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A Comparative Study of Two Dry Needling Interventions for Plantar Heel Pain

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ClinicalTrials.gov Identifier: NCT03236779
Recruitment Status : Active, not recruiting
First Posted : August 2, 2017
Last Update Posted : April 10, 2019
Sponsor:
Collaborators:
Universidad San Jorge
Ministry of Health, Kuwait
Information provided by (Responsible Party):
ZAID AL BOLOUSHI, Universidad de Zaragoza

Brief Summary:
This is a clinical trial that will be done in the state of Kuwait, at the physical rehabilitation medicine hospital. the participants will be recruited from all over Kuwait, there is a clinical registry upon the ethical committee in Kuwait assigned by the ministry of health.

Condition or disease Intervention/treatment Phase
Plantar Fascitis Myofacial Pain Syndromes Trigger Point Pain, Myofascial Other: dry needling Not Applicable

Detailed Description:

Physical therapy approaches continue evolving. During the last years, minimally invasive techniques such as percutaneous needle electrolysis (PNE) was being developed, obtaining promising results for tendon pathology. PNE technique is a minimally invasive treatment that consists of an application of a galvanic electrolytic current that causes a controlled local inflammatory process in the target tissue. This allows for phagocytosis and the subsequent regeneration of the affected tissue. Nowadays, PNE is being used in clinical practice to manage MTrP, but there are no studies supporting that they have an additional beneficial effect over DN.

From a biological point of view, it seems reasonable to ascertain that a patient will obtain benefits thanks to the mechanical effects provided by the needle and that patients may benefit more if the electrolysis effect is added to the mechanical stimuli provided by the needle. Therefore, the aim of this randomized controlled study is to compare the effectiveness of DN versus PNE for the level of pain in patients suffering from PHP.


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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 102 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: This study is a prospective, two parallel-groups (participant) randomized controlled trial with blinded outcome assessment at baseline, and at 4, 8, 12, 26 and 52 weeks. The study flow chart shown in Figure 1 conforms to the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines for nonpharmacological studies
Masking: Double (Participant, Outcomes Assessor)
Masking Description: Participants who fulfill the inclusion criteria will receive the standardized oral and written information, and, once they consent to participate in the trial, will be randomized in a block system by blocks of 10 patients. Allocation to the groups will be achieved using a computer program (Randomizer, https://www.randomizer.org/) generated a random patient file numbers sequence by a third person not involved in the study from the file section in Kuwait. This person will be responsible for guarding the envelope with the information of the randomization. The envelopes will be closed until the moment of the intervention to maintain the blinding. This professional also will ask the patients for informed consent. The consent form is recruited upon the ethical medical committee at the ministry of health in the state of Kuwait.
Primary Purpose: Treatment
Official Title: A Comparative Study of Two Dry Needling Interventions for Plantar Heel Pain: A Randomized Clinical Trial
Actual Study Start Date : January 14, 2018
Estimated Primary Completion Date : October 10, 2019
Estimated Study Completion Date : April 10, 2020

Arm Intervention/treatment
Experimental: Dry needling (DN) arm
Once the clinician locates the MTrP, he will insert the needle over it and he will do a quick entry of the needle. The chosen technique to manipulate the needle will be Hong technique, which consist of quick entry and exit of the needle (fast in/fast out) to get local twitch response (LTR), it will be repeated 5 times with a rhythmic movement of 1Hz/sec. LTRs will be counted and registered.
Other: dry needling
The electrotherapy equipment used (Enruf) produces a continuous galvanic current through the cathode (modified electrosurgical scalpel with the needle) while the patient holds the anode (handheld electrode) (42). Once the needle have reach the relevant treatment area, a continuous current of 3 pulses at an intensity of 3 1.5 mA for 5 seconds conveyed to the muscle will be applied.
Other Name: Percutaneous needle electrolysis

