Table 3.
Characteristics of the dry needling intervention of the included studies.
| Study | Group | TrP criteria | Technique Used | No. Punctures for Patient in Every Intervention | Needle Approach (Targeted Muscles or Tendon) | Gauge (mm) | Depth (mm) | Time of DN | Frequency of Incisions (Hz) | Number of Incisions in Every Needle Intervention | LTR | Therapist that Performed Intervention |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Ibuldu et al. 2004 [36] | G1: DN | Yes | NR | 1 | Upper trapezius | 0.25 × 25 | NR | NR | NR | NR | NR | Physician |
| Itoh et al. 2007 [33] | G1: DN-Trp | Yes | “sparrow pecking” technique | NR | Splenius capitis, Upper trapezius, sternocleidomastoid, scalenus, levator scapulae, suboccipital |
0.2 × 0.50 mm | 20 mm | 10 min | 1 | The manipulation was stopped when the LTR was elicited | Yes | Acupuncturist |
| G2: Acupuncture | No | “sparrow pecking” technique | 9 | GB20, GB21, BL10, BL11, S12, S13, TE5, LI4, SI3 | 0.2 × 0.40 mm | 20 mm | 10min | 1 | When the subject felt dull pain or the acupuncture sensation (de qi), the manipulation was stopped | No | Acupuncturist | |
| G3: DN-Non-TrP | Yes | “sparrow pecking” technique | NR | Splenius capitis, upper trapezius, sternocleidomastoid, scalenus, levator scapulae, suboccipital | 0.2 × 0.40 mm | 0 mm | 10 min | 1 | The manipulation was stopped when the LTR was elicited | Yes | Acupuncturis | |
| Myburgh et al. 2012 [27] | G1: DN | Yes | Repeated fanning needling insertion | 1 | Upper trapezius | 32 × 0.25 mm | No less than 10 mm | 90 sg | NR | Elicit and exhaust LTR | Yes | Clinician |
| G2: Superficial DN | Yes | The needle inserted into the epidermis until | 1 | Upper trapezius | 32 × 0.25 mm | 5 mm | 90 sg | 1 | 1 | No | Clinician | |
| Tekin et al. 2012 [46] | G1: DN | Yes | Needle moved forward until the TrP was reached | 6 | Neck and shoulder muscles | 0.25 × 0.25 mm | Until muscle | NR | 1 | 1 | No | Physician |
| G2: Sham-DN | Yes | The blunted needle for sham dry needling | 6 | Neck and shoulder muscles | 0.25 × 0.25 mm | Until skin | NR | 1 | 1 | No | Physician | |
| Llamas-Ramos et al. 2014 [32] | G1: DN | Yes | Hong | 1 | Upper trapezius | 0.30 × 30 mm | 10–15 mm | 20–30 sg | 1 | Once the first LTR was obtained, the needle was moved up and down | Yes | Physiotherapist |
| Mejuto-Vázquez et al. 2014 [28] | G1: DN | Yes | Hong | 1 | Upper trapezius | 0.30 × 30 mm | 10–15 mm | 20–30 sg | 1 | Once the first LTR was obtained, the needle was moved up and down | Yes | Physiotherapist |
| Ziaeifar et al. 2014 [35] | G1: DN | Yes | Hong | 1 | Upper trapezius | NR | NR | NR | NR | Was repeatedly needled forward and backward to the TrP until there were no more LTRs | Yes | Physiotherapist |
| Rayegani et al. 2014 [51] | G1: DN | Yes | NR | 2 | Upper trapezius | 23-gauge needle | NR | NR | NR | NR | No | Physician |
| Campa-Moran et al. 2015 [41] | G1: DN | Yes | Hong | 2 | Levator scapulae and upper trapezius muscles |
0.25 × 25 mm | Until muscle | 2 min | At least 3 times at each point | The needle insertions were repeated to achieve at least three LTR |
Yes | Physiotherapist |
| Pecos-Martín et al. 2015 [25] | G1: TrP-DN | Yes | Hong | 1 | Lower trapezius | 0.25 × 25 mm | Until muscle | NR | NR | 8-10 times | No | Physiotherapist |
| G2: Non-TrP-DN | No | Hong | 1 | Lower trapezius | 0.25 × 25 mm | 1.5cm medially from TrP | NR | NR | 8–10 times | No | Physiotherapist | |
| Aridici et al. 2016 [42] | G1: DN | Yes | Hong | 1 | Upper trapezius | 22-gauge needle and 1.5 inch | Until muscle | NR | NR | 8–10 times | Yes | Physician |
| Hayta et al. 2016 [37] | G1: DN | Yes | Manual stimulation was produced (at the TrP) by rotating the needle counterclockwise | 3 | Trapezius | 0.25 × 25 mm | Inside of muscle | 10–20 min | 1 | 1 | No | NR |
