Effect of dry needling plus static stretching on plantar flexor spasticity, function, and quality of life in a patient with chronic stroke: a case report

Mahdi Esmaeeli, Nastaran Ghotbi, Kazem Malmir, Noureddin Nakhostin Ansari, Pablo Herrero, Shohreh Jalaie, Elham Loni, Sajede Mazidi

Abstract Background Static stretching is a treatment that reduces spasticity by elongating the muscle fbers. Dry needling is also a novel intervention that reduces spasticity by destroying dysfunctional endplates. Plantar fexor spasticity can cause gait disturbances and impaired balance in patients who have had a stroke. Therefore, reducing the spasticity of these muscles can improve the patient’s independence and overall function. This study reported the additional efects of dry needling on static stretching in reducing spasticity and function in a chronic stroke patient. Case presentation The patient was a 47-year-old Iranian woman with a past-7-month history of stroke and plantar fexor muscle spasticity. In this study, interventions were conducted for 5 days. In the treatment session, frst dry needling (60 seconds×3 days/week for 1 week total) was applied on the gastrocnemius, and then, an orthosis was used for static stretching (20 minutes×5 days/week for 1 week total). The outcome measures were the Modifed Modifed Ashworth Scale, active and passive range of motion, the timed up and go test, and the European Quality of Life questionnaire. The patient was assessed at baseline (T0), immediately following treatment (T1), and at 1-week follow-up (T2). The results were reported as follows: The Modifed Modifed Ashworth Scale score decreased from 2 at T0 to 1 at T1 and remained 1 at T2. Active range of motion increased from 10° at T0 to 25° at T1 and decreased again to 15° at T2. Passive range of motion increased from 40° at T0 to 50° at T1 and decreased again to 45° at T2. The timed up and go test decreased from 50 seconds at T0 to 40 seconds at T1 and increased again to 42 seconds at T2. Her European Quality of Life questionnaire score increased from 0.25 at T0 to 0.39 at T1 and remained unchanged at 0.39 at T2. Conclusion this case study reported a patient with post-stroke spasticity. After dry needling in combination with static stretching, spasticity and overall function improved. It would be benefcial to conduct a randomized clinical trial study with a control group to comprehend the additional impact of dry needling on static stretching. Trial registration IRCT20230719058844N1, Registered 7 August 2023, https://irct.behdasht.gov.ir/trial/71395. Keywords Stroke, Spasticity, Stretching, Dry needling, plantar flexors.

Journal of Medical Case Reports (2025) 19:233 https://doi.org/10.1186/s13256-025-05270-7