The effect of dry needling on spasticity, gait and muscle architecture in patients with chronic stroke: A case series study

Abstract

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 medialis, lateralis, and soleus muscles. The main outcome measures were the Modified Modified Ashworth Scale (MMAS), and Timed Up and Go test (TUG). In addition, ultrasonography measurements (e.g. thickness, pennation angle, and fascicle length) were performed for gastrocnemius medialis at baseline (T0), immediately after intervention (T1) and 30 min after intervention (T2), while the MMAS and TUG Test were only measured at T0 and T2. Results Based on the TUG test, there was a significant improvement in gait function (p = 0.023). Furthermore, the MMAS results (p = 0.014) showed a decrease in resistance to passive movements from plantar flexor muscles. Furthermore, a significant decrease in pennation angle (p = 0.014) and muscle thickness (p = 0.001), and also a significant increase in fascicle length of gastrocnemius medialis (p = 0.001) were observed after dry needling. Discussion & conclusions Based on the outcomes of this study, dry needling application seems to have short term effects in terms of reducing spasticity, improving gait, and muscle architecture of gastrocnemius medialis in patients with chronic stroke. The changes of muscle architecture may be interpreted as the positive effects of dry needling on the physical properties of hypertonic muscles.

Dry needling for treating spasticity in multiple sclerosis

“…Given the novelty of the technique, the optimal frequency of its application is not defined at present. In order not to hinder the daily life of the patients, it was applied once a week in this study based on the minimal time of muscle recuperation 29) .…”

“…As an immediate action, there is rupture of the endomysium and changes in the elongation of actin and myosin fibers. Posteriorly, the inflammatory action allows an improvement in blood flow and oxygen saturation of the stimulated region 28,29) .…”

Effectiveness of dry needling for upper extremity spasticity, quality of life and function in subacute phase stroke patients

“…9 These have usually been case studies 11,28 or single group studies. 10,29 Although some randomised trials with a comparator 9,27 have been reported, the evidence is still scarce. However, all these studies have been carried out with stroke patients in the chronic phase.…”

Dry needling technique decreases spasticity and improves general functioning in incomplete spinal cord injury: A case report

“…24 Nevertheless, reports are scarce regarding the potential effect of DNT in reducing spasticity in an incomplete SCI (iSCI), 25 and the effect on functionality is not yet described. The hypothesized relation between DNT and decreased spasticity is established in prior research reporting a decrease in noise at the dysfunctional endplate, 26,27 restoration of muscle architecture, 20 contractile properties, 17 and a positive effect on regional brain activity. 19 The MTrPs may be responsible for joint-range restrictions and alterations to muscle activation patterns.…”

“…stroke and cerebral palsy) is the dry needling technique (DNT). [17][18][19][20][21][22][23] DNT is a specialized intervention that uses a fine filiform needle to penetrate muscle directly at a myofascial trigger point (MTrP). 24 Nevertheless, reports are scarce regarding the potential effect of DNT in reducing spasticity in an incomplete SCI (iSCI), 25 and the effect on functionality is not yet described.…”