Biomechanical Profile after Dry Needling in Mixed Martial
                    Arts

Robert Trybulski; Adrian Kużdżał; Arkadiusz Stanula; Sebastian Klich; Filipe Manuel Clemente; Adam Kawczyński; Cesar Fernández-de-las-Peñas

doi:10.1055/a-2342-3679

International Journal of Sports Medicine, Inhaltsverzeichnis

Int J Sports Med 2024; 45(13): 968-979
DOI: 10.1055/a-2342-3679

Physiology & Biochemistry

Biomechanical Profile after Dry Needling in Mixed Martial Arts

Robert Trybulski

¹Department of Medical Sciences, Department of Medical Sciences, The Wojciech Korfanty School of Economics, 40-065 Katowice, Poland

,

Adrian Kużdżał

²Institute of Health Sciences, College of Medical Sciences, Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, Rejtana Street 16C, 35-959 Rzeszow, Poland

,

Arkadiusz Stanula

³Laboratory of Sport Performance Analysis, Institute of Sport Sciences, Laboratory of Sport Performance Analysis, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Mikolowska Street 72a, 40-065 Katowice, Poland

,

Sebastian Klich

⁴Department of Paralympic Sport, Department of Paralympic Sport, Wrocław University of Health and Sport Sciences, 51-612 Wrocław, Poland

,

Filipe Manuel Clemente

⁵Sports Sciences, Instituto Politécnico de Viana do Castelo Escola Superior de Desporto e Lazer, Melgaco, Portugal

⁶Department of Biomechanics and Sport Engineering, Gdansk University of Physical Education and Sport, Gdansk, Poland

,

Adam Kawczyński

⁷Department of Biomechanics and Sport Engineering, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Gdansk, Poland

⁸Departament of Paralympic Games, Wrocław University of Health and Sport Sciences, Departament of Paralympic Games, Wrocław, Poland

,

Cesar Fernández-de-las-Peñas

⁹Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcon, Spain

› Institutsangaben

Abstract

The purpose of this study was to compare the effects of dry needling (DN) intervention on the responses of muscle tone, stiffness, and elasticity, as well as power, pressure pain thresholds, and blood perfusion of the flexor carpi radialis muscle in mixed martial arts (MMA) athletes. Thirty-two trained/developmental men MMA fighters (25.5±4.5 years; 24.5±3 body mass index) participated in a randomized crossover study. Participants underwent a single intervention, receiving both DN and placebo. Laser Doppler flowmetry measured blood perfusion, while a myotonometer assessed the mechanical characteristics of muscle tone, stiffness, and elasticity of the flexor carpi radialis muscle. Pressure pain thresholds (PPT) were measured using an algometer, and maximal forearm muscle force was measured using a hand dynamometer. Outcomes were assessed at baseline, immediately after, and 24 hours and 48 hours post-intervention. A two-way repeated-measures ANOVA revealed significant Intervention*Time interaction for all outcomes: perfusion unit (p<0.001), muscle tone (p<0.001), stiffness (p<0.001), elasticity (p<0.001), PPT (p<0.001) and maximal forearm muscle force (p<0.001). The current study suggests that a single session of DN enhances muscle recovery, increases muscle strength, and improved PPT in MMA athletes. These positive adaptations appear to last up to 48 hours in some variables.

