Shane L Koppenhaver

Baylor University | BU · Doctor of Physical Therapy Program

Objective: The purpose of this study was to determine the immediate effects of adding dry needling (DN) to thoracic spine manipulation and neck-specific exercise in individuals with neck pain. Methods: Forty-two participants with neck pain were randomized to either the true (n = 21) or sham (n = 21) DN groups, receiving treatment on the initial...

Background: Although lumbopelvic muscle stiffness is commonly clinically assessed in women with chronic pelvic pain (CPP), it has not been objectively quantified in this population, and its association with other pain-related impairments has not yet been established. Objective: To compare superficial lumbopelvic muscle stiffness in women with and w...

Objective: The aim of this study is to review the reasons reported within rehabilitative ultrasound imaging (RUSI) research for using percent change, and to conduct Monte Carlo simulations to evaluate the statistical assumptions, statistical power, reliability, and type 1 error rate regarding this practice. Design: Systematic review with Monte Car...

Myotonometry is a relatively novel method used to quantify the biomechanical and viscoelastic properties (stiffness, compliance, tone, elasticity, creep, mechanical relaxation) of palpable musculotendinous structures with portable mechanical devices called myotonometers. Myotonometers obtain these measures by recording the magnitude of radial tissu...

Study design Prospective cohort study. Background The cervical rotation lateral flexion (CRLF) test is frequently used in clinical practice to determine whether a thrust manipulation targeting the first rib should be performed. Objectives To evaluate the predictive validity of the CRLF test and manual examination in determining whether patients w...

Background Evidence suggests that tibialis posterior muscle plays an important role in equinovarus foot deformity in patients who had suffered a stroke and it is one of the most frequently injected lower-extremity muscles for the management of spasticity. Our aim was to assess if a needle accurately and safely penetrates the tibialis posterior musc...

Objective: The purpose of this case report is to describe the implementation and report early outcomes of a 2-year (6-trimester), hybrid doctor of physical therapy (DPT) program. Methods: The case report describes management of (1) Academic Affairs, (2) Student Affairs, (3) Faculty Affairs, and (4) Institutional Affairs for an accredited, fully...

Background: Typically treated medically, chronic rhinosinusitis (CRS) is a prevalent condition characterized by multiple craniofacial symptoms, some of which may respond favorably to dry needling intervention. Objective: To describe the outcomes of a patient presenting with craniofacial pain and symptoms consistent with a diagnosis of CRS who wa...

Background: The tibialis posterior (TP) muscle plays an important role in normal foot function. Safe, efficacious therapeutic approaches addressing this muscle are necessary; however, the location of the muscle in the deep posterior compartment can create challenges. Purpose: The purpose of this study was to assess the accuracy of needle placeme...

Background: Dry needling treatment focuses on restoring normal muscle function in patients with musculoskeletal pain; however, little research has investigated this assertion. Shear wave elastography (SWE) allows quantification of individual muscle function by estimating both resting and contracted muscle stiffness. Objective: To compare the eff...

Study design: Parallel-arm randomized controlled trial. Objective: To assess the effectiveness of an enhanced video education session highlighting risks of opioid utilization on long-term opioid utilization after spine surgery. Summary of background data: Long-term opioid use occurs in more than half of patients undergoing spine surgery and st...

Background Biomechanical muscle stiffness has been linked to musculoskeletal disorders. Assessing changes in muscle stiffness following DN may help elucidate a physiologic mechanism of DN. This study characterizes the effects of dry needling (DN) to the infraspinatus, erector spinae, and gastrocnemius muscles on biomechanical muscle stiffness. Met...

Background The popliteus muscle attaches posteriorly to the joint capsule of the knee. Although it is an important rotational stabilizer and has been implicated in various knee pathologies, research on its treatment with dry needling is scarce. Objective To determine if a needle accurately and safely penetrates the popliteus muscle during the clin...

Objective To investigate the reliability and discriminative validity of real-time ultrasound elastography (RTE) measures of soft-tissue elasticity after calf muscle tear. Design Cross-sectional, intra/inter-examiner reliability and comparative validity study. Setting Department of Physical Therapy. Participants Twenty-one recreational athletes w...

Background Dry needling (DN) has been consistently shown to increase pain sensitivity and flexibility local to the site of treatment, however it is unclear whether these effects are limited to the local region or can be observed remote to the area of treatment. Objective To determine the immediate, short-term effects of DN to the thoracolumbar jun...

