advanced dry needling packet texas

PT Solutions Evidence Based Practice Advanced Dry Needling for the Physical Therapist

COURSE DESCRIPTION:

This two-day, interactive course will facilitate advanced dry needling application an standards of practice to

varying clinical presentations. The intent of the course is to build on previous educational experiences with

dry needling with a course prerequisite of PT Solutions Primary Dry Needling for the Physical Therapist.

The course will promote advancement in application of dry needling practice utilizing didactic, laboratory

and case study learning experiences. The course will advance concepts previously taught in primary dry

needling course including: understanding of dry needling physiologic mechanisms, review and enhance the

neuroanatomical/physiologic knowledge of trigger points, dry needling pain management concepts and

safety issues related to dry needling practice including informed consent, preventing and managing adverse

responses to treatment. The course will also focus on the evaluation and assessment of current evidence-

based practice related to dry needling as well as education on appropriate utilization based on the

clinician’s state practice act.

LEARNING OBJECTIVES: PHYSICAL THERAPISTS

At the conclusion of the course, the physical therapist will be able to... 1. Demonstrate performance of dry needling intervention including justification of needle placement

given a case scenario of a patient with cervicogenic headaches.

2. Demonstrate performance of dry needling intervention including justification of needle

placement given a case scenario of a patient with plantar fasciitis.

3. Demonstrate performance of dry needling intervention including justification of needle

placement given a case scenario of a patient with SI joint dysfunction.

4. Defend clinical reasoning behind dry needling application based on current evidence,

given a case scenario.

5. Present three case studies that document clinical reasoning for dry needling including

patient outcome.

6. Demonstrate three assessments to determine patient response to intervention, given a case

scenario.

7. Verbalize four potential adverse responses to dry needling intervention.

8. Integrate dry needling into a patient plan of care given case scenario of a patient with

Temporo-mandibular Disorder with therapeutic assessment.

INTENDED PARTICIPANTS:

PT Solutions clinical employees to include Physical Therapists. This course is not intended for Physical

Therapist Assistants. Successful completion of PT Solution’s Primary Dry Needling course is required to

enroll in this course.

METHODS:

28.75 hours in total – 4.5 hours allocated to pre-reading and self study in preparation for course from

journals of education and learning, 24.25 hours in total allocated to didactic, lab and dry needling

techniques, case study review and practical examination. Dry needling techniques will be performed under

supervision, medical difficulties should be relayed to the instructor prior to course. Method of instruction

25% lecture and participation in clinical concepts, work in group for logical progression and problem

solving. 75% Lab including: testing and assessment, case study presentation, written documentation, hands

on treatment, with peer supervision and feedback. A post-test and practical examination will be given upon

completion of the


course with a minimum score of 80% required to pass and receive credit for participation. One re-take will

be allowed.

Additional assignments: Participants will be required to present three case studies utilizing dry needling

practice to include description of techniques utilized, patient response and patient outcome. Further

instruction and guidance on format of presentation included in course pre-assignments.

PLACE: PT Solutions Physical Therapy

ATTIRE: Lab Attire


AGENDA:

Day 1

• 7:00-8:00AM- Review of pain vs. nociceptive processes and responses

• 8:00-8:30AM- Review of trigger point physiology

• 8:30-9:00AM- Review of impact of dry needling

• 9:00-10:30AM- LAB: Tissue assessment and homeostatic points

• 10:30-11:00AM- Acute vs. chronic pain and clinical implications

• 11:30-12:00PM- Current literature review

• 12:00-12:30PM- Lunch

• 12:30-1:00PM- LAB: Review of safety, needle selection, technique justification

• 1:00-1:30PM- Review of neurophysiology and impact of dry needling

• 1:30-3:30PM- LAB: Case study presentations of lumbar spine and practical application

• 3:30-3:45PM- Break

• 3:45-6:00PM- LAB: Case study presentations of hip and SI joint and practical application

• 6:00-6:30PM- Dinner

• 6:30-8:00PM- LAB: Case study presentations of knee and practical application

• 8:00-8:15PM: Q&A and daily wrap-up

Day 2

• 7:00-7:30AM- Review of day 1 techniques; Q&A

• 7:30-9:30AM- LAB: Case study presentations of foot and ankle and practical application

• 9:30-11:30AM- LAB: Case study presentations of thoracic spine and abdomen practical application

• 11:30-12:00PM- Lunch

• 12:00-2:00PM- LAB: Case study presentations of head and neck and practical application

• 2:00-4:00PM- LAB: Case study presentations of shoulder and practical application

• 4:00-4:15PM- Break

• 4:15-6:15PM- LAB: Case study presentation of elbow, wrist and hand and practical application

• 6:15-6:45PM- Dinner

• 6:45-7:45PM- Assessing patient response to intervention; managing an adverse response

• 7:45-8:00PM- Course Wrap-Up; Q&A

• 8:00-8:30PM- Post-Test Assessment; Adjourn

Total Live In-Person: 24.25 hours


COURSE PRE-ASSIGNMENTS

Clinicians are expected to review the following concepts prior to course attendance: 1. Anatomy of Brachial, Cervical and Lumbosacral Plexus

2. Anatomy of spinal nerve

3. Anatomy of trigger point

4. Review of sympathetic and parasympathetic systems

5. Pre-reading materials listed below

Case Studies: Clinicians are required to document three case studies for presentation during the advanced dry

needling course. Case format and instructions are provided below.