Keywords

physical therapy modalities - therapeutics - muscle strength - sports medicine

Volltext

Referenzen

References
1 Andrade A, Flores MA, Andreato LV. et al. Physical and Training Characteristics of Mixed Martial Arts Athletes: Systematic Review. Strength Cond J 2019; 41: 51-63
2 Kirk C, Clark DR, Langan-Evans C. et al. The physical demands of mixed martial arts: A narrative review using the ARMSS model to provide a hierarchy of evidence. J Sports Sci 2020; 38: 2819-2841
3 Alm P. Physiological Characters in Mixed Martial Arts. Am J Sports Sci 2013; 1: 12
4 Slimani M, Davis P, Franchini E. et al. Rating of Perceived Exertion for Quantification of Training and Combat Loads During Combat Sport-Specific Activities. J Strength Cond Res 2017; 31: 2889-2902
5 Ballyns JJ, Turo D, Otto P. et al. Office-Based Elastographic Technique for Quantifying Mechanical Properties of Skeletal Muscle. J Med Ultrasound 2012; 31: 1209-1219
6 Kelly JP, Koppenhaver SL, Michener LA. et al. Characterization of tissue stiffness of the infraspinatus, erector spinae, and gastrocnemius muscle using ultrasound shear wave elastography and superficial mechanical deformation. J Electromyogr Kinesiol 2018; 38: 73-80
7 Coswig VS, Ramos S, de P, Del Vecchio FB. Time-Motion and Biological Responses in Simulated Mixed Martial Arts Sparring Matches. J Strength Cond Res 2016; 30: 2156-2163
8 Fricton J. Myofascial Pain. Oral Maxillofac Surg Clin North Am 2016; 28: 289-311
9 Gattie E, Cleland JA, Snodgrass S. The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther 2017; 47: 133-149
10 Fernández-de-Las-Peñas C, Nijs J. Trigger point dry needling for the treatment of myofascial pain syndrome: Current perspectives within a pain neuroscience paradigm. J Pain Res 2019; 12: 1899-1911
11 APTA. Physical therapists & the performance of dry needling: An educational resource paper. Alexandria, VA, USA: APTA Department of Practice and APTA State Government Affairs; 2012
12 Roch M, Morin M, Gaudreault N. Immediate Effect of Dry Needling on the Viscoelastic Properties of a Trigger Point on the Infraspinatus Muscle Measured with MyotonPRO. Physiotherapy Canada 2022; 74: 232-239
13 Sánchez-Infante J, Bravo-Sánchez A, Jiménez F. et al. Effects of dry needling on mechanical and contractile properties of the upper trapezius with latent myofascial trigger points: A randomized controlled trial. Musculoskelet Sci Pract 2021; 56: 102456
14 Roch M, Morin M, Gaudreault N. Immediate Effect of Dry Needling on the Viscoelastic Properties of a Trigger Point on the Infraspinatus Muscle Measured with MyotonPRO. Physiother Can 2022; 74: 232-239
15 Ding CL, Ma YT, Huang QM. et al. Effect of Dry Needling Stimulation of Myofascial Trigger Point on Sample Entropy of Electromyography of Gastrocnemius Injured Site in Rats. Zhen Ci Yan Jiu 2018; 43: 127-132
16 Walsh R, Kinsella S, McEvoy J. The effects of dry needling and radial extracorporeal shockwave therapy on latent trigger point sensitivity in the quadriceps: A randomised control pilot study. J Bodyw Mov Ther 2019; 23: 82-88
17 Pérez-Bellmunt A, Casasayas-Cos O, López-de-Celis C. et al. Effects of Dry Needling of Latent Trigger Points on Viscoelastic and Muscular Contractile Properties: Preliminary Results of a Randomized Within-Participant Clinical Trial. J Clin Med 2021; 10: 3848
18 Bandy WD, Nelson R, Beamer L. Comparison of dry needling vs. sham on the performance of vertical jump. Int J Sports Phys Ther 2017; 12: 747-751
19 Haser C, Stoggl T, Kriner M. et al. Effect of Dry Needling on Thigh Muscle Strength and Hip Flexion in Elite Soccer Players. Med Sci Sports Exerc 2017; 49: 378-383
20 Ceballos-Laita L, Medrano-de-la-Fuente R, Estébanez-De-Miguel E. et al. Effects of Dry Needling in Teres Major Muscle in Elite Handball Athletes. A Randomised Controlled Trial. J Clin Med 2021; 10: 4260
