Clinical impact and relevance of dry needling site location in the management of chronic neck pain: a randomized controlled trial
Bibliographic record
Abstract
Objective Clinical guidelines recommend combining exercise with other interventions, including dry needling (DN), for chronic neck pain (NP). The aim was to compare the effects of adding DN, applied locally or distant to the myofascial trigger point (MTrP) site location, to home exercise (HE) on pain, disability, and pressure pain sensitivity for chronic mechanical NP.Methods A single-blind parallel randomized controlled trial was conducted, including 68 adults (78.7% females, mean age: 47 ± 8.2 years) with chronic NP. All participants were assigned to one of the four groups: local DN + HE; distant DN + HE; sham DN + HE; or HE alone. A 12-week HE program was combined with three DN sessions over 4 weeks. The primary outcome was pain intensity at rest in neutral position, highest pain during cervical rotation and in the last 24 h, and pain in the previous week. The arithmetic mean (overall pain) of these ratings was calculated. Secondary measures included neck disability, pressure pain thresholds (PPTs) at muscular and neural sites, and the global rating of change (GROC). Data were collected at baseline, 4 weeks, and at 3- and 6-months.Results A group-by-time interaction was found for pain intensity at rest in neutral position, and for PPTs at ulnar nerve (both sides) and median nerve, anterior scalene, and splenius cervicis (all, left side only; p < 0.05). Post hoc comparisons showed a decrease of overall pain intensity at 6-months in the local DN vs. sham DN groups: estimated ratio ± standard error, 0.55 ± 0.09, p = 0.017. There were no differences between local or distant DN, except for the GROC at discharge.Conclusions Combining DN with HE reduces pain intensity in the medium term compared with HE alone. There were no differences between DN site locations (whether local or distant to the MTrP).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.006 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".