Pre-Reading Material:

1. Halle JS, Halle RJ. Pertinent dry needling considerations for minimizing adverse effects- part one. Int J

Sports Phys Ther. 2016 Aug;11(4):651-662. (11 pages)

2. Halle JS, Halle RJ. Pertinent dry needling considerations for minimizing adverse effects- part two.

IJSPT 2016 Oct;11(5):810-819 (9 pages)

3. Kalichman L, Vulfsons S. Dry needling in the management of musculoskeletal pain. JABFM 2010

Oct;23(5):640-646. (6 pages)

4. Dunning J, Butts R, Mourad F et al. Dry needling: a literature review with implications for clinical

practice guidelines. Phys Ther Reviews 2014;19(4):252-265. (10 pages)

5. Liu QG, Liu L, Huang QM, et al. Decreased spontaneous electrical activity and acetylcholine at

myofascial trigger spots after dry needling treatment: a pilot study. Evid Based Complement Alternat

Med. 2017;2017:1-7. (7 pages)

6. Morihisa R, Eskew J, McNamara A. Dry needling in subjects with muscular trigger points in the lower

quarter: a systematic review. Int J Sports Phys Ther. 2016 Feb;11(1):1-14. (13 pages)

56 total pages at Intermediate level = 3.75 CCUs

PT Solutions Level 2 Dry Needling Course Advanced Clinical Application

Case Study

©2021 PT Solutions Level 2 Dry Needling Course - Advanced Clinical Application – Case Study

Case Study Requirement: Due on no later than DATE HERE emailed to Lilly Castor ([email protected])

Written in single space format 2 case reports, one on each page, of patients that have been dry needled (by

you, if you have sufficient hours or by another certified clinician):

1. History2. Subjective history3. Objective treatment summary including dry needling use – length of needle – number of times

applied, response, application time,4. Other clinical treatment included5. Outcome


Case Study


Case Study Report 1:

History:

Subjective History:

Objective Treatment Summary:

Other Clinical Treatment:

Outcome:


Case Study



History:

Subjective History:



Outcome:

Course Evaluation PT Solutions

Advanced Dry Needling Course

Please rate experience today on the following scale from 1-5.

1. Instructor Poor 1 2 3 4 5 Excellent

2. Content Poor 1 2 3 4 5 Excellent

3. Pre-course Reading Material Poor 1 2 3 4 5 Excellent

4. Usefulness of Material Poor 1 2 3 4 5 Excellent

5. Clarity of Discussion Points Poor 1 2 3 4 5 Excellent

6. Ability to relate to my clinic/hospital Poor 1 2 3 4 5 Excellent

7. Meeting Room Poor 1 2 3 4 5 Excellent

8. I felt today was valuable Poor 1 2 3 4 5 Excellent

9. I suggest the following improvements totoday’s presentation:

10. How will the course change the way you practice and treat your patients?

11. I would like to see future meetings/seminars discussing the following topics:

_

_

_

_

PT Solutions Physical Therapy

Advanced Dry Needling Exam

Name:

1. The gold standard for testing the integrity of a nerve is NCV/EMG.

a. True

b. False

2. Dry needling uses the same monofilament needle as acupuncture.

a. True

b. False

3. The purpose of homeostatic points is to evaluate the patient.

a. True

b. False

4. The C5-6 cervical segment has relationships with all of the following nerves except:

a. suprascapular and subscapular nerve

b. Radial and axillary nerve

c. Dorsal Scapular nerve

d. Musculocutaneous nerve

5. The femoral nerve is made up of which lumbar nerve roots?

a. L1, 2, and 3

b. L2 and 3

c. L2, 3, and 4

d. L3, 4, and 5

6. What is the dermatome, myotome, and DTR for the C6 nerve root?

a. Third digit, elbow flexion/wrist flexion, and biceps brachii

b. Third digit, elbow extension/wrist flexion, and brachialis

c. First digit, elbow flexion/wrist extension, and brachioradialis

d. First digit, elbow extension/wrist extension, and biceps brachii

7. Which of the following can cause allodynia at the trigger point site and hyperalgesia awayfrom

the trigger point site?

a. Latent trigger points

b. Active trigger points

c. Both a and b

d. None of the above

8. According to which model, muscle pain inhibits the alpha-motor neurons leading to activation

of antagonists and an overall decrease in motor function?

a. Pain-adaptation model

b. New motor adaptation model

c. Pain-spasm-pain cycle theory

d. Ma theory of homeostasis

9. targets primarily peripheral sensory afferents, while targets mostly

dysfunctional motor units.

a. Intrasmuscular stimulation, superficial trigger point dry needling

b. Wet needling, integrative systemic dry needling

c. Deep trigger point dry needling, superficial needling

d. Superficial needling, deep trigger point dry needling

e. None of the above

10. A is a receptor specialized in detecting stimuli that can damage tissue and perceived

as painful.

a. Mechanoreceptor

b. Nociceptor

c. Golgi tendon organ

d. Muscle spindle

11. Active trigger points are associated with:

a. Neuromuscular “jitter”

b. Higher pain thresholds with electrical stimulation

c. Contractured muscle fibers

d. Downregulation of acetylcholine

e. A and C

f. B and C

12. Endplate dysfunction does not play a role in most trigger points.

a. True

b. False

13. At PT Solutions Physical Therapy, a verbal consent is sufficient prior to performing dry needling.

a. True

b. False

14. PT Solutions Physical Therapy has a dry needling policy and procedure which can be found in

which of the following places in ALL clinics?

