J Bodyw Mov Ther. 2025 Oct;44:423-431. doi: 10.1016/j.jbmt.2025.05.072. Epub 2025 Jun 7.

ABSTRACT

BACKGROUND: Patellofemoral pain (PFP) involves 25-40 % of painful knee cases. These patients complain of pain around the knee that is aggravated by pressure on the patella or upon stair climbing, standing, running and squatting. The effect of stretching exercises with or without dry needling treatment was investigated.

METHODS: This single-blind RCT enrolled 36 participants randomly allocated to either a stretching-only group (SO: 32.89 ± 7.51 years, BMI 23.00 ± 1.59 kg/m²) or a stretching plus dry needling group (SDN: 31.89 ± 8.32 years, BMI 22.47 ± 1.94 kg/m²) via permuted block randomization, with no significant demographic differences (all p > 0.05). Both groups completed 10 stretching sessions over two weeks (5 sessions/week), with the SDN group additionally receiving dry needling twice weekly (total of 4 sessions).Outcome measures included pain intensity, functional level, pain-pressure threshold, lunge and step-down tests, and ankle ROM, assessed at baseline, immediately post-intervention, and at 2-week follow-up.

RESULTS: The intervention group showed superior improvements in pain intensity and Kujala scores with significant time group interactions (p < 0.05). Both groups exhibited progressive gains in ROM, pain pressure thresholds, and functional tests over time (p < 0.001). Between-group comparisons confirmed larger post-intervention and sustained benefits for the SDN group, particularly in pain reduction, functional outcomes, and dorsiflexion ROM (p < 0.001). Lasting effects were observed at follow-up.

CONCLUSIONS: Combining dry needling with stretching exercises led to significantly greater pain reduction, improved functional score, enhanced dorsiflexion ROM compared to stretching alone, with benefits sustained long-term. Both groups improved over time, but the SDN group achieved superior, emphasizing dry needling’s added value in PFP rehabilitation.

TRIAL REGISTRATION: The article is registered in Shiraz University of Medical Sciences with grant number: 25297 and the prospective study protocol was reviewed and approved by the Iranian Center for Clinical Trials (IRCT20190909044734N3) with first trial registration at July 27, 2022.

PMID:40954611 | DOI:10.1016/j.jbmt.2025.05.072