Quantification of Dry Needling and Posture Effects on Myofascial Trigger Points Using Ultrasound Shear-Wave Elastography Ruth M. Maher, PT, PhD, DPT,

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Quantification of Dry Needling and Posture Effects on Myofascial Trigger Points Using Ultrasound Shear-Wave Elastography Ruth M. Maher, PT, PhD, DPT, WCS, BCB-PMD, CEAS, Dawn M. Hayes, PT, PhD, GCS, Minoru Shinohara, PhD, FACSM Archives of Physical Medicine and Rehabilitation Volume 94, Issue 11, Pages 2146-2150 (November 2013) DOI: 10.1016/j.apmr.2013.04.021 Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 1 An example of a change in shear modulus in the upper trapezius muscle resulting from dry needling and posture. Color-coded representation in the presence of a palpable MTrP in the upper trapezius muscle in the sitting position before (A) and after dry needling (B) and in the prone position before (C) and after dry needling (D). The color-coded scale was identical across images. Archives of Physical Medicine and Rehabilitation 2013 94, 2146-2150DOI: (10.1016/j.apmr.2013.04.021) Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 2 Effect of dry needling and posture on shear modulus of the upper trapezius muscle. Main effects of dry needling (time) and posture (position) are presented. **P<.01 vs Pre; *P<.05 vs Sitting. Archives of Physical Medicine and Rehabilitation 2013 94, 2146-2150DOI: (10.1016/j.apmr.2013.04.021) Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 3 Relative changes in shear modulus of the upper trapezius muscle resulting from dry needling and subject posture. (Left) Relative change from before to after dry needling. (Right) Relative change from sitting to prone position. Archives of Physical Medicine and Rehabilitation 2013 94, 2146-2150DOI: (10.1016/j.apmr.2013.04.021) Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions