Dry Needling for Spine Related Disorders: a Scoping Review

Introduction/Background: The depth and breadth of research on dry needling (DN) has not been evaluated specifically for symptomatic spine related disorders (SRD) from myofascial trigger points (TrP), disc, nerve and articular structures not due to serious pathologies. Current literature appears to support DN for treatment of TrP. Goals of this review include identifying research published on DN treatment for SRD, sites of treatment and outcomes studied. Methods: A scoping review was conducted following Levac et al.’s five part methodological framework to determine the current state of the literature regarding DN for patients with SRD. Results: Initial and secondary search strategies yielded 55 studies in the cervical (C) region (71.43%) and 22 in the thoracolumbar-pelvic (TLP) region (28.57%). Most were randomized controlled trials (60% in C, 45.45% in TLP) and clinical trials (18.18% in C, 22.78% in TLP). The most commonly treated condition was TrP for both the C and TLP regions. In the C region, DN was provided to 23 different muscles, with the trapezius as treatment site in 41.88% of studies. DN was applied to 31 different structures in the TLP region. In the C region, there was one treatment session in 23 studies (41.82%) and 2–6 treatments in 25 (45.45%%). For the TLP region, one DN treatment was provided in 8 of the 22 total studies (36.36%) and 2–6 in 9 (40.9%). The majority of experimental designs had DN as the sole intervention. For both C and TLP regions, visual analogue scale, pressure pain threshold and range of motion were the most common outcomes. Conclusion: For SRD, DN was primarily applied to myofascial structures for pain or TrP diagnoses. Many outcomes were improved regardless of diagnosis or treatment parameters. Most studies applied just one treatment which may not reflect common clinical practice. Further research is warranted to determine optimal treatment duration and frequency. Most studies looked at DN as the sole intervention. It is unclear whether DN alone or in addition to other treatment procedures would provide superior outcomes. Functional outcome tools best suited to tracking the outcomes of DN for SRD should be explored.https://doi.org/10.1186/s12998-020-00310-

patients with axial psoriatic arthritis

Objectives In this study, we aimed to evaluate the effect of gender on clinical findings, disease activity, functional status and quality of life in patients with axial involvement in Turkey. Methods Patients with PsA who met the CASPAR classification criteria were enrolled consequently in this cohort. Turkish League Against Rheumatism (TLAR)-Network was formed with the participation of 25 centres. The demographic variables, fatigue, diagnostic delay, the beginning of peripheral arthritis, enthesitis, dactylitis and spine involvement, inflammatory low back pain, BASFI, HAQ, HAQ-s, visual analogue scale-pain (VAS-pain), anxiety, depression and disease activity parameters (ESR, DAS28, BASDAI) were recorded. Axial involvement was assessed according to clinical and radiological data according to modified New York (MNYC) or Assessment of SpondyloArthritis international Society (ASAS) criteria. Results A total of 1018 patients with PsA were included in this study. Of the 373 patients with axial involvement, 150 were male (40.2%) and 223 (59.8%) were female. Spondylitis was detected in 14,7% of men and 21,9% of women in all patients. Pain score (VAS) (p < .002), fatigue (p < .001), ESR (p < .001), DAS28 (p < .001), BASDAI score (p < .001), PsAQoL (p < .001), HAQ score (p < ,01), HAQ-S score (p < .001), anxiety (p < .001), depression (p < .024), FACIT (p < .001) and FiRST (p < .001) scores were statistically significantly worse in women than males with axial PsA. However, quality of life was better (p < .001) and PASI score (p < .005) were statistically worse in male patients than in female patients with axial involvement. Conclusion This study has shown that the burden of disease in axial PsA has significant difference between genders. Disease activity, physical disability, functional limitation, depression and anxiety scores were higher in female patients, while quality of life were better and PASI score were higher in male patients. Therefore, we suggest that new strategies should be developed for more effective treatment of axial PsA in female patients.C1 [Nas, Kemal; Tekeoglu, Ibrahim; Baykul, Merve; Kamanli, Ayhan] Sakarya Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol & Immunol, Sakarya, Turkey.[Kilic, Erkan] Kanuni Training & Res Hosp, Rheumatol Clin, Trabzon, Turkey.[Keskin, Yasar; Kucukakkas, Okan; Yurdakul, Ozan Volkan] Bezmialem Fdn Univ, Dept Phys Med & Rehabil, Istanbul, Turkey.[cevik, Remzi] Dicle Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Diyarbakir, Turkey.[Sargin, Betul; Sendur, Omer Faruk] Adnan Menderes Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Aydin, Turkey.[Acer Kasman, Sevtap; Duruoz, Mehmet Tuncay] Marmara Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Istanbul, Turkey.[Alkan, Hakan] Pamukkale Univ, Sch Med, Dept Phys Med & Rehabil, Denizli, Turkey.[Sahin, Nilay] Balikesir Univ, Sch Med, Dept Phys Med & Rehabil, Balikesir, Turkey.[Cengiz, Gizem] Univ Hlth Sci, Van Training & Res Hosp, Rheumatol Clin, Van, Turkey.[Cuzdan, Nihan] Balikesir Ataturk City Hosp, Rheumatol Clin, Balikesir, Turkey.[Albayrak Gezer, Ilknur] Selcuk Univ, Sch Med, Dept Phys Med & Rehabil, Konya, Turkey.[Keskin, Dilek] Kirikkale Univ, Sch Med, Dept Phys Med & Rehabil, Kirikkale, Turkey.[Mulkoglu, Cevriye] Ankara Numune Training & Res Hosp, Dept Phys Med & Rehabil, Ankara, Turkey.[Resorlu, Hatice] Canakkale Onsekiz Mart Univ, Sch Med, Dept Phys Med & Rehabil, Canakkale, Turkey.[Ataman, Sebnem] Ankara Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Ankara, Turkey.[Bal, Ajda] Univ Hlth Sci, Diskapi Yildirim Beyazit Training & Res Ho, Dept Phys Med & Rehabil, Ankara, Turkey.[Alkan Melikoglu, Meltem] Ataturk Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Erzurum, Turkey.[Ayhan, Fikriye Figen] Atilim Univ, Med Sch, Dept Phys Med & Rehabil, Ankara, Turkey.[Bodur, Hatice] Yildirim Beyazit Univ, Sch Med, Dept Phys Med & Rehabil, Ankara, Turkey.[Calis, Mustafa] Erciyes Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Kayseri, Turkey.[Capkin, Erhan] Karadeniz Tech Univ, Sch Med, Dept Phys Med & Rehabil, Trabzon, Turkey.[Devrimsel, Gul] Recep Tayyip Erdogan Univ, Sch Med, Dept Phys Med & Rehabil, Rize, Turkey.[Gok, Kevser] Ankara City Hosp, Rheumatol Clin, Ankara, Turkey.[Hizmetli, Sami] Cumhuriyet Univ Sivas, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Sivas, Turkey.[Kocabas, Hilal] Necmettin Erbakan Univ, Meram Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Konya, Turkey.[Kutluk, Oznur; Tuncer, Tiraje] Akdeniz Univ, Sch Med, Dept Phys Med & Rehabil, Div Rheumatol, Antalya, Turkey.[Sen, Nesrin] Kartal Dr Lutfi Kirdar Training & Res Hosp, Dept Rheumatol, Istanbul, Turkey.[Toprak, Murat] Yuzuncu Yil Univ, Sch Med, Dept Phys Med & Rehabil, Van, Turkey.[Tolu, Sena] Medipol Univ, Sch Med, Dept Phys Med & Rehabil, Istanbul, Turkey