Effectiveness of dry needling and injections of myofascial trigger points associated with plantar heel pain: a systematic review

<p>Abstract</p> <p>Background</p> <p>Plantar heel pain (plantar fasciitis) is one of the most common musculoskeletal pathologies of the foot. Plantar heel pain can be managed with dry needling and/or injection of myofascial trigger points (MTrPs) however the evidence for its effectiveness is uncertain. Therefore, we aimed to systematically review the current evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain.</p> <p>Methods</p> <p>We searched specific electronic databases (MEDLINE, EMBASE, AMED, CINAHL, SPORTDiscus and AMI) in April 2010 to identify randomised and non-randomised trials. We included trials where participants diagnosed with plantar heel pain were treated with dry needling and/or injections (local anaesthetics, steroids, Botulinum toxin A and saline) alone or in combination with acupuncture. Outcome measures that focussed on pain and function were extracted from the data. Trials were assessed for quality using the Quality Index tool.</p> <p>Results</p> <p>Three quasi-experimental trials matched the inclusion criteria<it>: </it>two trials found a reduction in pain for the use of trigger point dry needling when combined with acupuncture and the third found a reduction in pain using 1% lidocaine injections when combined with physical therapy. However, the methodological quality of the three trials was poor, with Quality Index scores ranging form 7 to 12 out of a possible score of 27. A meta-analysis was not conducted because substantial heterogeneity was present between trials.</p> <p>Conclusions</p> <p>There is limited evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. However, the poor quality and heterogeneous nature of the included studies precludes definitive conclusions being made. Importantly, this review highlights the need for future trials to use rigorous randomised controlled methodology with measures such as blinding to reduce bias. We also recommend that such trials adhere to the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) to ensure transparency.</p

The Auditory Comprehension of Unaccusative Verbs in Aphasia

Some persons with aphasia, particularly those diagnosed with a Broca’s aphasia, exhibit a delayed time course of lexical activation in canonically ordered S-V-O sentences (Ferrill et al., 2012) and delayed re-activation of displaced arguments in sentences that contain syntactic dependencies (Love et al., 2008). These patterns support the Delayed Lexical Activation (DLA) hypothesis: Lexical activation is delayed relative to the normal case, and thus lexical activation and syntactic operations are de-synchronized; that is, lexical access is too slow for normally fast-acting syntactic operations. This delay in lexical access leads to what appear to be syntactic comprehension deficits in aphasia. In the current study we further examined lexical activation during sentence comprehension in persons with aphasia by using unaccusative verbs. Unaccusative verbs are a type of intransitive verb with a single argument that is base generated in object position and displaced to the surface subject position, leaving behind a copy or trace (‘gap’) of the movement (see, for example, Burzio, 1986), as in: 1. The girl vanished Thus there is a syntactic dependency between the two positions. When encountering sentences that contain syntactic dependencies (e.g., object relatives, Wh-questions) neurologically unimpaired individuals immediately reactivate the displaced argument at the gap (Shapiro et al., 1999; Love et al., 2008). In contrast to this immediate reactivation, prior findings indicate that neurologically unimpaired individuals do not reactivate the displaced argument in similar sentences with unaccusative verbs until 750ms downstream from the gap (Friedmann et al., 2008). This built-in delay observed with unaccusative verbs in neurologically healthy participants provides a unique opportunity to further examine lexical delays in individuals with Broca’s aphasia. Importantly, individuals with Broca’s aphasia may have unaccusative verb deficits. Previous research has found that persons with aphasia have difficulty producing unaccusative verbs. Offline truth-value judgment tasks with intransitive sentences containing unaccusative verbs do not reveal comprehension deficits (Lee & Thompson, 2004). However, in a sentence-picture matching task, McAllister et al. (2009) found lower accuracy for intransitive sentences that contained unaccusative verbs than transitive sentences. We entertain the following hypothesis: The delayed lexical access routines better synchronize with the delay of reactivating the argument of unaccusatives, suggesting that individuals with Broca’s aphasia should evince a pattern like that of unimpaired individuals. Alternatively, participants with Broca’s aphasia might show activation even further downstream from the gap, given that in other sentence constructions containing syntactic dependencies they exhibit a delayed pattern of reactivation compared to neurologically unimpaired individuals

