Regression Model Decreasing the Risk of Femoral Neurovascular Bundle Accidental Puncture

Although most of the adverse events derived from dry needling are minor, avoiding potential hazards for patients including accidental invasion of vessels, ganglia, and nerves is essential to ensure patients’ safety. We aimed to investigate the contribution of predictors explaining the variance of sartorius muscle depth limit at proximal third and middle thigh as these locations lead to an augmented risk of neurovascular bundle invasion during dry needling application. A diagnostic study was conducted on 84 subjects to calculate the accuracy of a prediction model for sartorius depth, as assessed with ultrasound imaging, based on sex, age, height, weight, body mass index (BMI), thigh perimeter, and length. After calculating a correlation matrix, a multiple linear regression analysis was performed to detect those variables contributing to the sartorius deep limit in both locations. Although males showed greater thigh perimeter than women (p < 0.001), the deep limit of the sartorius muscle was significantly more superficial for both the proximal third (p = 0.003) and the mid-third (p = 0.004) points. No side-to-side anthropometric differences were found (p > 0.05). In addition, we found sartorius muscle depth to be associated with the proximal and mid-third girth, gender, height, and BMI (all, p < 0.01). Gender, proximal-third girth, and BMI explained 51.1% and 42.6% of the variance for the sartorius deep limit at the proximal and the mid-third, respectively. This study analyzed whether anthropometric features could predict sartorius muscle depth in healthy participants for assisting clinicians in choosing the optimal needle length to avoid accidental femoral bundle puncture.

[1]  Ashfaq Ahmed,et al.  Effects of dry needling in lower extremity myofascial trigger points. , 2021, JPMA. The Journal of the Pakistan Medical Association.

[2]  C. Fernández‐de‐las‐Peñas,et al.  Accuracy and safety of dry needling placement in the popliteus muscle: A cadaveric study , 2021, International journal of clinical practice.

[3]  C. Fernández‐de‐las‐Peñas,et al.  Prediction model of rhomboid major and pleura depth based on anthropometric features to decrease the risk of pneumothorax during dry needling , 2020, International journal of clinical practice.

[4]  F. Kaviani,et al.  Comparison of the prevalence of myofascial trigger points of muscles acting on knee between patients with moderate degree of knee osteoarthritis and healthy matched people. , 2020, Journal of bodywork and movement therapies.

[5]  J. Cleland,et al.  Prediction Model of Soleus Muscle Depth Based on Anthropometric Features: Potential Applications for Dry Needling , 2020, Diagnostics.

[6]  D. Boyce,et al.  ADVERSE EVENTS ASSOCIATED WITH THERAPEUTIC DRY NEEDLING. , 2020, International journal of sports physical therapy.

[7]  S. Abolahrari-Shirazi,et al.  Prevalence and sensitivity of trigger points in lumbo-pelvic-hip muscles in patients with patellofemoral pain syndrome. , 2020, Journal of bodywork and movement therapies.

[8]  D. Resnick,et al.  Pes Anserinus: Anatomy and Pathology of Native and Harvested Tendons. , 2019, AJR. American journal of roentgenology.

[9]  S. Venkatesh,et al.  An Exact Localization of Adductor Canal and Its Clinical Significance: A Cadaveric Study , 2019, Anesthesia, essays and researches.

[10]  J. Dommerholt,et al.  The relative risk to the femoral nerve as a function of patient positioning: potential implications for trigger point dry needling of the iliacus muscle , 2019, The Journal of manual & manipulative therapy.

[11]  Jae-Ho Lee,et al.  A unique case of an accessory sartorius muscle , 2018, Surgical and Radiologic Anatomy.

[12]  I. Tekdemir,et al.  Re-defining the anatomical structures for blocking the nerves in adductor canal and sciatic nerve through the same injection site: an anatomical study , 2018, Surgical and Radiologic Anatomy.

[13]  M. Teramoto,et al.  Ultrasound Verification Of Safe Needle Examination Of The Rhomboid Major Muscle , 2018, Muscle & nerve.

[14]  L. Chou,et al.  A critical overview of the current myofascial pain literature - October 2017. , 2017, Journal of bodywork and movement therapies.

[15]  Leonid Kalichman,et al.  A myofascial component of pain in knee osteoarthritis. , 2017, Journal of bodywork and movement therapies.

[16]  Todd R. Hooks,et al.  A critical overview of the current myofascial pain literature - March 2017. , 2017, Journal of bodywork and movement therapies.

[17]  J. Børglum,et al.  Defining the Location of the Adductor Canal Using Ultrasound , 2016, Regional Anesthesia & Pain Medicine.

[18]  J. Halle,et al.  PERTINENT DRY NEEDLING CONSIDERATIONS FOR MINIMIZING ADVERSE EFFECTS - PART TWO. , 2016, International journal of sports physical therapy.

[19]  P. Côté,et al.  Effectiveness of Acupuncture Therapies to Manage Musculoskeletal Disorders of the Extremities: A Systematic Review. , 2016, The Journal of orthopaedic and sports physical therapy.

[20]  David Moher,et al.  STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies , 2015, BMJ : British Medical Journal.

[21]  C. Fernández‐de‐las‐Peñas,et al.  Association between muscle trigger points, ongoing pain, function, and sleep quality in elderly women with bilateral painful knee osteoarthritis. , 2015, Journal of Manipulative and Physiological Therapeutics.

[22]  J. Dommerholt,et al.  Adverse events following trigger point dry needling: a prospective survey of chartered physiotherapists , 2014, The Journal of manual & manipulative therapy.

[23]  S. George,et al.  Clinical Prediction Rules for Physical Therapy Interventions: A Systematic Review , 2009, Physical Therapy.

[24]  H. Kitakoji,et al.  Trigger Point Acupuncture for Treatment of Knee Osteoarthritis – a Preliminary Rct for a Pragmatic Trial , 2008, Acupuncture in medicine : journal of the British Medical Acupuncture Society.

[25]  Y H Chan,et al.  Biostatistics 104: correlational analysis. , 2003, Singapore medical journal.

[26]  John Cp Henderson,et al.  Myofascial Pain and Dysfunction: The Trigger Point Manual , 1984 .

[27]  Kathy Hoffman-Grotting Myofascial Pain and Dysfunction: The Trigger Point Manual , 1984 .