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This study aims to evaluate the effectiveness of dry needling in reducing pain and improving functional outcomes in athletes with chronic hamstring strain. Chronic hamstring injuries are common among athletes and often lead to persistent pain, reduced performance, and limitations in daily and sports activities.
Dry needling is a therapeutic technique used to target myofascial trigger points and relieve muscle tension. This study will compare the effects of dry needling with conventional physiotherapy interventions to determine its role in managing chronic hamstring strain.
Participants will be athletes diagnosed with chronic hamstring strain. Outcomes will include pain intensity, muscle flexibility, and functional performance. The results of this study may help improve rehabilitation strategies and provide evidence for the use of dry needling in sports injuries.
Chronic hamstring strain (CHS) is a common musculoskeletal condition among athletes, particularly in sports involving high-speed running and sudden changes in direction. It is characterized by persistent or recurrent symptoms lasting more than three months and is often associated with reduced muscle flexibility, decreased performance, and an increased risk of reinjury.
Dry needling (DN) has emerged as a therapeutic intervention targeting myofascial trigger points to reduce pain, improve muscle function, and restore neuromuscular control. It is believed to act through both mechanical and neurophysiological mechanisms, including reduction of muscle tension and modulation of pain pathways.
This study aims to investigate the effectiveness of dry needling as an adjunct to conventional physiotherapy in athletes with chronic hamstring strain. Participants will be randomly assigned into two groups. The experimental group will receive dry needling combined with a structured physiotherapy program, while the control group will receive the same physiotherapy program without dry needling.
The physiotherapy program will include stretching exercises, strengthening exercises with an emphasis on eccentric loading, and functional training. Dry needling will be applied to identified trigger points in the hamstring muscles using standard clinical techniques.
Outcome measures will include pain intensity, hamstring flexibility, and functional performance. Assessments will be conducted before and after the intervention period.
The results of this study are expected to provide evidence regarding the added value of dry needling in improving rehabilitation outcomes for athletes with chronic hamstring strain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control Group (A) | Active Comparator | Participants will receive only the standard rehabilitation program without dry needling. |
|
| Intervention Group (B) | Experimental | Participants will receive dry needling treatment in addition to a standard rehabilitation program for chronic hamstring strain |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dry Needling | Procedure | Participants will receive dry needling treatment applied to active myofascial trigger points in the hamstring muscles (biceps femoris, semitendinosus, and semimembranosus). Sterile filiform needles will be inserted into identified trigger points to elicit local twitch responses and reduce muscle pain and tightness. Treatment will be performed in addition to a standardized rehabilitation program including stretching and strengthening exercises for the hamstring muscle group. Sessions will be administered over the study period according to a predefined treatment schedule. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain Intensity | Pain intensity in chronic hamstring strain will be assessed using the Visual Analog Scale (VAS), a 10-cm scale ranging from 0 (no pain) to 10 (worst imaginable pain). Measurements will be taken at baseline and after completion of the intervention period to evaluate changes in pain perception. | Baseline (pre-intervention) and after 6 weeks of treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Functional Performance | Functional outcomes will be assessed using the Lower Extremity Functional Scale (LEFS) to evaluate the impact of intervention on daily and sports-related activities. | Baseline (pre-intervention) and after 6 weeks of treatment |
| Hamstring Muscle Strength |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Amr Anas, BSc | Contact | +201023924004 | amr.anas109@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Amr Anas, BSc | Cairo University | Principal Investigator |
| Ebtessam Gomaa, PhD | Cairo University | Study Director |
| Marihan Makary |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Abu Qir General Hospital | Alexandria | Alexandria Governorate | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21825112 | Background | Petersen J, Thorborg K, Nielsen MB, Budtz-Jorgensen E, Holmich P. Preventive effect of eccentric training on acute hamstring injuries in men's soccer: a cluster-randomized controlled trial. Am J Sports Med. 2011 Nov;39(11):2296-303. doi: 10.1177/0363546511419277. Epub 2011 Aug 8. | |
| 28735825 | Background | Espejo-Antunez L, Tejeda JF, Albornoz-Cabello M, Rodriguez-Mansilla J, de la Cruz-Torres B, Ribeiro F, Silva AG. Dry needling in the management of myofascial trigger points: A systematic review of randomized controlled trials. Complement Ther Med. 2017 Aug;33:46-57. doi: 10.1016/j.ctim.2017.06.003. Epub 2017 Jun 15. |
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| ID | Term |
|---|---|
| D000079245 | Dry Needling |
| ID | Term |
|---|---|
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
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This is a randomized, parallel-group interventional study. Participants will be allocated into two groups: an experimental group receiving dry needling combined with conventional physiotherapy, and a control group receiving conventional physiotherapy alone.