| Segura-Ortí et al. 2016 [50] | G1: DN | Yes | Hong | 1 | Upper trapezius | 0.25 × 25 mm | Inside of muscle | NR | NR | Needling at the TrP was continued until the LTR was exhausted | Yes | Physiotherapist |
| Ziaeifar et al. 2016 [23] | G1: DN | Yes | Hong | 1 | Upper trapezius | 0.30 × 50 mm | Inside of muscle | NR | NR | The procedure was repeated until there was no more LTR | Yes | Therapist |
| Fernández-Carnero et al. 2017 [38] | G1: No-LTR-DN | Yes | Hong | 1 | Upper trapezius | 0.32 × 40 mm | Inside of muscle, 1.5 cm away from TrP |
NR | NR | 1 | No | Therapist |
| G2: 4-LTR-DN | Ye | Hong | 1 | Upper trapezius | 0.32 × 40 mm | Inside TrP | NR | NR | 10 times | Yes | Therapist | |
| G3: 6-LTr-DN | Ye | Hong | 1 | Upper trapezius | 0.32 × 40 mm | Inside TrP | NR | NR | 10 times | Yes | Therapist | |
| G4: More-6-LTR-DN | Ye | Hong | 1 | Upper trapezius | 0.32 × 40 mm | Inside TrP | NR | NR | 10 times | Yes | Therapist | |
| Sobhani et al. 2017 [49] | G1: DN | Yes | NR | 2 | Upper trapezius and levator scapulae muscles | NR | NR | NR | 20 min | NR | No | Therapist |
| Dogan et al. 2019 [39] | G1: DN | Yes | Hong and the needles were kept in the TrP for ten minutes, after which they were turned counterclockwise several times | 1 | Upper trapezius | 0.20 × 40 mm | Until TrP | 10 min | NR | At least 3 insertions and 1 LTR | Yes | Physician |
| Luan et al. 2019 [31] | G1: DN | Yes | Hong | 1 | Upper trapezius | 0.30 × 50 mm | 30–35 mm | NR | NR | 10 | Yes | Physiotherapist |
| Manafnezhad et al. 2019 [30] | G1: DN | Yes | Hong | 1 | Upper trapezius | 0.30 × 0.50 mm | Until TrP | 1–2 min | NR | Until at least one or two LTR were obtained | Yes | Physiotherapist |
| Martín-Rodríguez et al. 2019 [29] | G1: DN | Yes | Hong | 1 | Sternocleidomastoid muscle | 0.25 × 0.25 mm | Until TrP | NR | NR | 8–10 | No | Physiotherapist |
| G2: DN | Yes | Hong | 1 | Sternocleidomastoid muscle | 0.25 × 0.25 mm | 1.5cm away the TrP | NR | NR | 8–10 | No | Physiotherapist | |
| Onat et al. 2019 [26] | G1: DN | Yes | Hong | 1 | The posterior muscles of the cervical spine | NR | Until TrP | NR | NR | 6–8 | No | Physician |
| Tabatabaiee et al. 2019 [47] | G1: DN | Yes | Hong | 1 | Upper trapezius | 0.25 × 40 mm | Until TrP | NR | 60 sg | Until a LTR was elicited | Yes | Physiotherapist |
| Ziaeifar et al. 2019 [24] | G1: DN | Yes | Hong | 1 | Upper trapezius | 0.30 × 50 mm | Until TrP | NR | NR | After eliciting LTR, needling was stopped. If no twitch was elicited, needling was stopped after 2-3 stellate movements | Yes | Therapist |
| Sukareechai et al. 2019 [48] | G1: DN | Yes | Multiple needle entry technique | NR | Upper trapezius, rhomboid and infraspinatus muscle | 0.25 × 50 mm | NR | NR | NR | NR | No | NR |
| Arias-Buría et al. 2020 [43] | G1: DN | Yes | Hong | 1 | Anterior scalene muscle | 0.30 × 30 mm | Until TrP | 25–30 sg | 1 | Until the first LTR was obtained | Yes | Physiotherapist |
| García-de-Miguel et al. 2020 [44] | G1: DN | Yes | Hong | 1 | Levator scapulae | 0.25 × 25 mm | Until TrP | NR | NR | 8–10 times | No | Physiotherapist |
| G2: PENS | Yes | Hong and electrostimulation asymmetric current at a 2-Hz with a pulse width of 100 us | 2 | Levator scapulae | 0.25 × 25 mm | Until TrP | 20 min | NR | 8–10 times | No | Physiotherapist | |
| Valiente-Castrillo et al. 2020 [45] | G1: DN | Yes | Hong | 4 | Upper trapezius, levator scapulae, cervical multifidus, and splenius cervicis |
032x40 mm | Until TrP | NR | NR | Until to obtain five LTR | Yes | Physiotherapist |
DN: dry needling, G: group, and LTR: local twitch response.