a. Email in Outlook

b. Physical Front office Policy and Procedure Binder

c. Internet


15. Trigger points may develop due to all of the following except?

a. Eccentric and concentric loading

b. High-load repetitive tasks

c. Repiratory distress

d. Visceral pain and dysfunction

16. Which reflex most accurately tests the C6 neurological level?

a. Triceps

b. Long Finger flexors

c. Brachioradialis

d. Biceps Brachii

17. The following statements concerning the lateral cord of the brachial plexus are true exceptwhich?

a. It contains sympathetic nerve fibers

b. It has a branch that supplies the pectoralis major muscle

c. It has a branch that supplies the skin on the lateralside of the forearm

d. It has a branch that supplies the skin on the lateralside of the upper arm

e. It lies lateral to the second part of the axillary artery

18. Arthritic pain can effectively be treated by dry needling of trigger points surrounding joints.

a. True

b. False

19. At the active trigger point sites, you find all of the following except?

a. Decrease ATP

b. Increased Substance P

c. Decreased pH

d. Increased Bradykinin

e. You find all of these at the site of an active trigger point.

20. In which of the following states may a Physical Therapist not practice Dry Needling?

a. GA

b. AL

c. FL

d. IL

21. PTAs may perform Dry Needling in which of the following states?

a. GAb. ALc. TXd. FLe. None of the above

22. Patients with active trigger points in the upper trapezius muscle exhibit all except which of thefollowing?

a. Enhanced somatosensory activityb. Enhanced limbic activityc. Increased activity of the dorsal hippocampusd. Increased levels of Substance P at the gastrocnemius muscle.

23. Dry needling can result in which of the following?

a. Decrease in painb. Increase in range of motionc. Restore muscle activation patternsd. Reduce endplate noisee. All of the above

24. Lidocaine injections have been found to be far superb to dry needling, especially in terms oflong-term pain reduction.

a. Trueb. False

*PLACE THE LETTER FROM ABOVE BY THE CORRESPONDING STRUCTURAL NAME BELOW.

25. Suprascapular nerve 33. Musculocutaneous nerve

26. Medial cutaneous nerve of forearm 34. Upper subscapular nerve

27. Dorsal scapular nerve 35. Ulnar nerve

28. Nerve to subclavius 36. Long thoracic nerve

29. Thoracodorsal nerve 37. Medial pectoral nerve

30. Lower subscapular nerve 38. Radial nerve

31. Axillary nerve 39. Median nerve

32. Lateral pectoral nerve 40. Medial cutaneous nerve of arm

41. At what angulation of needle insertion is used to create the largest amount of tissue lesion?

a. Parallel to muscle fiber orientation

b. Perpendicular to muscle fiber orientation

c. 45 degree angle to muscle fiber orientation

d. Needle angulation does not matter to create tissue lesion.

42. What nerve is responsible for innervating the prime retractors of the scapula?

a. Dorsal scapular nerve

b. Long thoracic nerve

c. Thoracodorsal nerve

d. Lower subscapular nerve

43. A 32 year old patient presents to your clinic with reports of numbness and parasthesia

throughout her forearm. Symptoms are along the radial/palmer region of the forearm. With

no additional information from subjective or objective assessment , what nerve is mostlikely

involved?

a. Superficial sensory branch of the radial nerve

b. Lateral antebrachial cutaneous nerve

c. Posterior interosseus nerve

d. Medial antebrachial cutaneous nerve

44. Possible side effects from dry needling may persist for how long?

a. 3-8 hours

b. Up to 4 days

c. Up to 1 week

d. 24 hours

45. When performing dry needling to lumbar paraspinals what was the rule of thumb that was

discussed in laboratory training?

a. 1inch needle 1 finger width from spinous process

b. 2 inch needle 2 fingers width from spinous process

c. 3inch needle 3 fingers width the spinous process


46. You are considering needling someone with TMJ dysfunction and they present with pain from

their maxilla, forehead and side of head above the ear. Trigger points in what muscle are most

likely to refer pain to these areas?

a. Masseter

b. Posterior scalene

c. SCM

d. Temporalis

47. Dry needling can be indicated for individuals with muscle or ligament sprains/strain, what is the

most commonly sprained ligament in the ankle?

a. Anterior talofibular ligament

b. Deltoid ligament

c. Calcaneofibular ligament

d. Anterior tibiofibular ligament

48. A patient presents to therapy with diagnosis of chronic Achilles tendonapthy. What single

treatment method is most likely to allow the patient to achieve the greatest results?

a. Dry needling to Achilles tendon and related trigger points throughout gastrocnemius

and soleus, 3x week for 6 weeks

b. Thrust and non-thrust mobilization to talocrural joint , 3x week for 6 weeks

c. Eccentric exercises, 3x15 BID for 12 weeks

d. Concentric exercises, 3x15 BID for 12 weeks

49. What are normal patient responses to dry needling?

a. Dull Ache

b. Heavy Feeling

c. Warm or burning feeling

d. All of the above

50. Based on Needle safety what is the longest length of dry needle that should be used whenneedling the shoulder? (i.e deltoid muscle belly)

a. 0.5-1 inchb. 1-2 inchesc. 2-3 inchesd. 3-4 inches

51. How many research papers have been written on dry needling in 2013?

a. 143

b. 230

c. 246

d. 346

52. Sensory nerve fibers have three phase which include

a. Latent

b. Passive

c. Active

d. Homeostatic

e. A, B, and C

53. How many pounds of pressure is applied when the thumbnail color changes to white when

applying pressure to a trigger point?

a. 1 pound of pressure

b. 2-3pounds of pressure

c. 7 pounds of pressure

d. 10 pounds of pressure

54. What size needling shoulder be used when needling the facial and cranial region?

a. .5-1 inch

b. 1-2 inches

c. 2-3 inches

d. 3-4 inches

55. The following statements concerning the rotator cuff are correct except which?

a. It adds stability to the shoulder joint.

b. It is formed by the tendons of the short muscles around the shoulder joint.

c. The muscle tendons are fused to the capsule of the shoulder joint.

d. Degeneration or tearing of the cuff will cause severe pain in the shoulder region.

e. All the muscle tendons associated with the cuff are innervated by the suprascapular nerve.

