Dry needling equilibration theory: A mechanistic explanation for enhancing sensorimotor function in individuals with chronic ankle instability

Jennifer F. Mullins, Arthur J. Nitz, Matthew C. Hoch

Research output: Contribution to journalArticlepeer-review

Abstract

Patients with chronic ankle instability (CAI) experience a dynamic interplay between impaired mechanical structures and sensorimotor deficiencies that contribute to recurrent sprains and sensations of instability. Concomitantly, muscular trigger points (MTrPs) are known to occur following trauma, maximal or submaximal concentric contractions, and unaccustomed eccentric loads. Additionally, MTrPs are theorized to be exacerbated in low-load and repetitive strain activities. MTrPs located within a muscle are associated with altered motor control, reaction delay, and decreased strength, deficits also found among those with CAI. Dry needling (DN) is reported to improve muscle range of motion, motor control, and pain in a myriad of neuromusculoskeletal conditions by decreasing spontaneous electrical activity and stiffness of taut muscle bands while improving filament overlap. Building on evidence supporting neuromechanical decoupling in chronic ligamentous injury with what is known about the development of MTrPs, this paper proposes a centrally mediated mechanism for improved sensorimotor function following DN for individuals with CAI. Dry needling equilibration theory (DNET) states that proprioception is improved following DN in the lower extremity by changing the muscle’s length–tension relationship and leveraging minor acute discomfort to improve muscle spindle afferent information via the gamma motor system. The application of DNET for individuals with CAI may provide a mechanistic explanation for improved descending cortical output, resulting in enhanced sensorimotor function.

Original languageEnglish
Pages (from-to)672-681
Number of pages10
JournalPhysiotherapy Theory and Practice
Volume37
Issue number6
DOIs
StatePublished - 2021

Bibliographical note

Publisher Copyright:
© 2021 Taylor & Francis Group, LLC.

Keywords

  • Dry needling
  • ankle
  • sensorimotor

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

Fingerprint

Dive into the research topics of 'Dry needling equilibration theory: A mechanistic explanation for enhancing sensorimotor function in individuals with chronic ankle instability'. Together they form a unique fingerprint.

Cite this