Effect of Dry Needling Treatment on Tibial Musculature in Combination with Neurorehabilitation Treatment in Stroke Patients: Randomized Clinical Study

Abstract

(1) Background: Introducing ultrasound-guided dry needling to neurorehabilitation treatments increases the beneficial effects of therapy. The aim of this study was to compare the effects of including an ultrasound-guided dry needling session in neurorehabilitation treatment on spasticity and gait–balance quality versus neurorehabilitation treatment in subjects who had suffered a stroke. (2) Methods: A single-blind, randomized clinical trial was conducted. Thirty-six patients who had suffered a stroke in the right middle cerebral artery signed the informed consent for participation in the study. Twenty patients finally participated and were randomly assigned to the control group (neurorehabilitation treatment) or experimental group (neurorehabilitation treatment plus ultrasound-guided dry needling). Pre-treatment and post-treatment data were collected on the same day. The experimental group (n = 10) first underwent an ultrasound-guided dry needling intervention on the tibialis anterior and tibialis posterior musculature, followed by neurorehabilitation treatment; the control group (n = 10) underwent their corresponding neurorehabilitation without the invasive technique. Pre-treatment and post-treatment measurements were taken on the same day, assessing the quality of balance–gait using the “Up and Go” test and the degree of spasticity using the Modified Ashworth Scale. (3) Results: The patients who received neurorehabilitation treatment plus ultrasound-guided dry needling showed a greater decrease in spasticity in the tibial musculature after the neurorehabilitation treatment session (p < 0.001), improving balance and gait (p < 0.001). (4) Conclusions: An ultrasound-guided dry needling session combined with neurorehabilitation treatment reduced spasticity and improved balance and gait in stroke patients.

Safety of dry needling in stroke patients: a scoping review

“…Full text of the remaining 25 publications was screened and all were included based on the eligibility criteria. 13 , 14 , 17 - 39 …”

“…The characteristics of the 25 included studies are shown in Supplementary Digital Material 2, Supplementary Table II. 13 , 14 , 17 - 39 All studies were published between 2004 and 2022. Of these studies, nine were case reports/series and 16 were clinical trials of which twelve were randomized controlled trials.…”

“… 18 , 21 , 22 , 25 The remaining 21 articles did not mention whether patients were taking any form of antiplatelet or anticoagulant therapy (Supplementary Table II). 13 , 14 , 17 - 39 Researchers from six of the studies responded to direct contact by the authors to state that the use of anticoagulants was not interrupted during their trials.…”

“… Extracted data: Characteristics of the included studies, dry needling characteristics, assessed outcome of interest. 13 , 14 , 17 - 39 …”

“…As the diameter of the needles used is usually between 160 and 450 µm, and the diameter of the normal adult myocyte is 20-60 µm, the application of DN can induce tissue damage in the muscle fiber, the motor plate and axon. 13 An alternative hypothesis suggests DN may modulate α-motoneuron activity and therefore decrease spinal reflex excitability. 11 , 12 , 14 …”