56. The Gunn intramuscular stimulation (IMS) technique is based on the thought that myofascial pain syndrome

is always the result of peripheral neuropathy.

a. True

b. False

57. According to Gunn, MTrPs are a result of shortened multifidi muscles.

a. True

b. False

58. How many days should lapse between dry needling treatments of a healthy patient?

a. 24 hours

b. 2-3 days

c. 4-7 days

d. It doesn’t matter if they are healthy.

66

77

76

69

62

61

65

83

64

82

63

73 81

80

79

78

72

71

70

75 68

67

74

60

59. Common structural components of a neuron include all of the following except:

a. Dendrite

b. Cell body

c. Axon

d. Ganglion

**For numbers 60-83, please identify the 24 homeostatic acupoints. Note: There are a couple on the

posterior view that could be interchanged easily and you will still get credit for those (69, 70, 75 and 76) as

long as they are one of the four answers mentioned.

60.

61.

62.

63.

64.

65.

66.

67.

68.

69.

70.

71.

72.

73.

74.

75.

76.

77.

78.

79.

80.

81.

82.

83.

a. supraorbital

b. infraorbital

c. deep fibular

d. tibial

e. common fibular

f. saphenous

g. lateral pectoral

h. greater occipital

i. sural

j. lateral popliteal

k. iliotibial

l. spinal accessory

m. dorsal scapular

n. suprascapular (infraspinatus)

o. lateral antebrachial cutaneous

p. superficial radial

q. inferior gluteal

r. superior cluneal

s. posterior cutaneous of L2

t. spinous process of T7

u. greater auricular

v. posterior cutaneous of L5

w. posterior cutaneous of T6

x. deep radial

Name: Date:

Clinic: Score:

PT Solutions Evidence Based Practice Advanced Dry Needling Reference List

1. Abate M, Di Carlo L, Salini V. Platelet rich plasma compared to dry needling in the treatment of non-insertionalAchilles tendinopathy. Phys Sportsmed 2019;47(2):232-37 doi: 10.1080/00913847.2018.1548886published Online First: Epub Date]|.

2. Abbaszadeh-Amirdehi M, Ansari NN, Naghdi S, Olyaei G, Nourbakhsh MR. Neurophysiological and clinical effectsof dry needling in patients with upper trapezius myofascial trigger points. J Bodyw Mov Ther 2017;21(1):48-52doi: 10.1016/j.jbmt.2016.04.014published Online First: Epub Date]|.

3. Abbaszadeh-Amirdehi M, Ansari NN, Naghdi S, Olyaei G, Nourbakhsh MR. Therapeutic effects of dry needling inpatients with upper trapezius myofascial trigger points. Acupunct Med 2017;35(2):85-92 doi: 10.1136/acupmed-2016-011082published Online First: Epub Date]|.

4. Anandkumar S. Effect of dry needling on myofascial pain syndrome of the quadratus femoris: A case report.Physiother Theory Pract 2018;34(2):157-64 doi: 10.1080/09593985.2017.1376021published Online First: Epub Date]|.

5. Anandkumar S, Manivasagam M. Effect of dry needling on cubital tunnel syndrome: Three case reports.Physiother Theory Pract 2019;35(4):363-72 doi: 10.1080/09593985.2018.1449275published Online First: Epub Date]|.

6. Ansari NN, Alaei P, Naghdi S, Fakhari Z, Komesh S, Dommerholt J. Immediate Effects of Dry Needling as a NovelStrategy for Hamstring Flexibility: A Single-Blinded Clinical Pilot Study. J Sport Rehabil 2019:1-6 doi: 10.1123/jsr.2018-0013published Online First: Epub Date]|.

7. Arias-Buria JL, Fernandez-de-Las-Penas C, Palacios-Cena M, Koppenhaver SL, Salom-Moreno J. Exercises andDry Needling for Subacromial Pain Syndrome: A Randomized Parallel-Group Trial. J Pain 2017;18(1):11-18doi: 10.1016/j.jpain.2016.08.013published Online First: Epub Date]|.

8. Arias-Buria JL, Martin-Saborido C, Cleland J, Koppenhaver SL, Plaza-Manzano G, Fernandez-de-Las-Penas C.Cost-effectiveness Evaluation of the Inclusion of Dry Needling into an Exercise Program for Subacromial Pain Syndrome: Evidence from a Randomized Clinical Trial. Pain Med 2018;19(12):2336-47 doi: 10.1093/pm/pny021published Online First: Epub Date]|.

9. Aydin T, Dernek B, Senturk Ege T, Karan A, Aksoy C. The Effectiveness of Dry Needling and Exercise Therapy inPatients with Dizziness Caused By Cervical Myofascial Pain Syndrome; Prospective Randomized Clinical Study. Pain Med 2019;20(1):153-60 doi: 10.1093/pm/pny072published Online First: Epub Date]|.