The deep posterior cervical muscles (DPCM), specifically the semispinalis cervicis and cervical multifidus, are often impaired in patients with neck disorders and have been assessed by several imaging techniques. Prior ultrasound shear wave elastography (SWE) imaging and reliability assessments of the DPCM were performed utilizing similar positioni...

Background: Quantifying muscle stiffness may aid in the diagnosis and management of individuals with muscle pathology. Therefore, the primary purpose of this study was to establish normative parameters and variance estimates of muscle stiffness in the gastrocnemius muscle in a resting and contracted state. A secondary aim was to identify demograph...

Abnormal muscle stiffness is a potential complication after injury and identifying interventions that modify muscle stiffness may be useful to promote recovery. The purpose of this study was to identify the short-term effects of dry needling (DN) on resting and contracted gastrocnemius muscle stiffness and strength of the triceps surae in individua...

Background Evidence suggests that medial pterygoid muscle plays an important role in temporomandibular pain. Therapeutic approaches targeting this muscle are needed. Objective To determine if a solid needle accurately penetrates the medial pterygoid muscle during the application of dry needling. Design A cadaveric and human descriptive study. Me...

Objective: To assess the costs, health gains, and cost-effectiveness of operative versus non-operative treatment of calcaneal fractures over a 5-year time horizon from both US societal and payer perspectives. Methods: The societal perspective analysis included both direct medical costs and costs for missed work, whereas the healthcare payer pers...

Background: Lumbar muscle dysfunction is commonly implicated in low back pain (LBP). Shear-wave elastography (SWE) uses ultrasound technology to quantify absolute soft tissue stiffness (shear modulus), thereby allowing for estimation of individual muscle contraction and function. Objectives: To compare resting and contracted stiffness of lumbar...

Background: Evidence suggests that suboccipital musculature plays an important role in headache. Proper therapeutic approaches targeting this muscle are needed. Objective: Our aim was to determine with fresh cadavers and ultrasound imaging if a solid needle is able to properly penetrate the obliquus capitis inferior muscle during the application...

Background: Physical therapy interventions of exercise and manual therapy provide benefit in treatment of subacromial pain syndrome (SAPS). Dry needling is an emerging technique for treating musculoskeletal conditions; however, conflicting investigative evidence exists regarding the use of dry needling for SAPS. Purpose: The purpose of this case...

Objectives: Prudent dry needling techniques are commonly practiced with the intent to avoid large neurovascular structures, thereby minimizing potential excessive bleeding and neural injury. Patient position is one factor thought to affect the size of the safe zone during dry needling of some muscles. This study aimed to compare the size of the nee...

Background: Patients with surgical fixation of ankle and/or hindfoot fractures often experience decreased range of motion and loss of function following surgery and postsurgical immobilization, yet there is minimal evidence to guide care for these patients. Objectives: To assess whether manual therapy may provide short-term improvements in range...

Background: Quantifying stiffness of the lumbar spine musculature using shear-wave elastography (SWE) maybe beneficial in the diagnosis and treatment of non-specific low back pain (LBP). The primary purpose of this study was to establish normative parameter and variance estimates of lumbar spine muscle stiffness at rest and during submaximal contr...

Purpose: Investigate the construct validity of prognostic factors purported to predict clinical success with stabilization exercise for low back pain by exploring their associations with lumbar multifidus composition. Methods: Patients with low back pain were recruited from a hospital imaging department. The presence of fivepredictors (age <40 year...

Background The global burden of low back pain is growing rapidly, accompanied by increasing rates of associated healthcare utilization. Health seeking behavior (HSB) has been suggested as a mediator of healthcare utilization. The aims of this study were to: 1) develop a proxy HSB measure based on healthcare consumption patterns prior to initial con...

Background: Patellofemoral pain syndrome (PFPS) is a prevalent knee disorder. A novel yet increasingly popular treatment for PFPS is trigger point dry needling (DN). Purpose: The purpose of this study was to determine if DN is more effective at reducing pain and disability than a sham treatment in individuals with PFPS. Study design: Randomize...

Objective To examine the prognostic value of the Fear Avoidance Model (FAM) variables when predicting pain intensity and disability 10-weeks postoperative following lumbar disc surgery. Methods We recruited patients scheduled for first-time, single level lumbar disc surgery. The following aspects of the FAM were assessed at preoperative baseline a...

FAM_minimal data set. (XLSX)

Objective: To evaluate the cost-effectiveness of the inclusion of trigger point-dry needling (TrP-DN) into an exercise program for the management of subacromial pain syndrome. Methods: Fifty patients with unilateral subacromial pain syndrome were randomized with concealed allocation to exercise alone or exercise plus TrP-DN. Both groups were ask...

