Combined effects of dry needling and exercises therapy on muscle spasticity and motor function in chronic stroke: a pretest-posttest pilot study
Seyedeh Saeideh Babazadeh-Zavieh 1 , Noureddin Nakhostin Ansari 1,2 , Nastaran Ghotbi 1* , Soofia Naghdi 1 , Seyed Mohammad Jafar Haeri 3 , Mohammadreza Khanmohammadi 1 , Korosh Mansoori 4
Explor Neuroprot Ther. 2022;2:100–109
Received: November 14, 2021 Accepted: April 18, 2022 Published: June 20, 2022
Academic Editor: Rafael Franco, Universidad de Barcelona, Spain
This article belongs to the special issue Dry Needling for Neurological Disorders
Abstract
Aim:
Spasticity is one of the most common symptoms in post-stroke patients. Dry needling (DN) is a relatively new method for the management of muscle spasticity. A multimodal treatment may be more effective in spasticity management. The purpose of this study was to explore the short-term combined effects of DN and exercise therapy on wrist flexor spasticity, motor function, and motor neuron excitability in patients with chronic stroke.
Methods:
Ten patients with stroke and a mean age of 52 ± 4.9 years participated in this pretest-posttest pilot study. Patients received four sessions of DN and exercise therapy. Affected flexor carpi radialis and flexor carpi ulnaris muscles were needled each for 1 min. Patients underwent exercise therapy for about 30 min, once a week after DN. The outcome measures were the Modified Modified Ashworth Scale (MMAS), the maximal amplitude of H wave/maximal amplitude of M wave ratio (Hmax/Mmax Ratio), H-reflex latency, wrist extension active and passive range of motion (ROM), Action Research Arm Test (ARAT), and Fugl-Meyer Assessment (FMA). Assessments were performed at baseline, after four sessions of treatment, and three weeks after treatment.
Results:
After treatment, significant improvements in MMAS, wrist passive ROM, ARAT, and FMA were obtained (P ≤ 0.05).
Conclusions:
DN combined with exercise therapy improved muscle spasticity and motor function in patients with chronic stroke. Further investigations with a randomized controlled trial design with a comparator group of DN only are warranted (https://www.irct.ir/ identifier: IRCT20180611040061N1).
Keywords
Stroke, spasticity, dry needling, exercise therapy, Hoffmann reflex
