Effects of dry needling on muscle spasticity in adults with neurological disorders: a systematic review

Abstract

Background

Spasticity is a motor disorder often associated with decreased ROM, ADL performance, and QOL. DN has shown potential to improve spasticity by stimulating spastic muscle tissue with a stainless steel monofilament needle.

Objective

To determine the effects of dry needling (DN) on muscle spasticity in adults with neurological disorders.

Methods

Literature search of Cochrane, CINAHL, Google Scholar, and ProQuest was conducted. Search limits: English, journals, human subjects, 2009–2019. Selection criteria: Adults 18+ with neurological disorders and interventions included dry needling as treatment for spasticity. Two reviewers, for methodological quality based on Oxford Levels of Evidence, independently assessed each study.

Results

Ten articles met the selection criteria, all showing reductions in spasticity. Secondary outcomes were reported with improvements at the impairment level including muscle length, range of motion, pain, and motor performance (Fugl-Meyer motor subscale); and at the functional level including hand dexterity (box and block test), balance (computerized dynamic posturography) and mobility (TUG).

Conclusions

There is low to moderate evidence in support of using DN to decrease spasticity in adults with neurological disorders, specifically in those with a history of stroke. Limitations included lack of follow-up and small sample sizes. Further high-level research is required to determine long-term outcomes of DN in spastic muscles. There was a short-term decrease in spasticity of target muscles after the performance of DN. Evidence included improvements at the impairment and functional levels after the use of DN. DN poses as a safe, feasible option to improve spasticity and impact other targeted outcomes in adults with neurological disorders.

Keywords:

• Dry needling
• spasticity
• hypertonia
• dystonia
• stroke

Disclosure statement

The authors report no conflict of interests with detail to the research, authorship, and/or publication of this systematic review.

Additional information

Notes on contributors

Anthony F. Carusotto

Anthony F. Carusotto, PT, DPT, CLT, received a Doctor of Physical Therapy degree from Misericordia University and is currently a faculty instructor at the University of Scranton’s DPT program. Areas of teaching expertise involve human anatomy, kinesiology, physical agents, and cardiopulmonary studies. Research interests include varying aspects to improve muscle performance and function, also improving mental health amongst DPT students and faculty through varying aspects of resiliency training.

Renée M. Hakim

Renée M. Hakim, PT, PhD is a Professor and Chairperson/Program Director in the Department of Physical Therapy (PT) at the University of Scranton. She has been teaching primarily in the areas of adult neurologic rehabilitation and motor control/motor learning since 1996. Dr. Hakim received her entry-level PT degree from the University of Scranton, a Master’s degree in Neurologic PT from the University of Pittsburgh, and a PhD in Public Health from Temple University. She received American Board of Physical Therapy Specialties (ABPTS) certification as a Neurologic Clinical Specialist in 1997, re-certification in 2007 and emeritus status in 2017. Her primary areas of research include balance testing/training/fall prevention and use of technology (e.g., haptic robotics, wearable sensors, VR) in rehabilitation.

Rebecca G. Oliveira

Rebecca G. Oliveira, PT, DPT, ATC, received a Doctor of Physical Therapy degree from the University of Scranton, and is currently a staff physical therapist for Kessler Rehabilitation Center in New Jersey. Areas of expertise include general orthopedics and sports rehabilitation. Research interests include biomechanics and movement dysfunctions, management of neuromuscular dysfunctions, and levels of clinical confidence in DPT students treating in a pro-bono clinic.

Alyssa Piranio

Alyssa Piranio, PT, DPT, received a Doctor of Physical Therapy degree from the University of Scranton and is currently practicing in Wilmington, DE. Research interests include stroke and spinal cord injury rehabilitation, as well as the impact of physical therapy techniques on patients with multiple sclerosis.

Conor P. Coughlan

Conor P. Coughlan, PT, DPT, received a Doctor of Physical Therapy degree from University of Scranton and is currently a Physical Therapist working in the Orthopedic Outpatient setting. Research interests includes maximizing throwing athlete’s recovery process to prevent UCL injuries, also improving ACL prevention techniques for athletes under the age of 18 to limit injuries.

Thomas J. MacDonald

Thomas J. MacDonald received a Doctor of Physical Therapy degree from the University of Scranton, and is currently a staff physical therapist at Pivot Health Solutions in Scranton, PA. Areas of interest include general orthopedic and sport specific rehabilitation. Research affinities include orthopedic rehab as well as interest in shoulder pathologies and associated rehabilitation.