Effects of Dry Needling on Latent Myofascial Trigger Points of the Extensor Digitorum Communis

Myofascial trigger points are hyperirritable spots located within a taut band of skeletalmuscle. Latent myofascial trigger points do not cause spontaneous pain but may contributeto motor dysfunction, increased fatigability, reduced range of motion, and altered muscleperformance. Dry needling is a commonly used physiotherapy technique for the treatment ofmyofascial trigger points. However, post‐needling soreness is one of the most frequentadverse effects associated with this intervention and may influence patient comfort,adherence, and functional performance in the hours following treatment.Electrical dry needling, also known as intramuscular electrical stimulation, combines dryneedling with transcutaneous electrical nerve stimulation applied through the insertedneedle. Different modalities of electrical dry needling are used in clinical practice,including bipolar and monopolar applications. Nevertheless, limited evidence is availableregarding the effect of these techniques on post‐needling soreness, particularly whenshort‐duration monopolar stimulation is applied using a pointer‐type device.The aim of this randomized single‐blind clinical trial is to compare the effects ofdifferent dry needling and electrical dry needling techniques applied to latentmyofascial trigger points in the extensor digitorum muscle of the dominant forearm inhealthy adults. The primary objective is to compare the effect of electrical dry needlingversus Hong fast‐in and fast‐out dry needling on the intensity and duration ofpost‐needling soreness. Secondary objectives include comparing post‐needling sorenessamong the different dry needling techniques, analyzing immediate changes in handgripstrength, assessing changes in finger flexion and wrist palmar flexion range of motion,evaluating pain during the needling procedure, assessing pressure pain threshold byalgometry, and analyzing perceived comfort and interference of post‐needling sorenesswith daily activities.Healthy adults with a latent myofascial trigger point in the extensor digitorum muscle ofthe dominant forearm will be recruited. Participants will be randomly assigned to one offive groups: control group, Hong fast‐in and fast‐out dry needling group, rotational dryneedling group, bipolar electrical dry needling group, or monopolar electrical dryneedling group. Participants in the control group will not receive any dry needlingintervention but will undergo the same assessment schedule as the intervention groups.In the Hong fast‐in and fast‐out dry needling group, a sterile needle will be insertedinto the latent myofascial trigger point and repeated fast‐in and fast‐out movements willbe performed. In the rotational dry needling group, a sterile needle will be insertedinto the latent myofascial trigger point and a rotational dry needling technique will beapplied according to the study protocol. In the bipolar electrical dry needling group, asterile needle will be inserted into the latent myofascial trigger point, an adhesiveelectrode will be placed near the needle, and a TENS current will be applied for 15minutes. In the monopolar electrical dry needling group, a sterile needle will beinserted into the latent myofascial trigger point and stimulation will be applied using aPointer Plus Excel‐II device for 3 minutes.Outcome assessments will be performed at baseline and 5 minutes after the intervention.Post‐needling soreness intensity and duration will also be recorded at 24, 48, and 72hours after the intervention. The study will use separated roles for recruitment,assessment, intervention delivery, and data analysis in order to reduce bias. Outcomeassessors and the researcher responsible for data analysis will be blinded to groupallocation.