Active Comparator: Percutaneous needle electrolysis (PNE) arm
The electrotherapy equipment used (Enraf) produces a continuous galvanic current through the cathode (modified electrosurgical scalpel with the needle) while the patient holds the anode (handheld electrode). Once the needle have reach the relevant treatment area, a continuous current of 3 pulses at an intensity of 3, 1.5 mA for 5 seconds conveyed to the muscle will be applied. It will be done exactly the same way as in the DN group with the only difference that the needle will be transmitting the electrical current.
Other: dry needling
The electrotherapy equipment used (Enruf) produces a continuous galvanic current through the cathode (modified electrosurgical scalpel with the needle) while the patient holds the anode (handheld electrode) (42). Once the needle have reach the relevant treatment area, a continuous current of 3 pulses at an intensity of 3 1.5 mA for 5 seconds conveyed to the muscle will be applied.
Other Name: Percutaneous needle electrolysis




Primary Outcome Measures :
  1. Foot Health status questioner (FHSQ) [ Time Frame: 10 Minutes ]

Secondary Outcome Measures :
  1. VAS [ Time Frame: 5 Minute ]
    Participants will complete the visual analogue scale (VAS) before each treatment session, considering the level of pain they have just before start the treatment session and the highest level of pain they have had during the last 48 hours. The exact words of the questions will be: 1) what is the level of pain, as average, you have feel during last 48 hours?; and 2) what is the maximum level of pain you have feel during last 48 hours? Participants will be explained that a score of 0 indicates the absence of pain whereas a score of 10 represents the maximum tolerable pain. The VAS is widely used and is valid and reliable

  2. The Quality of Life (QoL) will be assessed with the EuroQoL-5 dimensions (EQ-5D [ Time Frame: 5 minute ]


Information from the National Library of Medicine

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Ages Eligible for Study:   21 Years to 60 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Clinical diagnosis of PHP in accordance with the Clinical Guidelines linked to the International Classification of Function, Disability, and Health from the Orthopedic Section of the American Physical Therapy Association
  • Age greater than 21 years according to the Kuwaiti law.
  • History of plantar heel pain for greater than one month.
  • Walking 50 meters without any support
  • Having MTPs on initial physical examination on plantar and calf muscles
  • Accepting to be treated by a male physiotherapist.
  • Capacity to understand the study and the informed consent, as well as having signed the document.

Exclusion Criteria:

  • - Needle phobia
  • Allergy from needles or hypersensitivity to metals
  • Presence of coagulopathy or use of anticoagulants
  • Presence of peripheral arterial vascular disease
  • Pregnancy
  • Dermatological disease with the dry needling area
  • The presence of a chronic medical condition that might preclude participation in the study such as malignancy, systemic inflammatory disorders (e.g. psoriatic arthritis, ankylosing spondylitis, septic arthritis), neurological diseases, polyneuropathy, mononeuropathy.
  • Treatment of plantar heel pain with needling or acupuncture during last 4 weeks.
  • A history of injection therapy in the heel in the previous three months.
  • Previous history of foot surgery or fracture.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03236779


Locations
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Kuwait
Physical Medicine and rehabilitation Kuwait
Kuwait, Kuwait
Sponsors and Collaborators
Universidad de Zaragoza
Universidad San Jorge
Ministry of Health, Kuwait

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: ZAID AL BOLOUSHI, PhD student, Universidad de Zaragoza
ClinicalTrials.gov Identifier: NCT03236779     History of Changes
Other Study ID Numbers: ALBOLOUSHI
First Posted: August 2, 2017    Key Record Dates
Last Update Posted: April 10, 2019
Last Verified: April 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: ACCORDING TO THE LAW AND REGULATIONS FROM THE ETHICAL COMMITTEE IN KUWAIT. I CAN'T SHARE THE NAME OF THE PATIENTS, THEIR CONTACT OR ID. OTHER DATA WHICH ARE RELATED TO THE STUDY I CAN SHARE.

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:
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Fasciitis
Fasciitis, Plantar
Facial Pain
Myofascial Pain Syndromes
Facial Neuralgia
Musculoskeletal Diseases
Foot Diseases
Pain
Neurologic Manifestations
Signs and Symptoms
Muscular Diseases
Facial Nerve Diseases
Mouth Diseases
Stomatognathic Diseases
Cranial Nerve Diseases
Nervous System Diseases