Pablo Herrero

• PhD
• Lecturer at University of Zaragoza

Background Static stretching is a treatment that reduces spasticity by elongating the muscle fibers. Dry needling is also a novel intervention that reduces spasticity by destroying dysfunctional endplates. Plantar flexor spasticity can cause gait disturbances and impaired balance in patients who have had a stroke. Therefore, reducing the spasticity...

Background/Objective Dual‐task training (DTT) positively impacts stroke recovery, but its effects on electroencephalography (EEG) using Fourier series analysis are under‐researched. This study aimed to evaluate the effects of DTT on EEG in stroke patients by analyzing different EEG bands with fast Fourier transform (FFT). Methods Five participants...

Background/Objectives: Ultrasound (US) imaging and echotexture analysis are emerging techniques for assessing muscle tissue quality in the post-stroke population. Clinical studies suggest that echovariation (EV) and echointensity (EI) serve as objective indicators of muscle impairment, although methodological limitations hinder their clinical trans...

Purpose This study investigates bioelectrical changes in thigh muscles associated with referred pain following noxious stimulation of the gluteus minimus, focusing on understanding motor alterations related to the network of trigger points. While previous research suggested atypical autonomic activity, motor alterations in referred pain areas remai...

Purpose The main objective was to study the anatomy of the adductor longus by ultrasound and cadaveric dissection, correlate the findings with the different approaches described, and evaluate the feasibility of defining a “safe window” for interventional musculoskeletal procedures. Methods The anatomical study was performed on six cadaveric pieces...

Background/Objectives: Strokes remain a major global health concern, contributing significantly to disability and healthcare costs. Currently, there are no established indicators to accurately assess the degree of muscle tissue impairment in stroke-affected individuals. However, ultrasound imaging with an echotexture analysis shows potential as a q...

Background/Objectives: Chronic migraine (CM) is a neurological disorder that causes significant disability, loss of productivity, and economic burden. Preventive treatments, including pharmacological and educational interventions, are crucial for managing CM effectively. The aim of this study was to analyze whether adding a therapeutic telehealth e...

Stroke is a leading cause of disability worldwide and is often accompanied by complications such as spasticity. Static stretching (SS) is a common physiotherapy intervention for reducing spasticity, whereas dry needling (DN) is a novel approach. However, the combined effects of DN and SS on spasticity have not been thoroughly investigated. Given th...

Introduction Short-track speed skating (short track) is an Olympic sport characterized by a specific body position and counterclockwise movement on the track. Based on previous studies, we hypothesized that athlete body positions employed in this sport could lead to asymmetric overuse disorders of the left lower limb muscles. An increased number of...

No study has evaluated the effects of dry needling on Paralympic athletes. Therefore, in this study, we will evaluate the effect of dry needling on lower limb spasticity and motor performance, as well as the range of motion of Paralympic athletes. The study will be a triple-blinded, randomised controlled trial. Twenty-four athletes aged 18–45 in T3...

Purpose: The gastrocnemius venous system presents different anatomical variants. There have been described four locations of myofascial trigger points (MTrPs) in this muscle. However, no studies have analyzed the coincidence between vessels and MTrPs present in the gastrocnemius. Therefore, the main objective was to study the anatomical variability...

The myodural bridge complex (MDBC) consists of connective tissue bands connecting the spinal dura mater to the suboccipital muscles passing throughout the posterior atlanto-occipital and atlanto-axial spaces. It is a universal evolutionarily conserved anatomical structure present in most vertebrate species including humans. Its physiology is unknow...

Citation: Herrero, P.; Val, P.; Lapuente-Hernández, D.; Cuenca, N.; Calvo, S.; Gómez-Trullén, E.M. Effects of Lifestyle Interventions on the Improvement of Chronic Non-Specific Low Back Pain: A Systematic Review and Network Meta-Analysis. Healthcare 2024, 12, 505. https:// Abstract: Chronic non-specific low back pain (CNSLBP) is a highly prevalen...

