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Systematic Review of Dry Needling Parameters for Improvements in Muscle Performance.
Yifan Liu1, Yongni Zhang1, Susan Falsone2,3
1Duquesne-China Health Institute, Duquesne University, Pittsburgh, Pennsylvania.
American Journal of Physical Medicine & Rehabilitation
|April 10, 2026
Summary
Dry needling (DN) may improve muscle performance when targeting trigger points (MTrPs) to elicit a local twitch response (LTR). This localized approach, combined with exercise, shows potential for musculoskeletal conditions.
Area of Science:
- Physiotherapy
- Rehabilitation Science
- Musculoskeletal Medicine
Background:
- Clinical evidence on dry needling (DN) for muscle performance is inconsistent.
- Treatment parameter variability may explain inconsistent findings.
Purpose of the Study:
- To evaluate the evidence for dry needling's effect on muscle performance.
- To identify specific dry needling parameters associated with improved muscle performance.
Main Methods:
- Systematic review following PRISMA guidelines.
- Searched major databases (PubMed, CINAHL, Embase, SPORTDiscus) through April 2025.
- Synthesized data from 11 randomized controlled trials (RCTs), assessing quality with PEDro scale and evidence certainty with GRADE.
Main Results:
- Nine of eleven RCTs reported improvements in local muscle performance.
- Heterogeneity prevented meta-analysis; local twitch response (LTR) elicitation was noted in most effective studies.
- Certainty of evidence was low for immediate outcomes and moderate for short- to mid-term outcomes.
Conclusions:
- Dry needling may improve muscle performance when applied locally to MTrPs, aiming for LTR.
- DN can be an effective adjunct to therapeutic exercise for specific musculoskeletal conditions.