10. Azizian M, Bagheri H, Olyaei G, et al. Effects of dry needling on tendon-pulley architecture, pain and handfunction in patients with trigger finger: a randomized controlled trial study. J Phys Ther Sci 2019;31(4):295-98doi: 10.1589/jpts.31.295published Online First: Epub Date]|.

11. Ball AM, Finnegan M, Koppenhaver S, et al. The relative risk to the femoral nerve as a function of patientpositioning: potential implications for trigger point dry needling of the iliacus muscle. J Man Manip Ther 2019;27(3):162-71 doi: 10.1080/10669817.2019.1568699published Online First: Epub Date]|.

12. Bandy WD, Nelson R, Beamer L. Comparison of Dry Needling Vs. Sham on the Performance of Vertical Jump. IntJ Sports Phys Ther 2017;12(5):747-51

13. Baraja-Vegas L, Martin-Rodriguez S, Piqueras-Sanchiz F, et al. Localization of Muscle Edema and Changes onMuscle Contractility After Dry Needling of Latent Trigger Points in the Gastrocnemius Muscle. Pain Med 2019 doi: 10.1093/pm/pny306published Online First: Epub Date]|.

14. Berrigan WA, Whitehair CL, Zorowitz RD. Acute Spinal Epidural Hematoma as a Complication of Dry Needling: ACase Report. PM R 2019;11(3):313-16 doi: 10.1016/j.pmrj.2018.07.009published Online First: Epub Date]|.

15. Blasco-Bonora PM, Martin-Pintado-Zugasti A. Effects of myofascial trigger point dry needling in patients withsleep bruxism and temporomandibular disorders: a prospective case series. Acupunct Med 2017;35(1):69-74doi: 10.1136/acupmed-2016-011102published Online First: Epub Date]|.

16. Brennan KL, Allen BC, Maldonado YM. Dry Needling Versus Cortisone Injection in the Treatment of GreaterTrochanteric Pain Syndrome: A Noninferiority Randomized Clinical Trial. J Orthop Sports Phys Ther 2017;47(4):232-39 doi: 10.2519/jospt.2017.6994published Online First: Epub Date]|.

17. Calvo-Lobo C, Pacheco-da-Costa S, Hita-Herranz E. Efficacy of Deep Dry Needling on Latent Myofascial TriggerPoints in Older Adults With Nonspecific Shoulder Pain: A Randomized, Controlled Clinical Trial Pilot Study. J Geriatr Phys Ther 2017;40(2):63-73 doi: 10.1519/JPT.0000000000000048published Online First: Epub Date]|.

18. Calvo-Lobo C, Pacheco-da-Costa S, Martinez-Martinez J, Rodriguez-Sanz D, Cuesta-Alvaro P, Lopez-Lopez D.Dry Needling on the Infraspinatus Latent and Active Myofascial Trigger Points in Older Adults With Nonspecific


Shoulder Pain: A Randomized Clinical Trial. J Geriatr Phys Ther 2018;41(1):1-13 doi: 10.1519/JPT.0000000000000079published Online First: Epub Date]|.

19. Castro Sanchez AM, Garcia Lopez H, Fernandez Sanchez M, et al. Improvement in clinical outcomes after dryneedling versus myofascial release on pain pressure thresholds, quality of life, fatigue, pain intensity, quality of sleep, anxiety, and depression in patients with fibromyalgia syndrome. Disabil Rehabil 2019;41(19):2235-46doi: 10.1080/09638288.2018.1461259published Online First: Epub Date]|.

20. Castro-Sanchez AM, Garcia-Lopez H, Mataran-Penarrocha GA, et al. Effects of Dry Needling on Spinal Mobilityand Trigger Points in Patients with Fibromyalgia Syndrome. Pain Physician 2017;20(2):37-52

21. Cruz-Montecinos C, Nunez-Cortes R, Bruna-Melo T, et al. Dry needling technique decreases spasticity andimproves general functioning in incomplete spinal cord injury: A case report. J Spinal Cord Med 2018:1-5 doi:10.1080/10790268.2018.1533316published Online First: Epub Date]|.

22. De Meulemeester K, Calders P, Dewitte V, Barbe T, Danneels L, Cagnie B. Surface Electromyographic Activity ofthe Upper Trapezius Before and After a Single Dry Needling Session in Female Office Workers With Trapezius Myalgia. Am J Phys Med Rehabil 2017;96(12):861-68 doi: 10.1097/PHM.0000000000000761published Online First: Epub Date]|.

23. De Meulemeester KE, Castelein B, Coppieters I, Barbe T, Cools A, Cagnie B. Comparing Trigger Point DryNeedling and Manual Pressure Technique for the Management of Myofascial Neck/Shoulder Pain: A Randomized Clinical Trial. J Manipulative Physiol Ther 2017;40(1):11-20 doi: 10.1016/j.jmpt.2016.10.008published Online First: Epub Date]|.

24. Dekkers TJ, van Rentergem JAA, Meijer B, Popma A, Wagemaker E, Huizenga HM. A meta-analytical evaluationof the dual-hormone hypothesis: Does cortisol moderate the relationship between testosterone and status, dominance, risk taking, aggression, and psychopathy? Neurosci Biobehav Rev 2019;96:250-71 doi: 10.1016/j.neubiorev.2018.12.004published Online First: Epub Date]|.