Alcohol Perceptions and Behavior in a Residential Peer Social Network

Personalized normative feedback is a recommended component of alcohol interventions targeting college students. However, normative data are commonly collected through campus-based surveys, not through actual participant-referent relationships. In the present investigation, we examined how misperceptions of residence hall peers, both overall using a global question and those designated as important peers using person-specific questions, were related to students’ personal drinking behaviors. Participants were 108 students (88% freshman, 54% White, 51% female) residing in a single campus residence hall. Participants completed an online baseline survey in which they reported their own alcohol use and perceptions of peer alcohol use using both an individual peer network measure and a global peer perception measure of their residential peers. We employed network autocorrelation models, which account for the inherent correlation between observations, to test hypotheses. Overall, participants accurately perceived the drinking of nominated friends but overestimated the drinking of residential peers. Consistent with hypotheses, overestimating nominated friend and global residential peer drinking predicted higher personal drinking, although perception of nominated peers was a stronger predictor. Interaction analyses showed that the relationship between global misperception and participant self-reported drinking was significant for heavy drinkers, but not non-heavy drinkers. The current findings explicate how student perceptions of peer drinking within an established social network influence drinking behaviors, which may be used to enhance the effectiveness of normative feedback interventions

Examining the Efficacy of a Brief Group Protective Behavioral Strategies Skills Training Alcohol Intervention With College Women

College students’ use of protective behavioral strategies (PBS; e.g., determining not to exceed a set number of drinks, avoiding drinking games) is related to lower levels of alcohol consumption and problems. The present study evaluated the efficacy of a novel brief, single-session group PBS skills training intervention aimed at increasing college students’ use of PBS and reducing risky drinking and consequences. Participants (N = 226) were heavy-drinking incoming first-year college women randomized to either a PBS skills training intervention or study skills control condition. Participants attended a 45-min group session and completed online surveys pre- and postintervention (1 month and 6 months). We conducted a series of 2 × 2 × 3 repeated-measures ANCOVAs with condition and baseline mental health (anxiety/depression) as the between-subjects factors and time as the within-subjects factor. Intervention participants, relative to controls, reported significantly greater increases in PBS use and reductions in both heavy episodic drinking and alcohol consequences. The intervention was particularly effective in increasing PBS use at 1 month among participants with high anxiety. Further, tests of moderated mediation showed a significant conditional indirect effect of condition on 1-month consequences through PBS use among participants with high levels of anxiety. Findings provide preliminary support for a brief PBS-specific group intervention to reduce alcohol risk among college women, particularly anxious women. Future research is needed to strengthen the long-term effectiveness of the present approach and further explore the moderating effects of mental health

Precision Sensorimotor Control in Aging FMR1 Gene Premutation Carriers.

Background: Individuals with premutation alleles of the Materials and Methods: 26 Results: Relative to controls, premutation carriers showed reduced rates of initial force generation during rapid motor actions and longer durations of their initial pressing with their dominant hand. During sustained force, premutation carriers demonstrated reduced force complexity, though this effect was specific to younger premutation carries during dominant hand pressing and was more severe for younger relative to older premutation carriers at low and medium force levels. Increased reaction time and lower sustained force complexity each were associated with greater CGG repeat length for premutation carriers. Increased reaction time and increased sustained force variability were associated with more severe clinically rated FXTAS symptoms. Conclusion: Overall our findings suggest multiple sensorimotor processes are disrupted in aging premutation carriers, including initial force control guided by feedforward mechanisms and sustained sensorimotor behaviors guided by sensory feedback control processes. Results indicating that sensorimotor issues in aging premutation carriers relate to both greater CGG repeat length and clinically rated FXTAS symptoms suggest that quantitative tests of precision sensorimotor ability may serve as key targets for monitoring FXTAS risk and progression

Enrollment and Assessment of a First-Year College Class Social Network for a Controlled Trial of the Indirect Effect of a Brief Motivational Intervention

