Dry Needling and Bobath Treatment Clinical Effects Focused on Stroke Patients

Universidad Rey Juan Carlos

Status: Completed

Conditions: Ischemic Stroke; Spasticity

Treatments: Other: Dry needling in a non myofascial trigger points area plus physical therapy based on Bobath concept; Other: Dry needling in a myofascial trigger points area plus physical therapy based on Bobath concept

Study type: Interventional

Funder types: Other

Identifiers

NCT03906305

Pending

Details and patient eligibility

About

The investigators aim to determine if dry needling technique in a non myofascial trigger point area generate the same changes in spasticity, function and pain responses as with dry needling in a myofascial trigger point area.

Full description

Spasticity is a consequence of multiple diseases that affect the Central Nervous System, such as stroke and other neurodegenerative diseases. Its pathophysiology is unclear and the variety of clinical symptoms is determined by the injury location. Several studies have suggested the possibility of active pain treatment effectiveness through myofascial trigger points management. One of these interventions is dry needling, which has been used in several scientific studies. However, these investigations have been based on spasm response or deep dry needling mechanisms always over a trigger point, but none of the participants compare the possible mechanical effects of the insertion of a needle into a spastic muscle without targeting specifically a trigger point. Therefore, the aim of this study is to evaluate the effects on spasticity, pain and motor function after a dry needling intervention versus the insertion of a needle into a non trigger point area in patients who had experienced a stroke.

Enrollment: 18 patients

Sex: All

Ages: 35 to 81 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Medical diagnosis of unilateral ischemic Stroke
• Unilateral hemiplegia resulting from Stroke
• Evolution of at least 6 months since the Stroke
• Age between 35 and 81 years of age
• Presence of hypertonia in the upper extremity
• Restricted shoulder range of motion

Exclusion criteria

• Recurrent Stroke
• Previous treatment with nerve blocks, motor point injections with neurolytic agents for Spasticity at any time, or with BTX-A in the previous 6 months
• Cognitive deficits
• Progressive or severe neurological diseases, eg, heart conditions, unstable hypertension, fractures or implants in upper extremity
• Belonephobia (fear to needles)
• Have received pharmacological treatment for shoulder pain 3 months before the study
• Existence of peripheral nerve injury
• Previous history of fracture in the gleno-humeral joint
• Episodes of epilepsy in the year prior to participation in the study

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Triple Blind

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18 participants in 2 patient groups

Dry needling in a myofascial trigger points area

Experimental group

Description:

The intervention will consist of a sixty minutes physical therapy session based on the modulating Bobath technique focused on the upper limb. Besides, during the intervention patients will receive deep dry needling that will be inserted into trigger point spastic muscle of the shoulder.

Treatment:

Other: Dry needling in a myofascial trigger points area plus physical therapy based on Bobath concept

Dry needling in a non myofascial trigger points area

Active Comparator group

Description:

The intervention will consist of a sixty minutes physical therapy session based on the modulating Bobath technique focused on the upper limb. Besides, during the intervention patients will receive deep dry needling that will be inserted into a non trigger point spastic muscle of the shoulder.

Treatment:

Other: Dry needling in a non myofascial trigger points area plus physical therapy based on Bobath concept