Ultrasound-Guided Percutaneous Neuromodulation in Multiple Sclerosis: A Case Report

Abstract

Multiple sclerosis is a degenerative inflammatory disease that causes different musculoskeletal problems. Its impact has led to the study of treatment alternatives such as the use of invasive physiotherapy. In this study, we analyze the effects of ultrasound-guided percutaneous neuromodulation to a 51-year-old man suffering from multiple sclerosis and an associated hemiparesis in the left upper limb. A dry needling needle was placed in contact with the median nerve under ultrasound guidance and 10 trains of 10 seconds of electrostimulation with a frequency of 10 Hz and an impulse width of 240 µs were applied, with 10 seconds of pause between them. There was a significant improvement in the grip strength immediately after the treatment which increased progressively at 24 hours and at 4 days follow-up. There was also an improvement in the hand function, with a decrease in the time necessary to perform the 9 Hole Peg Test immediately after the treatment, which was maintained at 24 hours and at 4 days follow-up. Future studies with larger samples are needed to further test the effects of this invasive physiotherapy technique as well as its possible applications to other neurological conditions.

Keywords:

• physiotherapy
• multiple sclerosis
• dry needling
• percutaneous neuromodulation

Data Sharing Statement

The data that support the findings of this study are available from the first author [AJO], upon reasonable request by email to [email protected]. Clinical deidentified participant data will be made available after the manuscript publication.

Ethical Approval and Informed Consent

This study was approved by the Committee of Ethics of Hospital Universitario de Canarias, Canary Islands, Spain with code NEUROECO-2020 and is compliance with the declaration of Helsinki. The participant signed informed consent.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Funding

This research received no external funding.