use of stabilizing gait belt. A max force production will be created over three seconds. Three trials will be recorded, and average will be used as the final number. For the intervention group, measurements will be taken immediately prior to dry needling and immediately following dry needling for both sessions of intervention (week 6 and week 7). Additional post intervention measurements will be taken 2 weeks following dry needling intervention (week 9). For the Control Group, measurements will be taken during week 6, week 7, and week 9. Measurements will be taken at the start of the physical therapy visit. |
Countries
United States
Contacts
CONTACTMellony J Mann, DPT
CONTACTShannon R Margherio, PT
PRINCIPAL_INVESTIGATORMellony J Mann, DPT
Children's Mercy Hospital Kansas City
Outcome results
None listed