Author links open overlay panelSeyedeh Saeideh Babazadeh-Zavieh ^a, NoureddNakhostin Ansari ^a b, Nastaran Ghotbi ^a, Soofia Naghdi ^a, Korosh Mansouri ^c, Mohammadreza Khanmohammadi ^a, Seyed Mohammad Jafar Haeri ^d

^a  Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran

^b  Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran

^c  Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran

^d  Department of Anatomical Sciences, Medical School, Arak University of Medical Sciences, Arak, Iran

Abstract

Background and purpose

The use of dry needling (DN) with other treatments may be more beneficial in managing post-stroke spasticity. We report the effects of DN plus exercise therapy (ET) on wrist flexor spasticity.

Patient presentation

The patient was a 45-year-old man with an 8-year history of stroke. The outcome measures included the Modified Modified Ashworth Scale (MMAS), H_max/M_max ratio, H-reflex latency, Action Research Arm Test (ARAT), Fugl-Meyer Assessment (FMA), and range of motion (ROM) which were assessed before (T1), after (T2), and after 3-week follow-up (T3).

Conclusion

The MMAS was improved at T2 from “3” to “2”. The H_max/M_max decreased from 0.77 to 0.53 at T3. The H-reflex latency increased from 15.4 ms to 18.5 ms at T3. The wrist active and passive ROM increased ∼30° and ∼20° at T2, respectively.

A 4-session DN plus ET may improve spasticity and ROM. No meaningful improvement was observed in function.

Received 4 November 2020, Revised 14 November 2021, Accepted 27 November 2021, Available online 2 December 2021, Version of Record 5 December 2021.

https://doi.org/10.1016/j.ctcp.2021.101520