Effects of neurorehabilitation with and without dry needling technique on muscle thickness, reflex torque, spasticity and functional performance in chronic ischemic stroke patients with spastic upper extremity muscles: a blinded randomized sham-controlled clinical trial

Abstract

Purpose

Evaluation the effects of dry needling on sonographic, biomechanical and functional parameters of spastic upper extremity muscles.

Methods

Twenty-four patients (35–65 years) with spastic hand were randomly allocated into two equal groups: intervention and sham-controlled groups. The treatment protocol was 12-sessions neurorehabilitation for both groups and 4-sessions dry needling or sham-needling for the intervention group and sham-controlled group respectively on wrist and fingers flexor muscles. The outcomes were muscle thickness, spasticity, upper extremity motor function, hand dexterity and reflex torque which were assessed before, after the 12th session, and after one-month follow-up by a blinded assessor.

Results

The analysis showed that there was a significant reduction in muscle thickness, spasticity and reflex torque and a significant increment in motor function and dexterity in both groups after treatment (p < 0.01). However, these changes were significantly higher in the intervention group (p < 0.01) except for spasticity. Moreover, a significant improvement was seen in all outcomes measured one-month after the end of the treatment in the intervention group (p < 0.01).

Conclusions

Dry needling plus neurorehabilitation could decrease muscle thickness, spasticity and reflex torque and improve upper-extremity motor performance and dexterity in chronic stroke patients. These changes were lasted one-month after treatment.Trial Registration Number: IRCT20200904048609N1

IMPLICATION FOR REHABILITATION

• Upper extremity spasticity is one of the stroke consequences which interfere with motor function and dexterity of patient hand in activity of daily living

• Applying the dry needling accompanied with neurorehabilitation program in post-stroke patients with muscle spasticity can reduce the muscle thickness, spasticity and reflex torque and improve upper extremity functions

Keywords:

• Stroke
• muscle spasticity
• upper extremity
• dry needling
• ultrasonography
• reflex torque

Acknowledgment

The current article was extracted from the PhD thesis written by Fatemeh Panahi. We would like to thank the scientific and financial support from Shiraz University of Medical Sciences, the Deputy for Research Affairs, and the School of Rehabilitation Sciences.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by Shiraz University of Medical Sciences (Grant Number: 99-01-06-22644).