25. Escaloni J, Butts R, Dunning J. The use of dry needling as a diagnostic tool and clinical treatment for cervicogenicdizziness: a narrative review & case series. J Bodyw Mov Ther 2018;22(4):947-55 doi: 10.1016/j.jbmt.2018.02.015published Online First: Epub Date]|.

26. Espejo-Antunez L, Tejeda JF, Albornoz-Cabello M, et al. Dry needling in the management of myofascial triggerpoints: A systematic review of randomized controlled trials. Complement Ther Med 2017;33:46-57 doi: 10.1016/j.ctim.2017.06.003published Online First: Epub Date]|.

27. Espi-Lopez GV, Serra-Ano P, Vicent-Ferrando J, et al. Effectiveness of Inclusion of Dry Needling in a MultimodalTherapy Program for Patellofemoral Pain: A Randomized Parallel-Group Trial. J Orthop Sports Phys Ther 2017;47(6):392-401 doi: 10.2519/jospt.2017.7389published Online First: Epub Date]|.

28. Fakhari Z, Ansari NN, Naghdi S, Mansouri K, Radinmehr H. A single group, pretest-posttest clinical trial for theeffects of dry needling on wrist flexors spasticity after stroke. NeuroRehabilitation 2017;40(3):325-36 doi: 10.3233/NRE-161420published Online First: Epub Date]|.

29. Fernandez-Carnero J, Gilarranz-de-Frutos L, Leon-Hernandez JV, et al. Effectiveness of Different Deep DryNeedling Dosages in the Treatment of Patients With Cervical Myofascial Pain: A Pilot RCT. Am J Phys Med Rehabil 2017;96(10):726-33 doi: 10.1097/PHM.0000000000000733published Online First: Epub Date]|.

30. Gattie E, Cleland JA, Snodgrass S. The Effectiveness of Trigger Point Dry Needling for MusculoskeletalConditions by Physical Therapists: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther 2017;47(3):133-49 doi: 10.2519/jospt.2017.7096published Online First: Epub Date]|.

31. Gattie ER, Cleland JA, Snodgrass SJ. Dry Needling for Patients With Neck Pain: Protocol of a RandomizedClinical Trial. JMIR Res Protoc 2017;6(11):e227 doi: 10.2196/resprot.7980published Online First: Epub Date]|.

32. Gaubeca-Gilarranz A, Fernandez-de-Las-Penas C, Medina-Torres JR, et al. Effectiveness of dry needling ofrectus abdominis trigger points for the treatment of primary dysmenorrhoea: a randomised parallel-group trial. Acupunct Med 2018;36(5):302-10 doi: 10.1136/acupmed-2017-011566published Online First: Epub Date]|.

33. Geist K, Bradley C, Hofman A, et al. Clinical Effects of Dry Needling Among Asymptomatic Individuals WithHamstring Tightness: A Randomized Controlled Trial. J Sport Rehabil 2017;26(6):507-17 doi: 10.1123/jsr.2016-0095published Online First: Epub Date]|.

34. Gerber LH, Sikdar S, Aredo JV, et al. Beneficial Effects of Dry Needling for Treatment of Chronic Myofascial PainPersist for 6 Weeks After Treatment Completion. PM R 2017;9(2):105-12 doi: 10.1016/j.pmrj.2016.06.006published Online First: Epub Date]|.

35. Ghaffari MS, Shariat A, Honarpishe R, et al. Concurrent Effects of Dry Needling and Electrical Stimulation in theManagement of Upper Extremity Hemiparesis. J Acupunct Meridian Stud 2019;12(3):90-94 doi: 10.1016/j.jams.2019.04.004published Online First: Epub Date]|.

36. Gildir S, Tuzun EH, Eroglu G, Eker L. A randomized trial of trigger point dry needling versus sham needling forchronic tension-type headache. Medicine (Baltimore) 2019;98(8):e14520 doi: 10.1097/MD.0000000000014520published Online First: Epub Date]|.

37. Griswold D, Gargano F, Learman KE. A randomized clinical trial comparing non-thrust manipulation withsegmental and distal dry needling on pain, disability, and rate of recovery for patients with non-specific low back pain. J Man Manip Ther 2019;27(3):141-51 doi: 10.1080/10669817.2019.1574389published Online First: Epub Date]|.

38. Griswold D, Wilhelm M, Donaldson M, Learman K, Cleland J. The effectiveness of superficial versus deep dryneedling or acupuncture for reducing pain and disability in individuals with spine-related painful conditions: a systematic review with meta-analysis. J Man Manip Ther 2019;27(3):128-40 doi: 10.1080/10669817.2019.1589030published Online First: Epub Date]|.

39. Hadi S, Khadijeh O, Hadian M, et al. The effect of dry needling on spasticity, gait and muscle architecture inpatients with chronic stroke: A case series study. Top Stroke Rehabil 2018;25(5):326-32 doi: 10.1080/10749357.2018.1460946published Online First: Epub Date]|.

40. Hakim IK, Takamjani IE, Sarrafzadeh J, Ezzati K, Bagheri R. The effect of dry needling on the active trigger pointof upper trapezius muscle: Eliciting local twitch response on long-term clinical outcomes. J Back Musculoskelet Rehabil 2019 doi: 10.3233/BMR-181286published Online First: Epub Date]|.