Introduction: Gait disorders are a major cause of disability and reduced health-related quality of life in people with multiple sclerosis (pwMS). Dry needling (DN) has demonstrated positive results to improve gait parameters in patients with stroke. The main aim of this study was to evaluate the effect of a single session of DN in the gait perform...

Nociplastic pain is a non-specific, regional pain lasting more than three months, characterised by the onset of hypersensitivity, despite no clear evidence of tissue damage. It is a relatively new classified type of pain. As a result, there has not yet been much work describing its precise modelling. The mechanism of its formation needs to be clear...

Background Short-track speed skating movement involves asymmetric overloading of the lower left side of the body. The gluteus maximus fatigue limits the physical and mental athletic capacity to perform set tasks. A possible link between the presence of latent trigger points (LTrPs) and muscle fatigue development/persistence has been posited. The ai...

Non-specific low back pain (NSLBP) is a highly prevalent condition that implies substantial expenses and affects quality of life in terms of occupational and recreational activities, physical and psychological health, and general well-being. The diagnosis and treatment are challenging processes due to the unknown underlying causes of the condition....

The purpose of this systematic review and meta-analysis was to assess the short-, mid-, and long-term effectiveness of dry needling in improving pain and functional capacity of patients with chronic neck pain. Search strategy was performed on PubMed, Web of Science, Scopus, PEDro, and Cochrane Library Plus biomedical databases. The risk of bias was...

Background and Objectives: Trigger points (TrPs) are prevalent in patients with migraine headaches. Needling interventions targeting TrPs in migraine patients may reduce the intensity and frequency of headaches, yet systematic reviews reveal a lack of robust evidence. Intramuscular electrical stimulation (IMES) is a modality that delivers electrica...

Whiplash-Associated Disorders (WAD) represent a multifactorial condition often accompanied by altered nociceptive processing and psychological factors. This systematic review on acute and chronic WAD aimed to investigate the relationship between Quantitative Sensory Testing (QST) and psychological factors and quantify whether their trajectories ove...

Background Spasticity is a common symptom of multiple sclerosis (MS) which affects mobility. Dry Needling (DN) has shown a reduction in spasticity in neuromuscular conditions such as stroke and spinal cord injury although the mechanism of action is still unclear. In spastic individuals, the Rate-Dependent Depression (RDD) of the H reflex is decreas...

Dysmenorrhea, or recurrent menstrual pain, is a highly prevalent pain condition among otherwise healthy women. However, the progression of dysmenorrhea over time and the influence of the menstrual cycle phases need to be better understood. While the location and distribution of pain have been used to assess pain mechanisms in other conditions, it i...

Background: Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short- and long-term reliability of selected QSTs. Methods: Twenty healthy women participated in three experimental sessions: Baselin...

https://cslide.ctimeetingtech.com/global_storage/media/content/adpd23/ADPD23_-_Posters_for_website_Mar_29.pdf#page=1112 Aims: Muscle tremor and twitch can appear due to chronic muscle overload and local energy deficit due to posture imbalance. Dry needling under ultrasound guidance (DN-US) can treat myofascial pain, restore muscle function and mot...

Background and purpose: Brain function can be networked, and these networks typically present drastic changes after having suffered a stroke. The objective of this systematic review was to compare EEG-related outcomes in adults with stroke and healthy individuals with a complex network approach. Methods: The literature search was performed in th...

Multiple sclerosis is a degenerative inflammatory disease that causes different musculoskeletal problems. Its impact has led to the study of treatment alternatives such as the use of invasive physiotherapy. In this study, we analyze the effects of ultrasound-guided percutaneous neuromodulation to a 51-year-old man suffering from multiple sclerosis...

Introducción: El dolor lumbar crónico es una de las causas principales de discapacidad en adultos y el 85-90% presenta un origen inespecífico. El uso de sensores, entre ellos la electromiografía (EMG), se está implementando cada vez más en la práctica clínica con el objetivo de mejorar el proceso de evaluación complementando las medidas autoinforma...

