Dry Needling in Parkinson' s Disease: A Randomized Clinical Trial with Markerless Kinematic Analysis

Parkinsons disease (PD) is associated with debilitating motor symptoms, including gait impairments and stooped posture. While markerless motion capture offers a scalable alternative to quantify these deficits, the acute biomechanical effects of interventions like Dry Needling (DN) on PD gait remain under-investigated. This randomized clinical trial investigated the acute effects of upper trapezius myofascial release via DN on gait and turning biomechanics in individuals with PD, utilizing a 3D markerless motion capture system. Thirty-eight participants with mild-to-moderate PD and bilateral upper trapezius trigger points were randomly assigned to a DN or Sham group. Gait was evaluated during a modified Timed Up and Go (TUG) test at baseline, immediately post-intervention, and at a one-week follow-up. Video data were processed using the open-source vaila toolbox, which applied a rigorous spatial segmentation algorithm to isolate postural transitions, steady-state gait, and turning phases. Thirty-seven participants completed the protocol (DN = 18; Sham = 19). The algorithm-driven markerless pipeline successfully extracted high-fidelity spatiotemporal parameters and automated gait event detection. However, the quantitative analysis revealed no significant Group x Time interactions for spatiotemporal parameters or turning kinematics, with both groups exhibiting similar trajectories across all assessment points. In conclusion, a single session of upper trapezius DN does not yield superior acute improvements in gait or turning biomechanics compared to a sham intervention in PD, suggesting that macro-level motor adaptations likely require cumulative therapeutic sessions. Nevertheless, the successful implementation of this markerless workflow provides an objective, cost-effective framework for precisely tracking phase-specific kinematic changes in routine clinical settings.