Effects of Deep Dry Needling on Tremor Severity and Functionality in Stroke: A Case Report

Abstract

This study aimed to determine the effect of one session of dry needling on the severity of tremor, motor function and skills, and quality of life of a 39-year-old woman with post-stroke tremor. Myofascial trigger points (MTrP) of the following muscles were treated: extensor digitorum, flexor digitorum superficialis and profundus, brachioradialis, short head of biceps brachii, long head of triceps brachii, mid deltoid, infraspinatus, teres minor, upper trapezius, and supraspinatus. Outcomes were assessed via (i) clinical scales (activity of daily living (ADL-T24), a visual analog scale (VAS), and the Archimedes spiral), (ii) a functional test (9-Hole Peg test), and (iii) biomechanical and neurophysiological measurements (inertial sensors, electromyography (EMG), and dynamometry). The subject showed a decrease in the severity of tremor during postural (72.7%) and functional (54%) tasks after treatment. EMG activity decreased after the session and returned to basal levels 4 days after. There was an improvement post-intervention (27.84 s) and 4 days after (32.43 s) in functionality and manual dexterity of the affected limb, measured with the 9-Hole Peg test, as well as in the patient’s hand and lateral pinch strength after the treatment (26.9% and 5%, respectively), that was maintained 4 days later (15.4% and 16.7%, respectively).

Ultrasound-Guided Percutaneous Neuromodulation in Multiple Sclerosis: A Case Report

“…However, our results were not in line with a study carried out in a patient with post-stroke tremor 13 and post-stroke spasticity, 14 where the peak effects were achieved immediately after the DN intervention but did not maintain over time. This could be because the DN treatment performed in the aforementioned cases has demonstrated to have a mechanical effect, working through the mechanical disruption of dysfunctional endplates, which are reinnervated after 3 days, 15 whereas PN acts at a central level, without mechanical effects.…”

Dry needling in stroke

“…In a case report published by Ortí� n et al [23], the use of DN for the treatment of post-stroke tremor involving the myofascial trigger points of the muscles supraspinatus, infraspinatus, upper trapezius, mid-region of the deltoid, teres minor, biceps brachii short head, triceps brachii long head, brachioradialis, extensor digitorum, flexor digitorum profundus, and flexor digitorum superficialis was beneficial as evident in the clinical, electrophysiological and functional outcomes of the tremor. The patient had improved postural and functional components of tremor [23].…”