DnpL1 Physiological Effects PDF

8/9/2019 DnpL1 Physiological Effects PDF

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Physiological effectsWhen metal meets flesh

Local effects

Swelling

Mop upenzymes

Blood vessels

Phagocytes andmacrophages

Fascia

Nerves

! Rapid local vasodilation

! Increased capillarypermeability

(Kuo 2004,Sandberg et al 2003)

Enhances initial phase of

inflammation

(Sherwood,1989)

Fibroblastic activity levels increase

(Sumano,1999)

Increased phagocyte (neutrophils

and macrophage) production andlevel of activity

(Rogers et al 1995,Petti at al 1998)

Increased levels of thebuilding blocks for tissuerepair

– blood glucose,

– amino acids

– fatty acids

(Sherwood 1989)


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Reduce localised oedema

! Proposed due to release ofcortisol from adrenal glands

(Zhang et al 2004,2005)

Release of neuropeptides from nerveendings at the site of the injury

! release of substance P andcalcitonin gene related peptide(Lundeberg 1993)

!

these interact with endorphins andcytokines both locally and at aspinal cord level (Zijlsta et al 2003)

Neural and humeralmodulation ofinflammation

(Zhang et al 2004) Parasympatheticeffects

!

Triggers parasympatheticresponses! sweating! vasodilation

! Alters amount/type ofafferent activity in dorsal horn

! This in turn affects efferentactivity eg. notor output, neuralInhibition

Constitutional andsupraspinal effects


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constitutional or systemic effects of dryneedling

•

Increased serotonin levels (Foreman,2005)

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Increased leukocyte count (Petti at al1998)

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Increased cortisol level (Zhang et al2005)

– Reduced ESR

•

Smooth mm dilatation leading toimproved organ function

•

Increased opioid levels in CSF (Andersonand Lunderberg 1995)

dry needling literature acknowledges

constitutional effects

•

Travell , Baldry and Gunn all comment onrecipients of dry needling technique whoreport global benefits following treatment

– general increased feelings of well being

– improved sleep patterns

– reduction in systemic symptoms such as GITsymptoms, allergies

Dry needlingresearch

Research is dominated by

1. pain gating2. counter

irritantconcept

3. central pain

modulationmechanisms

Little or no research into:1. Effect on range of motion

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Effect on muscle function

3. Local and segmental signal

modulation resulting in improved

function

4.

different needle techniques

5. multi point treatments

6. individualisation of diagnosis

and treatment applied todifferent subject groups as

happens all the time inclinical interventions

7.

musculoskeletal outcomes


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research difficulties

double blind controlled designinappropriate

•

double blind research design limited as“sham” needling often produces effectsimilar to intervention needling

• difficult to blind the therapist

• difficult to account for therapist /clientinteraction

•

recent neurophysiological research issingle point focussed

dnp: integratedneuro-myofascialdry needlingresearch

! “this paradigm for needling is yet to beevidence based but is highly relevantclinically with sound test-retest methods

for assessing the treatment (effects)”! “the skills are well defined and

(provide) a safe scope for practice”

Review by the NZ college of Physiotherapy 17/8/09

! “there is no current research on this style ofneedling but in comparison to other styles of

needling there are extensive referenceshighlighting the clinical significance of dnp”

!

dnp is a “paradigm based on changes in

function following musculoskeletal screeningtests”

End of Module

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DnpL1 Physiological Effects PDF