Clinical criteria for the application of percutaneous needle electrolysis in tendinopathies: An expert Consensus cocument and cross-sectional study among physical therapists

Introduction Percutaneous needle electrolysis is a technique of invasive physical therapy which has been applied successfully in tendinopathies over the last decade. This study sought to explore the opinion and criteria employed by physical therapists who apply this technique in tendinopathies. Material and Methods A cross-sectional study based on a survey of 15 questions to gather the sociodemographic characteristics of attendees and to examine four dimensions associated with the application of percutaneous needle electrolysis (indications, dosage, ultrasound-guidance, supporting therapies). The participants voted on the survey simultaneously after installing the “Votephone” App on their mobile phones or smartphones. Results The study participants included 212 people who attended the CIFI 2018 conference and four experts. Of those who responded, 74.5% were men, who were mainly dedicated to clinical work (91.8%), and were aged between 25 and 45 years (97.6%). Electrolysis was used by 79% of respondents in their daily practice, for which 32.89% had over six years' experience. Percutaneous needle electrolysis was considered the therapy of choice in the treatment of tendinopathies for 91.03% of respondents, whereas 98.67% used it in situations of chronicity, and for tissue repair purposes (85%). Of all people surveyed, 97.74% considered that ultrasound guidance was essential for its application, employing intensities of between 2-4 mA (59.60%) and combined with therapeutic exercise (77.78%). Ultrasound in B mode (50.85%) and palpation with the needle and reproduction of symptoms (47.46%) are the criteria used to define the area of intervention. Conclusions Percutaneous needle electrolysis is often used by physical therapists in chronic tendinopathies, applying high intensities (2-4 mA) aimed at repair of the damaged tissue. Attendees considered that the use of ultrasound for assessment and as a guide for the intervention is essential to guarantee a safe application and improve effectiveness. Percutaneous needle electrolysis is most commonly associated with therapeutic exercise.