Study design Randomized clinical trial. Background Patients with fractures to the talus and calcaneus report decreased functional outcomes and develop long-term functional limitations. Although physical therapy is typically not initiated until six weeks after fixation, there’s little research on the optimal time to initiate a formal physical thera...

Background Physical therapists’ familiarity, perceptions, and beliefs about health services utilization and health seeking behaviour have not been previously assessed. Objectives The purposes of this study were to identify physical therapists’ characteristics related to familiarity of health services utilization and health seeking behaviour, and t...

The Army Physical Fitness Test (APFT) is a semiannual requirement. While conducting physical readiness training (PRT) is a requirement for all Soldiers, there is no requirement to train Soldiers on techniques that may help to optimize their performance on the APFT. A cohort of 34 officers that attended the Army Medical Department Basic Officer Lead...

Military service members receive regular screenings for a variety of health conditions, but a field-expedient and military-specific screening tool that identifies an individual's risk for injury has not yet been identified. The purpose of this study is to describe the conduct of a novel musculoskeletal readiness screening tool (MRST) and evaluate t...

Category Ankle, Hindfoot Introduction/Purpose Fractures to the hindfoot, including the talus and calcaneus, have devastating long-term functional outcomes. To date, no randomized trials have been done assessing the best time to initiate physical therapy after surgical fixation of these fractures. The purpose of this study is to assess whether init...

A 24-year-old male soldier on limited-duty status was referred to physical therapy by his primary care physician for a 2-year history of insidious-onset and slowly progressive low back pain. Lumbar radiographs were noncontributory. Shortly after initiating rehabilitation, the patient underwent magnetic resonance imaging that was previously ordered...

Background Application of dry needling is usually associated to post-needling induced-pain. Development of post-needling intervention targeting to reduce this adverse event is needed. Objective To determine the effectiveness of low-load exercise on reducing post-needling induced-pain after dry needling of active trigger points (TrPs) in the infras...

Study Design Case report. Background Abnormal sensation, such as numbness or tingling, is traditionally thought to originate from neural compression. There is limited evidence to support reports of abnormal sensation arising from a trigger point. Case Description The patient was a 60-year-old female with primary complaints of right shoulder pain an...

Objectives: Low back pain is common, costly, and disabling for active duty military personnel and veterans. The evidence is unclear on which management approaches are most effective. The purpose of this study was to assess the effectiveness of lumbar extensor high-intensity progressive resistance exercise (HIPRE) training versus control on improvi...

Trial registration: http://www.clinicaltrials.gov, ClinicalTrials.gov, NCT02338908. Perspective: This study found that the inclusion of two sessions of trigger point dry needling into an exercise program was effective for improving shoulder pain-related disability at short-, medium- and long-term; however, no greater improvement in shoulder pain...

Background: Recently, dry needling has emerged as a popular treatment for muscular pain and impairments. While there are numerous studies detailing the benefits of dry needling for pain, few studies exist examining the effects on soft tissue mobility. Purpose: The purpose of this study was to determine if the addition of hamstring dry needling to...

Background: Body armor is credited with increased survival rates in soldiers but the additional axial load may negatively impact the biomechanics of the spine resulting in low back pain. Multiple studies have found that lumbar stabilization programs are superior to generalized programs for patients with chronic low back pain. It is not known if su...

Background: Initial reports suggest that treating myofascial trigger points in the infraspinatus with dry needling may be effective in treating patients with shoulder pain. However, to date, high quality clinical trials and thorough knowledge of the physiologic mechanisms involved is lacking. Objectives: To examine the effect of dry needling to...

Objective: To investigate the relationship between dry needling-induced twitch response and change in pain, disability, nociceptive sensitivity, and lumbar multifidus muscle function, in patients with low back pain (LBP). Design: Quasi-experimental study. Setting: Department of Defense Academic Institution. Participants: Sixty-six patients w...

Explore the relationships between preoperative findings and clinical outcome following lumbar disc surgery, and investigate the prognostic value of physical examination findings after accounting for information acquired from the clinical history. We recruited 55 adult patients scheduled for first time, single-level lumbar discectomy. Participants u...

Objective The aim of this study was to determine if a needle is able to reach the cervical multifidus during the application of dry needling or acupuncture. Methods Dry needling and ultrasound imaging of cervical multifidi was conducted on 5 patients (age: 32±5years) with mechanical neck pain, and on 2 fresh cadavers (age: 64±1 years). Dry needlin...