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|
| Standard Rehabilitation Program | Procedure | Participants will receive a standardized rehabilitation program including stretching and eccentric strengthening exercises for hamstring muscles without dry needling. |
|
Hamstring muscle strength will be measured using a handheld dynamometer during maximal isometric contraction. |
| Baseline (pre-intervention) and after 6 weeks of treatment |
| Hamstring Flexibility | Hamstring flexibility will be assessed using the popliteal angle test with a universal goniometer. | Baseline (pre-intervention) and after 6 weeks of treatment |
| Kicking Speed | Kicking speed will be measured using a radar gun to assess football-specific performance. | Baseline (pre-intervention) and after 6 weeks of treatment |
| Cairo University |
| Study Director |
| 21335353 | Background | Ekstrand J, Hagglund M, Walden M. Epidemiology of muscle injuries in professional football (soccer). Am J Sports Med. 2011 Jun;39(6):1226-32. doi: 10.1177/0363546510395879. Epub 2011 Feb 18. |
| Background | Dunning J, et al. Dry needling clinical practice review. Phys Ther Rev. 2021;26(5-6):287-307. https://doi.org/10.1080/10833196.2021.1983244 |
| 15335244 | Background | Croisier JL. Factors associated with recurrent hamstring injuries. Sports Med. 2004;34(10):681-95. doi: 10.2165/00007256-200434100-00005. |
| Background | Chaabene H, et al. Hamstring strength assessment systematic review. Sports Med Open. 2019;5:23. https://doi.org/10.1186/s40798-019-0198-7 |
| Background | Chamorro C, et al. Reliability of handheld dynamometry and isokinetic testing. Open Med. 2014;9(4):382-397. https://doi.org/10.1515/med-2014-0058 |
| Background | Canosa-Carro L, et al. Dry needling effects on hamstring flexibility and performance. J Sport Rehabil. 2022;31(3):254-261. https://doi.org/10.1123/jsr.2020-0225 |
| Background | Buckthorpe M, et al. Hamstring injuries in football: risk factors and RTP. Br J Sports Med. 2020;54(19):1081-1091. |
| 26105015 | Background | Brukner P. Hamstring injuries: prevention and treatment-an update. Br J Sports Med. 2015 Oct;49(19):1241-4. doi: 10.1136/bjsports-2014-094427. Epub 2015 Jun 23. |
| Background | Bourne MN, et al. Eccentric training and hamstring injury risk. Scand J Med Sci Sports. 2017;27(11):1180-1187. |
| Background | Bahr R, et al. Hamstring injury prevention programs: systematic review. Br J Sports Med. 2018;52(17):1077-1085. |
| 25995308 | Background | Bahr R, Thorborg K, Ekstrand J. Evidence-based hamstring injury prevention is not adopted by the majority of Champions League or Norwegian Premier League football teams: the Nordic Hamstring survey. Br J Sports Med. 2015 Nov;49(22):1466-71. doi: 10.1136/bjsports-2015-094826. Epub 2015 May 20. |
| 23536466 | Background | Askling CM, Tengvar M, Thorstensson A. Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br J Sports Med. 2013 Oct;47(15):953-9. doi: 10.1136/bjsports-2013-092165. Epub 2013 Mar 27. |
| 23703914 | Background | Ahmad CS, Redler LH, Ciccotti MG, Maffulli N, Longo UG, Bradley J. Evaluation and management of hamstring injuries. Am J Sports Med. 2013 Dec;41(12):2933-47. doi: 10.1177/0363546513487063. Epub 2013 May 23. |