Journal of Pain Research (Mar 2024)

Dry Needling with the Use of FRSc Technique in Addition to Standard Rehabilitation Program for Chronic Low Back Pain: A Randomized Controlled Trial Using Both PROMs and Measurement Tools

  • Rajfur J,
  • Rajfur K,
  • Matusz T,
  • Malarska M,
  • Walewicz K,
  • Ptaszkowski K,
  • Dymarek R,
  • Taradaj J

Journal volume & issue
Vol. Volume 17
pp. 1041 – 1053

Abstract

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Joanna Rajfur,1 Katarzyna Rajfur,1 Tomasz Matusz,1 Maria Malarska,2 Karolina Walewicz,3 Kuba Ptaszkowski,4 Robert Dymarek,4 Jakub Taradaj5 1Institute of Health Sciences, University of Opole, Opole, 45-040, Poland; 2Department of Clinical Genetics, Medical University of Lodz, Lodz, 90-419, Poland; 3Department of Physiotherapy, Jan Grodek State University, Sanok, 38-500, Poland; 4Department of Physiotherapy, Wroclaw Medical University, Wroclaw, 50-368, Poland; 5Institute of Physiotherapy and Health Sciences, Academy of Physical Education, Katowice, 40-065, PolandCorrespondence: Joanna Rajfur, Institute of Health Sciences, University of Opole, Katowicka 68, Opole, 46-020, Poland, Tel +48 506 202 372, Email [email protected]: Dry needling (DN) has gained popularity for musculoskeletal conditions, but its commercial use often surpasses scientific evidence. The novel Five Regulatory Systems Concept (FRSc) of DN shows potential therapeutic mechanisms, including chronic low back pain (LBP). However, rigorous clinical assessment with patient-reported outcome measures (PROMs) and objective measures are necessary. This study aimed to evaluate the effect of DN according to pain levels, postural control and selected gait parameters in patients with chronic LBP.Patients and Methods: This prospective, double-blinded, randomized controlled study involved 30 patients with LBP allocated in the experimental (n=15, rehabilitation+ FRSc DN) or control group (n=15, rehabilitation + sham DN). The Roland-Morris questionnaire (RMQ) and Visual Analog Scale (VAS) were used as PROMs. Moreover, the posturography method for posture and balance control and the treadmill for gait analysis were used as objective tools. Measurements were taken before and immediately after the intervention and during 1- and 3-month follow up.Results: There was a statistically significantly greater improvement in the RMQ in the experimental group compared to the controls (p=0.923 before and p< 0.001 after treatment, as well as p< 0.001 after 1 and 3 months). Despite the favorable analgesic effect, a significant advantage of the experimental group over the controls in this respect is worth noting (p=0.001 in favor of DN in all intergroup comparisons concerning results from the subjective assessment of pain (VAS). A statistically insignificant post-treatment improvement in balance and postural stability was noted in both groups, although the effects appeared to be short-term. Surprisingly, again, DN had no advantage over sham interventions. In both groups, all changes in the swing phase were statistically insignificant (p=0.201 for the dominant and p=0.283 for the non-dominant side) for the initial swing phase. In both groups, all changes in the stance phase were statistically insignificant (p=0.480 for the dominant and p=0.410 for the non-dominant side of the body).Conclusion: DN based on the FRSc appears promising as an effective adjunct to standard rehabilitation for LBP, showing improvements in functional performance and pain reduction.Keywords: low back pain, dry needling, rehabilitation, postural control, gait analysis

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