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研究生(外文):Christopher Lo
論文名稱(外文):The Effects of Dry Needling on Gait Patterns in Subjects with Hamstring Muscle Fatigue
指導教授(外文):Shih-Wun HongChu-Fen Chang
外文關鍵詞:Dry NeedlingMuscle FatigueSurface Electromyography
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實驗會使用九台紅外攝像機(VICON、Bonita 3.0 和 Nexus 2.10 軟件,英國)、3D 動作捕捉系統和測力台(AMTI,Advanced Medical Technology,美國)用於收集數據。受試者被指示做各種動作,包括屈膝以誘導膕旁肌疲勞。根據他們被隨機分配到哪個組,受試者將被指示為每個組執行動作。使用的統計分析是具有事後的三向方差分析,顯著性設定為 p < 0.05。




Background: Muscle fatigue is one of the most common symptoms that can occur in both healthy people as well as athletes. Muscle fatigue can be described as a reduction of maximal force or power that the involved muscles can produce, and it can develop gradually after onset of sustained physical activity. There are many methods to treat muscle fatigue, such as resting, use of synthetic products, natural products, and nutritional supplements. An alternative for relieving muscle fatigue is through dry needling. Dry Needling is a known concept of treatment for myofascial trigger points (TrPs), but it is not commonplace in the current physical therapy work field. It is considered a relatively new type of invasive intervention that can be utilized by physical therapists who are licensed in the United States. Dry needling can be used to induce immediate analgesia of the myofascial trigger point without hyperaesthesia for patients with myofascial pain. Dry needling has also been shown to be effective in the short term for pain alleviation related to TrPs, increase in ROM, and the improvement of quality of life. Although there have been numerous studies on the use of dry needling treatment for TrPs for various muscles, there have been little to no research done on the effect of dry needling on muscle fatigue for the hamstring muscle.

Purpose: This study aims to determine the effectiveness of dry needling on gait patterns for healthy subjects with induced hamstring muscle fatigue. Subjects will be instructed to do knee flexion exercises with resistance from therabands to induce muscle fatigue. Data of the lower extremities will be recorded with the use of three-dimensional motion analysis and force plates, and then will be calculated to obtain kinematic data. The hypothesis is that dry needling would have a significant difference of reducing fatigue in the dry needling group compared to the sham and control groups.

Methods: Participants were recruited between the ages of 20 to 35 years old from Tzu Chi University and the Hualien Community. Each of the subjects were recruited via poster fliers and selected based on non-probability with convenience sampling. There is a total of 3 groups: the dry needling group (experimental), the sham dry needling group, and the resting group (control). The inclusion criteria for the subjects will be not having any lower extremity pain and neurological pain that can affect normal walking and balance for the past month. The exclusion criteria for the subjects will be if the subjects have had anterior or posterior cruciate ligament tears, surgery, metal allergy, fear of needles, bleeding disorders, and are currently taking anticoagulant medications.

The experiment will use nine infrared cameras (VICON, Bonita 3.0 with Nexus 2.10 software, UK), 3D motion capture system, and force plates (AMTI, Advanced Medical Technology, USA), were used to collect data. Subjects were instructed to do a variety of actions, including knee flexion for induced muscle fatigue at the hamstrings. Depending on which group they were randomly assigned to, the subjects would be instructed to perform actions for each group. Statistical analysis used were three-way ANOVA with post hoc and the significance was set at p < 0.05.

Result: For the knee angle, the dry needling intervention was the same as post-fatigue. For the knee moment however, there was greater extensor during the loading response. During hamstring fatigue, the hamstring muscle is shortened, hence the greater extensor during knee moment since the hamstring muscle is a knee flexor muscle. Dry needling has improved the flexion extension ability of the hamstring muscle.

Conclusion: Based on the results of this study, dry needling did improve gait patterns for subjects at the knee moment (experimental), as it showed greater extensor during loading response. However, this was the only positive change for the dry needling intervention.