Background: Stroke is the leading cause of disability in adults worldwide, with spasticity after stroke being one of the more common complications. Dry needling (DN) has been demonstrated to decrease spasticity in stroke patients, although its effects on improving function remain unclear. The purpose of this study protocol is to compare the short-...

Background: Dry Needling (DN) has been demonstrated to be effective in improving sensorimotor function and spasticity in patients with chronic stroke. Electroencephalogram (EEG) has been used to analyze if DN has effects on the central nervous system of patients with stroke. There are no studies on how DN works in patients with chronic stroke based...

Background About 40% of patients who have had COVID-19 still have symptoms three months later whereas a 10% may experience physical and/or psychological consequences two years later. Therefore, it is necessary to perform preventive interventions when patients are discharged from the hospital to decrease the aforementioned sequelae. The purpose of t...

Background: Widespread pain partially depends upon sensitization of central pain mechanisms. However, mechanisms controlling pain distribution are not completely known. The present study sought to assess skin temperature variations in the area of experimentally-induced pain and potential sex differences. Methods: Pressure-pain thresholds (PPTs)...

Stroke is one of the most common causes of disability and exerts a high burden of direct and indirect costs. Stroke may cause spasticity, which limits patients’ abilities and affects their activities of daily living, decreasing their quality of life. Conventional treatments are based on physical therapy, anti-spasticity medication, and botulinum to...

Objective To compare the cost-effectiveness of three patellar tendinopathy treatments. Design Secondary (cost-effectiveness) analysis of a blinded, randomised controlled trial, with follow-up at 10 and 22 weeks. Settings Recruitment was performed in sport clubs. The diagnosis and the intervention were carried out at San Jorge University. Partici...

Introduction Non-pharmacological treatment of patients with headache, such as dry needling (DN), is associated with less morbidity and mortality and lower costs than pharmacological treatment. Some of these techniques are useful in clinical practice. The aim of this study was to review the level of evidence for DN in patients with headache. Method...

Introduction/objective: Patellar tendinopathy (PT) is a pathology that affects the patellar tendon and produces decreased functionality and increased pain in the anterior part of the knee associated with tenderness to palpation in the lower pole of the patella. In the general population, the prevalence of PT is 14%; it affects 8.5% of amateur athle...

Objectives: To longitudinally investigate the relationships between neck/arm disability and pain profile measures in individuals with chronic nonspecific neck pain (NSNP) at baseline, one month, and six months after a standardized physiotherapy intervention. A secondary aim was to compare pain sensitivity of individuals with chronic NSNP at baseli...

Introduction: Dry needling is a non-pharmacological approach that has proven to be effective in different neurological conditions. Objective: The aim of this study was to evaluate the cost-effectiveness of a single dry needling session in patients with chronic stroke. Methods: A cost-effectiveness analysis was performed based on a randomized c...

Many clinicians increasingly use dry needling in clinical practice. However, whether patients’ intake of antithrombotic drugs should be considered as a contraindication for dry needling has not been investigated to date. As far as we know, there are no publications in analyzing the intake of antiplatelet or anticoagulant agents in the context of dr...

This randomized clinical trial analyzed whether a personalized cognitive stimulation based on the individual's preexisting cognitive levels may be more effective in the short and long terms than a standard cognitive stimulation program. In total, 288 older adults were randomized into an intervention group and a control group, stratified according t...

Background Persons with stroke commonly have impairments associated with a reduction in functionality. Motor impairments are the most prevalent, causing an impact on activities of daily life. Objective The aim of this study was to evaluate the effect of a session of dry needling (DN) applied to the upper extremity muscles on the sensorimotor funct...

Introduction Dry needling (DN) has been shown to be effective for the treatment of upper extremity hypertonia in patients with stroke. Purpose To evaluate the cost-effectiveness of DN in patients with stroke. Methods A cost-effectiveness analysis was performed in a research study conducted at a Spanish public hospital where patients were classifi...

Objective The aim of this study was to develop a multifactorial, self-report questionnaire: Prevent for Work Questionnaire (P4Wq). The questionnaire is intended for screening for risk factors in work-related musculoskeletal disorders (WMSDs). Design Data were collected from otherwise healthy workers employed in three service areas at a specialist...