Background: Military personnel and first responders (police and firefighters) often carry large amounts of gear. This increased load can negatively affect posture and lead to back pain. The ability to quantitatively measure muscle thickness under loading would be valuable to clinicians to assess the effectiveness of core stabilization treatment pr...

Purpose/hypothesis: Lower extremity and low back injuries represent a significant financial burden on the military healthcare system. Subsequent injuries often occur during the recuperation period or in the period directly after physical therapy ends when the patient returns to full duty. Medical providers have relatively few objective tools with...

Study Design Case report. Background Common complications from abdominal and pelvic surgery include adhesions and chronic pain. Laparoscopic adhesiolysis is sometimes used with the intent of reducing adhesions and related pain. Physical therapy interventions, such as soft tissue mobilization (STM) may be used for this condition, but evidence to sup...

Study Design Quasi-experimental. Objectives To explore for associations between demographic, patient history, and physical examination variables and short-term improvement in self-reported disability following dry needling therapy performed on individuals with low back pain (LBP). Background Dry needling is an intervention used with increasing freq...

Introduction. Manual therapists commonly use assessments of intervertebral motion to determine the need for spinal manipulation, but the reliability of these procedures demonstrates conflicting results. The objectives of this study were to investigate the interrater reliability of thoracic spine motion palpation for perceived joint restriction and...

The Army Physical Fitness Test (APFT) is a biannual training requirement for all soldiers. The Army has made significant overall fitness gains by developing functional and comprehensive Physical Readiness Training (PRT) programs, but more emphasis on individualized physical fitness test taking technique is warranted in order to optimize performance...

Rehabilitative ultrasound Imaging (RUSI) is increasingly used in the management of musculoskeletal conditions as it provides an objective measure of muscle function while being less invasive than needle electromyography. While research has documented the ability to reliably measure trunk muscles in patients with back pain, no study to date has used...

Little is known about the physiologic mechanism of dry needling. While some evidence suggests that dry needling may decrease nocioceptive sensitivity and facilitate muscle function, no studies to date have examined these physiologic changes compared to clinical outcomes. To examine changes in lumbar multifidus (LM) muscle function and nociceptive s...

Study design: Randomized, controlled, crossover trial. Objectives: To examine the effects of elastic therapeutic taping (ETT) applied to the lumbar paraspinal region on back muscle endurance (BME) compared to no tape or a rigid therapeutic taping (RTT) procedure in individuals with nonspecific low back pain. Background: Elastic therapeutic tap...

Abstract Assessment of spinal stiffness is widely used by manual therapy practitioners as a part of clinical diagnosis and treatment selection. Although studies have commonly found poor reliability of such procedures, conflicting evidence suggests that assessment of spinal stiffness may help predict response to specific treatments. The current stu...

The patient was a 22-year-old man who was currently serving in a military special operations training program. He was referred to a physical therapist for a chief complaint of left elbow pain that currently prevented him from performing routine upper extremity exercise activities. Due to the traumatic nature of the patient's injury, inability to fu...

Study design: Case report. Background: Prognosis for adhesive capsulitis has been described as self-limiting and can persist for 1 to 3 years. Conservative treatment that includes physical therapy is commonly advised. Case description: The patient was a 54-year-old woman with primary symptoms of shoulder pain and loss of motion consistent with...

Study design: Prospective, blinded, diagnostic-accuracy study. Objectives: To investigate the diagnostic accuracy of the ankle anterior drawer test (ADT) to detect anterior talocrural joint laxity in adults with a history of lateral ankle sprain. Background: The ADT is used to manually detect anterior talocrural joint laxity following lateral...

The lumbar multifidus muscle provides an important contribution to lumbar spine stability, and the restoration of lumbar multifidus function is a frequent goal of rehabilitation. Currently, there are no reliable and valid physical examination procedures available to assess lumbar multifidus function among patients with low back pain. To examine the...

The optimal components of postoperative exercise programmes following single-level lumbar discectomy have not been identified. Facilitating lumbar multifidus (LM) function after discectomy may improve postoperative recovery. The aim of this study was to compare the clinical and muscle function outcomes of patients randomised to receive early multim...

Understanding the clinical characteristics of patients with low back pain (LBP) who display improved lumbar multifidus (LM) muscle function after spinal manipulative therapy (SMT) may provide insight into a potentially synergistic interaction between SMT and exercise. Therefore, the purpose of this study was to identify the baseline historical and...</