21 Mansfield CJ, Vanetten L, Willy R. et al. The Effects of Needling Therapies on Muscle Force Production: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther 2019; 49: 154-170
22 Trybulski R, Stanula A, Żebrowska A. et al. Acute Effects of the Dry Needling Session on Gastrocnemius Muscle Biomechanical Properties, and Perfusion with Latent Trigger Points – A Single-Blind Randomized Controlled Trial in Mixed Martial Arts Athletes. J Sports Sci Med 2024; 136-146
23 Tang C-T, Song B. Acupuncture and Dry Needling for Sports Performance and Recovery. Curr Sports Med Rep 2022; 21: 213-218
24 Ghoul N, Tabben M, Miarka B. et al. Mixed Martial Arts Induces Significant Fatigue and Muscle Damage Up to 24 Hours Post-combat. J Strength Cond Res 2019; 33: 1570-1579
25 Tabben M, Ihsan M, Ghoul N. et al. Cold Water Immersion Enhanced Athletes’ Wellness and 10-m Short Sprint Performance 24-h After a Simulated Mixed Martial Arts Combat. Front Physiol 2018; 9: 1542
26 Cushman DM, Cummings K, Skinner L. et al. Postrace Dry Needling Does Not Reduce Subsequent Soreness and Cramping—A Randomized Controlled Trial. Clin J Sport Med 2021; 31: 225-231
27 Janowski JA, Phelan-Smith DML, Kroat Brady MN. et al. Acute Effects of Dry Needling on Myofascial Trigger Points in the Triceps Surae of Ballet Dancers: A Pilot Randomized Controlled Trial. Int J Sports Phys Ther 2021; 16: 418-430
28 Hong C-Z. Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil 1994; 73: 256-263
29 Perreault T, Dunning J, Butts R. The local twitch response during trigger point dry needling: Is it necessary for successful outcomes?. J Bodyw Mov Ther 2017; 21: 940-947
30 Fernández-de-las-Peñas C, Plaza-Manzano G, Sanchez-Infante J. et al. The importance of the local twitch response during needling interventions in spinal pain associated with myofascial trigger points: A systematic review and meta-analysis. Acupuncture Med 2022; 40: 299-311
31 Braithwaite FA, Walters JL, Li LSK. et al. Blinding Strategies in Dry Needling Trials: Systematic Review and Meta-Analysis. Phys Ther 2019; 99: 1461-1480
32 Liana R, Chudański M, Ponikowska I. Standardisation of laser Doppler flowmetry-own standards. Clin Diabetology 2009; 10: 58-64
33 Wright CI, Kroner CI, Draijer R. Non-invasive methods and stimuli for evaluating the skin’s microcirculation. J Pharmacol Toxicol Methods 2006; 54: 1-25
34 Rodrigues LM, Rocha C, Ferreira H. et al. Different lasers reveal different skin microcirculatory flowmotion – data from the wavelet transform analysis of human hindlimb perfusion. Sci Rep 2019; 9: 16951
35 Davidson MJ, Bryant AL, Bower WF. et al. Myotonometry Reliably Measures Muscle Stiffness in the Thenar and Perineal Muscles. Physiotherapy Canada 2017; 69: 104-112
36 Melo ASC, Cruz EB, Vilas-Boas JP. et al. Scapular Dynamic Muscular Stiffness Assessed through Myotonometry: A Narrative Review. Sensors 2022; 22: 2565
37 Bartsch K, Brandl A, Weber P. et al. Assessing reliability and validity of different stiffness measurement tools on a multi-layered phantom tissue model. Sci Rep 2023; 13: 815
38 Butler RJ, Crowell HP, Davis IM. Lower extremity stiffness: Implications for performance and injury. Clin Biomech 2003; 18: 511-517
39 Fernández-Lao C, Cantarero-Villanueva I, Fernández-De-Las-Peñas C. et al. Myofascial trigger points in neck and shoulder muscles and widespread pressure pain hypersensitivity in patients with postmastectomy pain: Evidence of peripheral and central sensitization. Clin J Pain 2010; 26: 798-806
40 Zebrowska A, Trybulski R, Roczniok R. et al. Effect of Physical Methods of Lymphatic Drainage on Postexercise Recovery of Mixed Martial Arts Athletes. Clin J Sport Med 2019; 29: 49-56
41 Hopkins WG, Marshall SW, Batterham AM. et al. Progressive Statistics for Studies in Sports Medicine and Exercise Science. Med Sci Sports Exerc 2009; 41: 3-13
42 Cagnie B, Dewitte V, Barbe T. et al. Physiologic Effects of Dry Needling. Curr Pain Headache Rep 2013; 17: 348