The objective of this work is to compare the homogeneity of instrumental and manual compression during the simulation of a pressure release technique, measured with a dynamometer, as well as to evaluate the comparative degree of comfort by physiotherapists and physiotherapy students when performing this technique. Methods: A comparative cross-sec...

Osteoarthrosis (OA) is a very prevalent degenerative joint disorder. The aim of this review is to provide a critical perspective on information published about OA, unraveling myths and building concepts that will improve our knowledge and management of this pathology. Pain appears as the main symptom of symptomatic OA, but current evidence shows th...

Objective To investigate the prevalence of first dorsal interosseous myofascial trigger point (MTrP) in patients with thumb carpometacarpal osteoarthritis (CMC OA). Methods Fifty subjects participated in the study, 25 with thumb CMC OA and 25 without thumb CMC OA. Participants were examined to identify first dorsal interosseous MTrP through palpat...

Background Alterations in gait and muscular rigidity are common and disabling in persons with Parkinson’s disease (PD). Objective The aim of this study was to determine whether a single dry needling (DN) session can promote changes in gait and muscle tone in the lower extremities as well as in the evolution of the disease in persons with PD. Meth...

Introduction Work-related musculoskeletal (MSK) pain is a highly prevalent condition and one of the main contributors to disability and loss of work capacity. Current approaches to the management and prevention of work-related MSK pain do not consistently integrate current evidence-based knowledge and seem to be outdated. The Prevent4Work (P4W) Pro...

Objectives: To investigate the pain-sensory profile of patients with whiplash-associated disorders (WAD) prior and post 2-weeks of standardized rehabilitation and after at 6-months follow-up. Methods: Twenty-two WAD-participants (Grade-II; 14 women) and 22 sex-and age-matched healthy controls were enrolled. Pressure pain thresholds (PPTs) were a...

Objective The purpose of the present study was to examine the effect of dry needling (DN) on the biomechanical properties of a latent medial myofascial trigger point (MTrP) of the soleus muscle compared with an adjacent point within the taut band (TB) measured by myotonometry. Methods Fifty asymptomatic volunteers were randomly assigned to an inte...

Background Myofascial trigger points (MTrPs) are hypersensitive nodules in a taut band (TB) of skeletal muscle. Dry needling (DN) is an invasive technique recommended for the treatment of MTrPs. However, to our knowledge, no studies have investigated the influence of the DN technique on modification of muscle stiffness and neurophysiological proper...

Objective: The objective of this study was to analyze the long-term effects of a personalized cognitive stimulation (PCS) program on the global cognition, cognitive aspects, activities of daily living (ADLs), anxiety, and depression in older adults with possible mild cognitive impairment (MCI). Methods: A 12-month follow-up analysis was carried out...

Assistants serve an essential role in special education to support children with disabilities, but they should be properly trained and supervised. The coaching approach represents one trend that has been gradually implemented in occupational therapy (OT) and rehabilitation services. Still, few studies clearly define the coaching intervention, measu...

Background: Spasticity is a common symptom in multiple sclerosis (MS). Dry needling (DN) has been considered a useful method for the treatment of spasticity; however, there are no studies on the effects of DN on spasticity in patients with MS. We propose a study protocol aiming to investigate the effects of DN on spasticity in patients with MS. M...

Objective This study aims to define appropriate domains and items for the development of a self-administered questionnaire to assess the risk of developing work-related musculoskeletal disorder (WMSD) and the risk of its progression to chronicity. Design Literature review and survey study. Setting and participants A literature review and a two-ro...

Background: Thumb carpometacarpal osteoarthritis (CMC OA) is a common disorder that interferes with the ability to perform the activities of daily life. The purpose of this study was to investigate the immediate effects of ischemic compression on myofascial trigger points (MTrPs) in the first dorsal interosseous (FDI) muscle in patients with the d...

