Submission note: "A thesis submitted in total fulfilment of the requirements for the degree of Doctor of Philosophy [to the] School of Allied Health, Faculty of Health Sciences, La Trobe University, Bundoora"
Thesis with publications
Aim: To evaluate the effectiveness of trigger point dry needling for plantar heel pain. Design: A systematic review of the literature was first conducted to evaluate the effectiveness of trigger point dry needling for plantar heel pain. This was followed by a Modified Delphi study to develop a consensus-driven trigger point dry needling treatment for plantar heel pain. Finally, a randomised controlled trial (RCT) was conducted to evaluate the effectiveness of trigger point dry needling for plantar heel pain. Setting: The modified Delphi Study was completed using the online survey tool SurveyMonkey® . The RCT was conducted at a university-based clinic. Participants: The Modified Delphi study included 30 experts in the use of trigger point dry needling. In the RCT, 84 participants with plantar heel pain were randomly allocated to a group that received either real or sham trigger point dry needling. Outcome measures: In the RCT, the primary outcome measures were a Visual Analogue Scale (VAS) and the Foot Health Status Questionnaire (FHSQ). Secondary outcome measures included the Depression, Anxiety and Stress Scale (DASS-21). Results: The results of the Modified Delphi study indicated that 93% of experts agreed with a consensus-driven dry needling treatment for plantar heel pain to be used in a RCT. In the RCT, significant effects favoured real trigger point dry needling over sham trigger point dry needling for pain at the primary end point of six weeks (adjusted mean difference: VAS first step pain -14.4mm, 95% CI -23.5 to -5.2; FHSQ foot pain 10.0 points, 95% CI 1.0 to 19.1), although the between group difference was lower than the minimal important difference. Conclusion: Dry needling provided statistically significant improvements in plantar heel pain but the magnitude of this effect was lower than what is considered clinically meaningful to people with plantar heel pain
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