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Effects of Trigger Point Dry Needling for the Management of Knee Pain Syndromes: A Systematic Review and Meta-Analysis

Escuela Internacional de Doctorado, Universidad Rey Juan Carlos (URJC), Alcorcón, 28922 Madrid, Spain
Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
Rehabilitación San Fernando, 28807 Madrid, Spain
Clínica Dinamia Fisioterapia, 28806 Madrid, Spain
Doctor of Physical Therapy Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Faculty of Health Sciences, Universidad Rey Juan Carlos (URJC), Alcorcón, 28922 Madrid, Spain
Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(7), 2044;
Received: 6 May 2020 / Revised: 23 June 2020 / Accepted: 25 June 2020 / Published: 29 June 2020
Background: To evaluate the effect of trigger point dry needling alone or as an adjunct with other interventions on pain and related disability in people with knee pain. Methods: Several electronic databases were searched for randomized controlled trials where at least one group received dry needling for knee pain. Studies had to include human subjects and collect outcomes on pain and pain-related disability in musculoskeletal knee pain. Data were extracted by two reviewers. The risk of bias was assessed by the Cochrane Guidelines, methodological quality was assessed with the Physiotherapy Evidence Database (PEDro) score, and the quality of evidence by using the GRADE approach. Standardized mean differences (SMD) were calculated. Results: Ten studies (six patellofemoral pain, two knee osteoarthritis, two post-surgery knee pain) were included. The meta-analysis found moderate effect sizes of dry needling for reducing pain (SMD −0.53, 95% CI −0.87 to −0.19) and improving related disability (SMD −0.58, 95% CI −1.08 to −0.09) as compared to a comparison group at short-term. The main effect was observed for patellofemoral pain (SMD −0.64, 95% CI −1.17 to −0.11). No significant effects were observed at mid- or long-term follow-ups. The risk of bias was generally low, but the heterogenicity and the imprecision of the results downgraded the level of evidence. Conclusion: Low to moderate evidence suggests a positive effect of trigger point dry needling on pain and related disability in patellofemoral pain, but not knee osteoarthritis or post-surgery knee pain, at short-term. More high-quality trials investigating long-term effects are clearly needed. View Full-Text
Keywords: dry needling; knee pain; musculoskeletal pain; meta-analysis dry needling; knee pain; musculoskeletal pain; meta-analysis
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Rahou-El-Bachiri, Y.; Navarro-Santana, M.J.; Gómez-Chiguano, G.F.; Cleland, J.A.; López-de-Uralde-Villanueva, I.; Fernández-de-las-Peñas, C.; Ortega-Santiago, R.; Plaza-Manzano, G. Effects of Trigger Point Dry Needling for the Management of Knee Pain Syndromes: A Systematic Review and Meta-Analysis. J. Clin. Med. 2020, 9, 2044.

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