Effects on deep dry needling of the TIBIALIS posterior muscle on plantar pressure distribution: A single-blinded randomized controlled baropodometric trial

Introduction: Myofascial trigger points (MTrPs) in the tibialis posterior muscle (TP) can create a TP dysfunction, leading to alterations in plantar pressure distribution and foot loading patterns. These alterations can be objectively evaluated through baropodometric analysis. Our hypothesis was that the application of Deep dry needling (DDN) to the TP latent trigger points (LTrPs), may reverse these changes. Objective: to investigate whether changes in plantar pressure distribution occur after the application of DDN to the TP in individuals with LTrPs, to identify the specific areas where these changes take place and to assess their persistence over time. Material and methods: A single-blind randomized controlled trial was performed. Eighty-two individuals were randomly assigned to receive either DDN (n = 48) or simulated DDN (n = 34) on the MTrPs of the TP. Participants were evaluated using dynamic baropodometry prior the procedure, immediately after, and 24 and 72 hours after. Results: Immediately after the intervention, a significant increase in rearfoot pressure was observed in the experimental group. Twenty-four hours after, this group showed an increase in mean plantar pressure, a decrease in mean pressure surface, and a decrease in forefoot contact surface. Seventy-two hours after, no significant differences with the pre-intervention data were observed for any of the variables compared. Conclusion: A single session of DDN applied to a latent myofascial trigger point in the tibialis posterior muscle produces transient changes in plantar pressure distribution, reducing foot pronation and ankle valgus. These effects peak immediately and at 24 hours but are not sustained at 72 hours. DDN may be useful as an adjunctive technique in the management of tibialis posterior dysfunction, although multi-session protocols combined with other interventions should be investigated. ClinicalTrials.gov Identifier: NCT03756428