Heavy drinking and its consequences among college students represent a serious public health problem, and peer social networks are a robust predictor of drinking-related risk behaviors. In a recent trial, we administered a Brief Motivational Intervention (BMI) to a small number of first-year college students to assess the indirect effects of the intervention on peers not receiving the intervention. Objectives: To present the research design, describe the methods used to successfully enroll a high proportion of a first-year college class network, and document participant characteristics. Methods: Prior to study enrollment, we consulted with a student advisory group and campus stakeholders to aid in the development of study-related procedures. Enrollment and baseline procedures were completed in the first six weeks of the academic semester. Surveys assessed demographics, alcohol use, and social network ties. Individuals were assigned to a BMI or control group according to their dormitory location. Results: The majority of incoming first-year students (1342/1660; 81%) were enrolled (55% female, 52% nonwhite, mean age 18.6 [SD = 0.51]). Differences between the intervention and control group were noted in alcohol use, but were in large part a function of there being more substance-free dormitory floors in the control group. Conclusions: The current study was successful in enrolling a large proportion of a first-year college class and can serve as a template for social network investigations

Do Misperceptions of Peer Drinking Influence Personal Drinking Behavior? Results From a Complete Social Network of First-Year College Students

This study considered the influence of misperceptions of typical versus self-identified important peers\u27 heavy drinking on personal heavy drinking intentions and frequency utilizing data from a complete social network of college students. The study sample included data from 1,313 students (44% male, 57% White, 15% Hispanic/Latinx) collected during the fall and spring semesters of their freshman year. Students provided perceived heavy drinking frequency for a typical student peer and up to 10 identified important peers. Personal past-month heavy drinking frequency was assessed for all participants at both time points. By comparing actual with perceived heavy drinking frequencies, measures of misperceptions of heavy drinking (accurately estimate, overestimate, underestimate) were constructed for both general and important peers. These misperceptions were then used as predictors of concurrent and prospective personal heavy drinking frequency and intentions using network autocorrelation analyses. The majority of students (84.8%) overestimated, 11.3% accurately estimated, and 3.9% underestimated heavy drinking among their general peers, whereas 42.0% accurately estimated, 36.9% overestimated, and 21.1% underestimated important peers\u27 heavy drinking. For both referents, overestimation of peer heavy drinking was associated with more frequent heavy drinking and higher drinking intentions at both time points. Importantly, the effects of underestimating and overestimating close peers\u27 drinking on personal alcohol use were significant after controlling for the influence of misperceptions of general peers\u27 heavy drinking. Close peers are a critical referent group in assessments related to social norms for young adult alcohol use. Implications for prevention and intervention are discussed

Analytical Validation and Capabilities of the Epic CTC Platform: Enrichment-Free Circulating Tumour Cell Detection and Characterization

The Epic Platform was developed for the unbiased detection and molecular characterization of circulating tumour cells (CTCs). Here, we report assay performance data, including accuracy, linearity, specificity and intra/inter-assay precision of CTC enumeration in healthy donor (HD) blood samples spiked with varying concentrations of cancer cell line controls (CLCs). Additionally, we demonstrate clinical feasibility for CTC detection in a small cohort of metastatic castrate-resistant prostate cancer (mCRPC) patients. The Epic Platform demonstrated accuracy, linearity and sensitivity for the enumeration of all CLC concentrations tested. Furthermore, we established the precision between multiple operators and slide staining batches and assay specificity showing zero CTCs detected in 18 healthy donor samples. In a clinical feasibility study, at least one traditional CTC/mL (CK+, CD45-, and intact nuclei) was detected in 89 % of 44 mCRPC samples, whereas 100 % of samples had CTCs enumerated if additional CTC subpopulations (CK-/CD45- and CK+ apoptotic CTCs) were included in the analysis. In addition to presenting Epic Platform’s performance with respect to CTC enumeration, we provide examples of its integrated downstream capabilities, including protein biomarker expression and downstream genomic analyses at single cell resolution

Electrochemical Aminoxyl-Mediated α-Cyanation of Secondary Piperidines for Pharmaceutical Building Block Diversification

Secondary piperidines are ideal pharmaceutical building blocks owing to the prevalence of piperidines in commercial drugs. Here, we report an electrochemical method for cyanation of the heterocycle adjacent to nitrogen without requiring protection or substitution of the N–H bond. The reaction utilizes ABNO (9-azabicyclononane N-oxyl) as a catalytic mediator. Electrochemical oxidation of ABNO generates the corresponding oxoammonium species, which promotes dehydrogenation of the 2° piperidine to the cyclic imine, followed by addition of cyanide. The low-potential, mediated electrolysis process is compatible with a wide range of heterocyclic and oxidatively sensitive substituents on the piperidine ring and enables synthesis of unnatural amino acids