Keywords: Dry Needling, Muscle Fatigue, Surface Electromyography

Table of Contents
Chapter 1: Introduction

1.1 Background 1
1.2 Literature Reviews 3
1.2.1 Dry Needling for Clinical Purposes 3
1.2.2 Gait 3
1.2.3 Acupuncture 4
1.2.4 Heat and Cold Therapy 4
1.2.5 TENS 5
1.2.6 Massage Therapy 6
1.2.7 Functional Assessment Scale for Hamstrings (FASH) 6
1.3 Aims of This Study 7
Chapter 2: Materials and Methods

2.1 Subjects and Eligibility Criteria 7
2.2 Equipments 9
2.2.1 3-Dimensional Vicon Motion Analysis System 9
2.2.2 Noraxon USA Ultium EMG 10
2.2.3 Dongbang Stress Free Needle 11
2.3 Procedures 11
2.3.1 3D Motion Analysis System 12
2.3.2 Noraxon USA Ultium EMG 13
2.3.3 Dry Needling (Experimental) 14
2.3.4 Dry Needling (Sham) 16
2.3.5 Resting (Control) 17
2.4 Data Analysis 17
2.4.1 3D Motion Analysis System 17
2.4.2 Noraxon USA Ultium EMG 17
2.5 Statistical Analysis 19
2.6 Questionnaire Data and Analysis 19
Chapter 3: Results

3.1 Questionnaire results 19
3.2 Fatigue Effect (Experimental) 19
3.2.1 Joint Kinematics (Hip Angles) 19
3.2.2 Joint Kinematics (Knee Angles) 20
3.2.3 Joint Kinematics (Ankle Angles) 21
3.2.3 Joint Kinematics (Hip Moments) 22
3.2.3 Joint Kinematics (Knee Moments) 23
3.2.3 Joint Kinematics (Ankle Moments) 23
3.3 Dry Needle Effect (Experimental) 24
3.3.1 Joint Kinematics (Hip Angles) 24
3.3.2 Joint Kinematics (Knee Angles) 25
3.3.3 Joint Kinematics (Ankle Angles) 25
3.3.4 Joint Kinematics (Hip Moments) 26
3.3.5 Joint Kinematics (Knee Moments) 27
3.3.6 Joint Kinematics (Ankle Moments) 27
3.4 Dry Needle Effect (Sham) 28
3.4.1 Joint Kinematics (Hip Angles) 28
3.4.2 Joint Kinematics (Knee Angles) 28
3.4.3 Joint Kinematics (Ankle Angles) 29
3.4.4 Joint Kinematics (Hip Moments) 30
3.4.5 Joint Kinematics (Knee Moments) 31
3.4.6 Joint Kinematics (Ankle Moments) 31
Chapter 4: Discussion 32
Chapter 5: Conclusion 34
Tables 35
References 39
Appendix 42

List of Figures
Figure 1. Vicon, Bonita 3.0 with Nexus 2.10 Software, UK 9
Figure 2. Noraxon USA Ultium EMG 10
Figure 3. Dongbong Stress Free Needle 11
Figure 4. Marker position for lower limb 13
Figure 5. EMG position for lower extremities 14
Figure 6. Locations for needling of hamstring muscles 15
Figure 7. Insertion of needles on the hamstring muscles 16
Figure 8. 100% MVC of the biceps femoris 18
Figure 9. MVC of biceps femoris post-induced fatigue 18
Figure 10. Hip Angle comparison between pre and post fatigue 20
Figure 11. Knee Angle comparison between pre and post fatigue 21
Figure 12. Ankle Angle comparison between pre and post fatigue 22
Figure 13. Hip Moment comparison between pre and post fatigue 22
Figure 14. Knee Moment comparison between pre and post fatigue 23
Figure 15. Ankle Moment comparison between pre and post fatigue 24
Figure 16. Hip Angle comparison between post fatigue and intervention 24
Figure 17. Knee Angle comparison between post fatigue and intervention 25
Figure 18. Ankle Angle comparison between post fatigue and intervention 26
Figure 19. Hip Moment comparison between post fatigue and intervention 26
Figure 20. Knee Moment comparison between post fatigue and intervention 27
Figure 21. Ankle Moment comparison between post fatigue and intervention 27
Figure 22. Hip Angle (Sham) comparison between post fatigue and intervention 28
Figure 23. Knee Angle (Sham) comparison between post fatigue and intervention 29
Figure 24. Ankle Angle (Sham) comparison between post fatigue and intervention 30
Figure 25. Hip Moment (Sham) comparison between post fatigue and intervention 30
Figure 26. Knee Moment (Sham) comparison between post fatigue and intervention 31
Figure 27. Ankle Moment (Sham) comparison between post fatigue and intervention 32


Table 1. Experimental Group (Dry Needling) Demographic Data 35
Table 2. Experimental Group (Sham) Demographic Data 35
Table 3. Control Group (Resting) Demographic Data 36
Table 4. Functional Assessment Scale Hamstring (FASH) Items 36
Table 5. Functional Assessment Scale Hamstring Results (Experimental) 37
Table 6. Functional Assessment Scale Hamstring Results (Sham) 37
Table 7. Functional Assessment Scale Hamstring Results (Control) 37


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