Examination of Dry Needling Dose and Effect Duration for Individuals With Chronic Ankle Instability

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Objective: The purpose of this study was to evaluate the effect of a single treatment vs serial dry needling (DN) treatments of the fibularis longus on individuals with chronic ankle instability and to determine the longevity of any effect found. Methods: Thirty-five adults with chronic ankle instability (24.17 ± 7.01 years, 167.67 ± 9.15 cm, 74.90 ± 13.23 kg) volunteered for a university laboratory repeated-measures study. All participants completed patient-reported outcomes and were objectively tested using the Star Excursion Balance Test (SEBT), threshold to detect passive motion (TTDPM) measurements, and single limb time-to-boundary measurements. Participants received DN treatment to the fibularis longus once weekly for 4 weeks on the affected lower extremity by a single physical therapist. Data were collected 5 times: baseline 1 week before initial treatment (T0), pre-treatment (T1A), immediately after the first treatment (T1B), after 4 weekly treatments (T2), and 4 weeks after the cessation of treatment (T3). Results: Significant improvements were found for clinician-oriented (SEBT-Composite P < .001; SEBT-Posteromedial P = .024; SEBT-Posterolateral P < .001; TTDPM-Inversion P = .042) and patient-oriented outcome measures (Foot and Ankle Ability Measure–Activities of Daily Living P < .001; Foot and Ankle Ability Measure–Sport P = .001; Fear Avoidance Belief Questionnaire P = .021) following a single DN treatment. Compounding effects from additional treatments exhibited improvement of TTDPM (T1B to T2). No significant losses were noted 4 weeks after cessation of treatment (T2 to T3). Conclusion: For the participants in this study, outcomes improved immediately following the first DN treatment. This improvement was sustained but not further improved with subsequent treatments.

Original languageEnglish
JournalJournal of Manipulative and Physiological Therapeutics
StateAccepted/In press - 2023

Bibliographical note

Funding Information:
The authors thank Stefanie Faull for her contribution to this article. Funding was received from the Retired Army Medical Specialist Corps Association Scholarship. No conflicts of interest were reported for this study. Concept development (provided idea for the research): J.F.M. M.C.H. A.J.N. Design (planned the methods to generate the results): J.F.M. M.C.H. A.J.N. Supervision (provided oversight, responsible for organization and implementation, writing of the manuscript): J.F.M. M.C.H. K.K. Data collection/processing (responsible for experiments, patient management, organization, or reporting data): J.F.M. M.C.H. P.G. Analysis/interpretation (responsible for statistical analysis, evaluation, and presentation of the results): J.F.M. M.C.H. K.K. P.W. Literature search (performed the literature search): J.F.M. Writing (responsible for writing a substantive part of the manuscript): J.F.M. Critical review (revised manuscript for intellectual content, this does not relate to spelling and grammar checking): J.F.M. M.C.H. P.G. N.H. K.K. P.W. A.J.N.

Publisher Copyright:
© 2023


  • Ankle Injuries
  • Joint Instability
  • Kinesthesis
  • Postural Balance
  • Rehabilitation

ASJC Scopus subject areas

  • Chiropractic


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