Plantar heel pain is a common cause of foot pain that affects patients’ quality of life and represents a significant cost for the healthcare system. Dry needling and percutaneous needle electrolysis are two minimally invasive treatments that were shown to be effective for the management of plantar heel pain. The aim of our study was to compare thes...

Objective To determine the additional effect of dry needling (DN) or percutaneous needle electrolysis (PNE) combined with eccentric exercise (EE) and compare which one is the most effective for patients with patellar tendinopathy (PT). Design Blinded, randomized controlled trial, with follow-up at 10 and 22 weeks. Settings Recruitment was perform...

This study aimed to determine the effect of one session of dry needling on the severity of tremor, motor function and skills, and quality of life of a 39-year-old woman with post-stroke tremor. Myofascial trigger points (MTrP) of the following muscles were treated: extensor digitorum, flexor digitorum superficialis and profundus, brachioradialis, s...

Introduction: Treadmill training is considered an effective intervention to improve gait ability in patients with Parkinson's disease (PD). In parallel, virtual reality shows promising intervention with several applications in the inpatient medical setting. Aim: To evaluate the feasibility and preliminary efficacy of mechanical gait assistance com...

Objective: Nociception caused by injuries may sensitize central mechanisms causing expanded pain areas. After recovery, the status of such pain distribution and sensitivity mechanisms is unknown. The present study investigated whether individuals who have fully recovered from a distal radius fracture demonstrate increased pain sensitivity and expa...

Objective: To investigate the pain referral area (number of pixels) and extent (vector length) as elicited from increasing intensities of pressure-induced pain at the shoulder. Design: Cross-sectional design. Setting: Clinical laboratory setting. Participants: Twenty-two healthy men and women participated in two experimental sessions. Metho...

The aim was to determine the effectiveness of minimally invasive techniques (MIT) in patients with patellar tendinopathy. Database searches were performed for randomized controlled trials (RCTs) in electronic databases (WOS, Cochrane Central, SportDiscus, and Medline via PubMed and PEDro). The inclusion criteria used were published in English or Sp...

Background Stroke is the fourth leading cause of death in Europe, represents one of the most common causes of disability in adult patients, and involves considerable short- and long-term social and healthcare costs. The effectiveness of deep dry needling (DDN) on affected arm functionality was assessed throughout 8 weeks of treatment in patients wi...

ABSTRACT Objectives To compare the effectiveness of dry needling (DN) versus percutaneous needle electrolysis (PNE) for improving the level of pain, function and quality of life (QoL) of patients suffering from plantar heel pain (PHP) provoked by myofascial trigger points. Design A prospective, parallel-group, randomised controlled trial with blind...

INTRODUCCIÓN La tendinopatía rotuliana (TR) es una patología degenerativa del tendón rotuliano que ocasiona dolor en la parte anterior de la rodilla asociado con sensibilidad focal y palpable en el polo inferior de la rótula. Afecta principalmente a personas que realizan deportes de salto, apareciendo hasta en un 45% de jugadores profesionales de v...

Introduction Patellar tendinopathy is a degenerative disease of the patellar tendon, which affects athletes from a variety of sports, and is especially predominant in sports involving high-impact jumping. The aim of this study is to determine the additional effect of two interventions combined with eccentric exercise and compare which one is the mo...

Background Musculoskeletal (MSK) pain is the primary contributor to disability worldwide. There is a growing consensus that MSK pain is a recurrent multifactorial condition underpinned by health and lifestyle factors. Studies suggest that education on work-related pain and individualised advice could be essential and effective for managing persiste...

Introduction: Non-pharmacological treatment of patients with headache, such as dry needling (DN), is associated with less morbidity and mortality and lower costs than pharmacological treatment. Some of these techniques are useful in clinical practice. The aim of this study was to review the level of evidence for DN in patients with headache. Meth...

Background In patients with stroke, hemiplegic shoulder pain can be a major problem. One source of shoulder pain can be Myofascial Trigger Points (MTrPs). Objective To determine the prevalence of Myofascial Trigger Points (MTrPs) and the correlation between MTrPs and pain and function in patients presenting with shoulder pain following a stroke....