41. Hall ML, Mackie AC, Ribeiro DC. Effects of dry needling trigger point therapy in the shoulder region on patientswith upper extremity pain and dysfunction: a systematic review with meta-analysis. Physiotherapy 2018;104(2):167-77 doi: 10.1016/j.physio.2017.08.001published Online First: Epub Date]|.

42. Hando BR, Rhon DI, Cleland JA, Snodgrass SJ. Dry needling in addition to standard physical therapy treatmentfor sub-acromial pain syndrome: a randomized controlled trial protocol. Braz J Phys Ther 2018 doi: 10.1016/j.bjpt.2018.10.010published Online First: Epub Date]|.

43. Haser C, Stoggl T, Kriner M, et al. Effect of Dry Needling on Thigh Muscle Strength and Hip Flexion in EliteSoccer Players. Med Sci Sports Exerc 2017;49(2):378-83 doi: 10.1249/MSS.0000000000001111published Online First: Epub Date]|.

44. He C, Ma H. Effectiveness of trigger point dry needling for plantar heel pain: a meta-analysis of sevenrandomized controlled trials. J Pain Res 2017;10:1933-42 doi: 10.2147/JPR.S141607published Online First: Epub Date]|.

45. Hu HT, Gao H, Ma RJ, Zhao XF, Tian HF, Li L. Is dry needling effective for low back pain?: A systematic reviewand PRISMA-compliant meta-analysis. Medicine (Baltimore) 2018;97(26):e11225 doi: 10.1097/MD.0000000000011225published Online First: Epub Date]|.

46. Huang Q, Zhang Y, Ma Y, et al. [Understanding of the trigger points of myalgia: acupuncture and dry needlingexploration and modern acupuncture mechanism]. Zhongguo Zhen Jiu 2018;38(7):779-84 doi: 10.13703/j.0255-2930.2018.07.027published Online First: Epub Date]|.

47. Kamali F, Mohamadi M, Fakheri L, Mohammadnejad F. Dry needling versus friction massage to treat tension typeheadache: A randomized clinical trial. J Bodyw Mov Ther 2019;23(1):89-93 doi: 10.1016/j.jbmt.2018.01.009published Online First: Epub Date]|.

48. Kamali F, Sinaei E, Morovati M. Comparison of Upper Trapezius and Infraspinatus Myofascial Trigger PointTherapy by Dry Needling in Overhead Athletes With Unilateral Shoulder Impingement Syndrome. J Sport Rehabil 2019;28(3):243-49 doi: 10.1123/jsr.2017-0207published Online First: Epub Date]|.

49. Lake AD, Myers H, Aefsky B, Butler R. Immediate and Short Term Effect of Dry Needling on Triceps SuraeRange of Motion and Functional Movement: A Randomized Trial. Int J Sports Phys Ther 2018;13(2):185-95

50. Liu L, Huang QM, Liu QG, et al. Evidence for Dry Needling in the Management of Myofascial Trigger PointsAssociated With Low Back Pain: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil 2018;99(1):144-52 e2 doi: 10.1016/j.apmr.2017.06.008published Online First: Epub Date]|.

51. Machado E, Machado P, Wandscher VF, Marchionatti AME, Zanatta FB, Kaizer OB. A systematic review ofdifferent substance injection and dry needling for treatment of temporomandibular myofascial pain. Int J Oral Maxillofac Surg 2018;47(11):1420-32 doi: 10.1016/j.ijom.2018.05.003published Online First: Epub Date]|.


52. Martin-Pintado-Zugasti A, Fernandez-Carnero J, Leon-Hernandez JV, et al. Postneedling Soreness andTenderness After Different Dosages of Dry Needling of an Active Myofascial Trigger Point in Patients With Neck Pain: A Randomized Controlled Trial. PM R 2018;10(12):1311-20 doi: 10.1016/j.pmrj.2018.05.015published Online First: Epub Date]|.

53. Martin-Pintado-Zugasti A, Mayoral Del Moral O, Gerwin RD, Fernandez-Carnero J. Post-needling soreness aftermyofascial trigger point dry needling: Current status and future research. J Bodyw Mov Ther 2018;22(4):941-46 doi: 10.1016/j.jbmt.2018.01.003published Online First: Epub Date]|.

54. Martin-Rodriguez A, Saez-Olmo E, Pecos-Martin D, Calvo-Lobo C. Effects of dry needling in thesternocleidomastoid muscle on cervical motor control in patients with neck pain: a randomised clinical trial. Acupunct Med 2019;37(3):151-63 doi: 10.1177/0964528419843913published Online First: Epub Date]|.

55. McDevitt AW, Snodgrass SJ, Cleland JA, Leibold MBR, Krause LA, Mintken PE. Treatment of individuals withchronic bicipital tendinopathy using dry needling, eccentric-concentric exercise and stretching; a case series. Physiother Theory Pract 2018:1-11 doi: 10.1080/09593985.2018.1488023published Online First: Epub Date]|.

56. McDowell JM, Kohut SH, Betts D. Safe acupuncture and dry needling during pregnancy: New Zealandphysiotherapists' opinion and practice. J Integr Med 2019;17(1):30-37 doi: 10.1016/j.joim.2018.11.006published Online First: Epub Date]|.

57. Ozden MCP, Atalay B Dds MP, Ozden Av Dds P, Cankaya Ab Dds P, Kolay EP, Yildirim S Dds P. Efficacy of dryneedling in patients with myofascial temporomandibular disorders related to the masseter muscle. Cranio 2018:1-7 doi: 10.1080/08869634.2018.1526848published Online First: Epub Date]|.

58. Perez-Palomares S, Olivan-Blazquez B, Perez-Palomares A, et al. Contribution of Dry Needling to IndividualizedPhysical Therapy Treatment of Shoulder Pain: A Randomized Clinical Trial. J Orthop Sports Phys Ther 2017;47(1):11-20 doi: 10.2519/jospt.2017.6698published Online First: Epub Date]|.

59. Perreault T, Dunning J, Butts R. The local twitch response during trigger point dry needling: Is it necessary forsuccessful outcomes? J Bodyw Mov Ther 2017;21(4):940-47 doi: 10.1016/j.jbmt.2017.03.008published Online First: Epub Date]|.

60. Rajkannan P, Vijayaraghavan R. Dry needling in chronic abdominal wall pain of uncertain origin. J Bodyw MovTher 2019;23(1):94-98 doi: 10.1016/j.jbmt.2018.01.004published Online First: Epub Date]|.

61. Rastegar S, Baradaran Mahdavi S, Hoseinzadeh B, Badiei S. Comparison of dry needling and steroid injection inthe treatment of plantar fasciitis: a single-blind randomized clinical trial. Int Orthop 2018;42(1):109-16 doi: 10.1007/s00264-017-3681-1published Online First: Epub Date]|.

62. Rossi A, Blaustein S, Brown J, et al. Spinal and Peripheral Dry Needling Versus Peripheral Dry Needling Aloneamong Individuals with a History of Lateral Ankle Sprain: A Randomized Controlled Trial. Int J Sports Phys Ther 2017;12(7):1034-47

63. Salom-Moreno J, Jimenez-Gomez L, Gomez-Ahufinger V, et al. Effects of Low-Load Exercise on Postneedling-Induced Pain After Dry Needling of Active Trigger Point in Individuals With Subacromial Pain Syndrome. PM R 2017;9(12):1208-16 doi: 10.1016/j.pmrj.2017.04.012published Online First: Epub Date]|.

64. Sanchez Romero EA, Fernandez-Carnero J, Calvo-Lobo C, Ochoa Saez V, Burgos Caballero V, Pecos-Martin D.Is a Combination of Exercise and Dry Needling Effective for Knee OA? Pain Med 2019 doi: 10.1093/pm/pnz036published Online First: Epub Date]|.

65. Sanchez-Mila Z, Salom-Moreno J, Fernandez-de-Las-Penas C. Effects of dry needling on post-stroke spasticity,motor function and stability limits: a randomised clinical trial. Acupunct Med 2018;36(6):358-66 doi: 10.1136/acupmed-2017-011568published Online First: Epub Date]|.

66. Sanchez-Romero EA, Pecos-Martin D, Calvo-Lobo C, Ochoa-Saez V, Burgos-Caballero V, Fernandez-Carnero J.Effects of dry needling in an exercise program for older adults with knee osteoarthritis: A pilot clinical trial. Medicine (Baltimore) 2018;97(26):e11255 doi: 10.1097/MD.0000000000011255published Online First: Epub Date]|.

67. Sedighi A, Nakhostin Ansari N, Naghdi S. Comparison of acute effects of superficial and deep dry needling intotrigger points of suboccipital and upper trapezius muscles in patients with cervicogenic headache. J Bodyw Mov Ther 2017;21(4):810-14 doi: 10.1016/j.jbmt.2017.01.002published Online First: Epub Date]|.

68. Sutlive TG, Golden A, King K, et al. Short-Term Effects of Trigger Point Dry Needling on Pain and Disability inSubjects with Patellofemoral Pain Syndrome. Int J Sports Phys Ther 2018;13(3):462-73


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74. Uygur E, Aktas B, Eceviz E, Yilmazoglu EG, Poyanli O. Preliminary Report on the Role of Dry Needling VersusCorticosteroid Injection, an Effective Treatment Method for Plantar Fasciitis: A Randomized Controlled Trial. J Foot Ankle Surg 2019;58(2):301-05 doi: 10.1053/j.jfas.2018.08.058published Online First: Epub Date]|.

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This is to certify that

NAMELicense #

has satisfied all requirements and successfully completed

PT Solutions Advanced Dry Needling

DATE28.75 CCUs

Dale Yake, PT, DPT, OCS, ATC Course Sponsor/PT Solutions

Joseph Sharp 2407 Winding Way Valdosta, GA 31602

229-561-4152 [email protected]

Career objective: To find an opportunity to provide patients with the highest quality of care possible in the outpatient orthopedic setting. Education:

PT Solutions Orthopedic Residency Program 8/2013-9/2014 Georgia Health Sciences University, Augusta, Georgia 8/2009 – 5/2013

• Doctor of Physical Therapy • GPA: 3.71

Valdosta State University, Valdosta, Georgia 8/2005 - 7/2009 • Bachelor of Science in Exercise Physiology • GPA: 3.49

Work Experience: Staff Therapist -PT Solutions Harbin clinic Cartersville 8/2013-1/2014 Clinical Director- PT Solutions Chatsworth 1/2014-3/2015 Clinical Director- PT Solutions Calhoun 3/2015- 8/2017 Senior Clinic Director North GA- PT Solutions 8/2017-3/2019 Senior Clinic Director Valdosta – PT Solutions Valdosta 3/2019-present

Memberships/Certifications:

• Orthopedic Residency Graduate PT Solutions Sep 2014 • APTA May 2010 • Orthopedic Clinical Specialist June 2015 • CSCS Certification (Strength Coach) July 2009

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