Effects of dry needling (DNHS technique) on the contractile properties of spastic muscles in a patient with stroke: a case report

Abstract

Dry needling for hypertonia and spasticity (DNHS) is a technique used for decreasing hypertonia and spasticity and for the improvement of function in patients with damage to the central nervous system. There is limited evidence supporting the effectiveness of this technique on the basis of objective assessments. The aim of the present case report was to quantify the effects of dry needling (DNHS technique) on the contractile properties of spastic muscles in an individual with stroke. The DNHS technique was applied to a 50-year-old male 2.5 years after stroke who had a complaint of spasticity. The treated muscles were biceps brachii, triceps brachii, rectus femoris, semitendinosus, biceps femoris, medial gastrocnemius, and lateral gastrocnemius. Tensiomyography was used to assess maximal displacement (Dm) of treated muscles. We performed a preintervention and postintervention measurement and a follow-up measurement 3 weeks after intervention. After the application of the DNHS technique, a decrease in the level of local muscle stiffness was observed for all muscles after intervention and at the 3-week follow-up, quantified by an increase in Dm. The usefulness of tensiomyography for detecting changes in patients with spasticity correlated with clinical measures in this field requires further research to establish the reliability of the different parameters provided by the equipment.

Tensiomyography, sonoelastography, and mechanosensitivity differences between active, latent, and control low back myofascial trigger points

“…The Dm shows the deformation response (mm) to an electrical stimulus to the muscle belly, which depends on muscle elasticity. [16,31] This contractile property could provide a muscle belly stiffness measurement according to prior studies. [31,32] In addition, the sonoelastography strain index may show the stiffness characteristics of the muscle tissue.…”

“…[12,13,25] Finally, Dm may be the most recommended TMG parameter in MPS interventional studies due to its high reliability, clarity of interpretation, and variations after MTrPs treatment. [16,34] …”

“…[16] The 5 contractile objective parameters were bilaterally analyzed from the erector spinae muscle belly displacement–time curves (Fig. 1): maximal radial displacement (Dm; millimeters of displacement secondary to an electrical stimulus to the muscle belly), contraction time (Tc; seconds from 10% to 90% of Dm in the ascending curve), sustain time (Ts; seconds from 50% of Dm on both sides of the curve), delay time (Td; seconds from the onset of electrical stimulus to 10% of Dm), and half-relaxation time (Tr; seconds from 90% to 50% of Dm on the descending curve).…”

“…Despite this, a recent case report performed tensiomyography to assess maximal displacement of treated spastic muscles with dry needling showing a decrease in the level of local muscle stiffness. [16] …”

“…[16] Therefore, the main aim of this study was to determine the tensiomyography differences between the palpation area of active and latent MTrPs with regards to control points in the lumbar erector spinae muscles of subjects with LPP. In addition, the 2nd purpose was to establish their correlations between contractibility, stiffness, and mechanosensitivity, assessed by tensiomyography, sonoelastography, and PPT, respectively.…”