Background Both manual therapy techniques and dry needling have shown to be effective treatment options for the treatment of plantar heel pain; however, in recent years, other techniques based on dry needling (DN), such as percutaneous needle electrolysis (PNE), have also emerged. Currently, PNE is being used in clinical practice to manage myofasci...

La tendinopatía rotuliana crónica (TRC) es una lesión degenerativa del tendón rotuliano. El tratamiento Gold Standard de esta patología es la realización de ejercicio excéntrico (EE), aunque actualmente las técnicas invasivas como la Punción Seca (PS) y la Electrolisis Percutánea (EP) están teniendo un gran auge. Analizar si los pacientes refieren...

Background: Minimally invasive non-surgical techniques have been widely used worldwide to treat musculoskeletal injuries. Of these techniques, injectable pharmaceutical agents are the most commonly employed treatments, with corticosteroids being the most widely used drugs. The aim of this article is to review current scientific evidence as well as...

Objective: Several diagnostic methods have been used in the identification of mechanical properties of skeletal muscle, including myofascial trigger points (MTrPs), however, they are not suitable for daily clinical use. Myotonometry offers an easy noninvasive alternative to assess these muscle properties. Nevertheless, previous research has not ye...

Background: Passive oscillatory mobilizations are often employed by physiotherapists to reduce shoulder pain and increase function. However, there is little data about the neurophysiological effects of these mobilizations. Objectives: To investigate the initial effects of an anteroposterior (AP) shoulder joint mobilization on measures of pain an...

Objectives The objective of this study was to assess the short-term effects of dry needling on spasticity, gait, and muscle architecture of patients with chronic stroke. Methods A case series study was designed; and six chronic stroke patients with ankle spasticity and gait impairment received a single session of dry needling for gastrocnemius med...

Musculoskeletal trauma and pain can sensitize central pain mechanisms but whether these normalize upon recovery is unknown. This study compared the extent of pain referral in individuals recovered from a musculoskeletal trauma and healthy controls. Twenty pain-free participants recovered from a shoulder fracture and 20 age/gender matched controls p...

UPDATE ON THE CONSERVATIVE AND INVASIVE (NON-SURGICAL) TREATMENT OF PLANTAR FASCIITIS: BIBLIOGRAPHIC REVIEW OF THE LAST 2 YEARS, to read the full article you can check it in my profile.

Background: Dry needling [DNHS© technique] is a promising treatment modality for patients with spasticity. However, little is known regarding the indirect effects of dry needling on regional brain activity. This study aimed to describe the electroencephalographic changes found after the application of DNHS© in two patients with stroke. Findings: Tw...

Purpose: To systematically review and analyze the research evidence linking stress or anxiety to chronic nonspecific neck-arm pain (NSNAP) in adults. Subjects and methods: Data were obtained from Pubmed, Scopus, PsycInfo, Web of Science, Physiotherapy Evidence Database (PEDro) and The Cochrane library database fromtheir inception to July 2015. Two...

Introducción: El dolor del hombro hemipléjico es la patología más común en pacientes con Ictus. Uno de los factores más comunes es la subluxación de hombro, pero normalmente el dolor de hombro va asociado a trastornos del complejo capsular y del sistema musculoesquelético. Numerosos estudios han demostrado que los Myofascial Trigger Points (MTrPs)...

Introducción/objetivos: La tendinopatía rotuliana crónica (TRC) es una de las patologías más comunes del aparato locomotor. Actualmente el tratamiento gold standard de esta patología es la realización de ejercicio excéntrico (EE). Dada la efectividad clínica que está teniendo el tratamiento con electrolisis percutánea (EP) y punción seca (PS), el o...

Introducción/objetivo: La tendinopatía rotuliana crónica (TRC) es una de las patologías más comunes del aparato locomotor en la que se produce una degeneración del tendón rotuliano. Actualmente el tratamiento gold standard de esta patología es la realización de ejercicio excéntrico (EE). Dada la efectividad clínica que está teniendo el tratamientoc...