43 Simon AM, McWhorter AR. Vascular Abnormalities in Mice Lacking the Endothelial Gap Junction Proteins connexin37 and connexin40. Dev Biol 2002; 251: 206-220
44 Ohkubo M, Hamaoka T, Niwayama M. et al. Local increase in trapezius muscle oxygenation during and after acupuncture. Dynamic Med 2009; 8: 2
45 Sandberg M, Larsson B, Lindberg L. et al. Different patterns of blood flow response in the trapezius muscle following needle stimulation (acupuncture) between healthy subjects and patients with fibromyalgia and work-related trapezius myalgia. Euro J Pain 2005; 9: 497-497
46 Liu L, Huang Q-M, Liu Q-G. et al. Effectiveness of Dry Needling for Myofascial Trigger Points Associated With Neck and Shoulder Pain: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil 2015; 96: 944-955
47 Jiang F, Yu S, Su H. et al. Assessment of the effects of ischaemia/ hypoxia on angiogenesis in rat myofascial trigger points using colour Doppler flow imaging. PeerJ 2020; 8: e10481
48 Simons DG, Hong C-Z, Simons LS. Endplate Potentials Are Common to Midfiber Myofacial Trigger Points. Am J Phys Med Rehabil 2002; 81: 212-222
49 Bueno JCA, Faro H, Lenetsky S. et al. Exploratory Systematic Review of Mixed Martial Arts: An Overview of Performance of Importance Factors with over 20,000 Athletes. Sports 2022; 10: 80
50 Kietrys DM, Palombaro KM, Azzaretto E. et al. Effectiveness of Dry Needling for Upper-Quarter Myofascial Pain: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther 2013; 43: 620-634
51 Meerits T, Bacchieri S, Pääsuke M. et al. Acute effect of static and dynamic stretching on tone and elasticity of hamstring muscle and on vertical jump performance in track-and-field athletes. Acta Kinesiol Univ Tartu 2014; 20: 48
52 Feng YN, Li YP, Liu CL. et al. Assessing the elastic properties of skeletal muscle and tendon using shearwave ultrasound elastography and MyotonPRO. Sci Rep 2018; 8: 17064
53 Baraja-Vegas L, Martín-Rodríguez S, Piqueras-Sanchiz F. et al. Localization of Muscle Edema and Changes on Muscle Contractility After Dry Needling of Latent Trigger Points in the Gastrocnemius Muscle. Pain Med 2019; 20: 1387-1394
54 Gervasi M, Benelli P, Venerandi R. et al. Relationship between Muscle-Tendon Stiffness and Drop Jump Performance in Young Male Basketball Players during Developmental Stages. Int J Environ Res Public Health 2022; 19: 17017
55 Schneider E, Moore ES, Stanborough R. et al. Effects of Trigger Point Dry Needling on Strength Measurements and Activation Levels of the Gluteus Medius: A Quasi-Experimental Randomized Control Study. Int J Sports Phys Ther 2022; 17: 1404-1416
56 Castro Sánchez AM, García López H, Fernández Sánchez M. et al. Improvement in clinical outcomes after dry needling versus myofascial release on pain pressure thresholds, quality of life, fatigue, pain intensity, quality of sleep, anxiety, and depression in patients with fibromyalgia syndrome. Disabil Rehabil 2019; 41: 2235-2246
57 Unverzagt C, Berglund K, Thomas JJ. Dry needling for myofascial trigger point pain: A clinical commentary. Int J Sports Phys Ther 2015; 10: 402-418
58 Hsieh Y-L, Hong C-Z, Liu S-Y. et al. Acupuncture at Distant Myofascial Trigger Spots Enhances Endogenous Opioids in Rabbits: A Possible Mechanism for Managing Myofascial Pain. Acupuncture Med 2016; 34: 302-309
59 Zhang Q, Zhou M, Huo M. et al. Mechanisms of acupuncture-electroacupuncture on inflammatory pain. Mol Pain 2023; 19
60 Ma X, Chen W, Yang N-N. et al. Potential mechanisms of acupuncture for neuropathic pain based on somatosensory system. Front Neurosci 2022; 16
61 Hsieh M-C, Wang S-H, Chuah S-K. et al. A Prognostic Model Using Inflammation- and Nutrition-Based Scores in Patients With Metastatic Gastric Adenocarcinoma Treated With Chemotherapy. Medicine 2016; 95: e3504
62 Domingo A, Mayoral O, Monterde S. et al. Neuromuscular Damage and Repair after Dry Needling in Mice. Evidence-Based Complementary Alter Med 2013; 2013: 1-10