Dry Needling for Spasticity in Stroke

Universidad Rey Juan Carlos

Status: Completed

Conditions: Stroke

Treatments: Device: stainless steel needles (0.3mm x 50mm); Other: Physical Therapy; Other: Dry needling

Study type: Interventional

Funder types: Other

Identifiers

NCT02377804

HBMA-URJC

Details and patient eligibility

About

Stroke is the leading cause of physical disability due to the presence of spasticity. Different needling techniques, including Botulinum Toxin A are proposed for management of spasticity; however results are conflicting. The presence of spasticity in the upper extremity implies several impairments for daily life activities. No study has investigated the effects of deep dry needling inserted into the targeted spastic musculature of the shoulder region in patients who had suffered a stroke. The investigators will conduct a randomized controlled trial investigating the effects of the inclusion of deep dry needling into a rehabilitation program over the musculature of the shoulder region, pressure pain hyperalgesia and range of motion in individuals with chronic stroke. The investigators hypothesize that patients receiving dry needling into the spastic shoulder musculature would exhibit greater improvements in spasticity, pressure sensitivity and range of motion than those who will not receive the intervention.

Enrollment: 20 patients

Sex: All

Ages: 40 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• first-ever unilateral stroke;
• hemiplegia resulting from stroke;
• age between 40 and 65 years old;
• presence of hypertonicity in the upper extremity;
• restricted range of motion of the shoulder

Exclusion criteria

• recurrent stroke;
• previous treatment with nerve blocks, motor point injections with neurolytic agents for spasticity at any time;
• previous treatment with BTX-A in the 6 months prior the study;
• severe cognitive deficits; 5, progressive or severe neurologic diseases, e.g., heart conditions, unstable hypertension, fracture or implants in the lower extremity;
• fear to needles;
• any contraindication for deep dry needling, e.g., anticoagulants, infections, bleeding, or psychotic.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Double Blind

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20 participants in 2 patient groups

Experimental intervention

Experimental group

Description:

The experimental intervention will consist of 3 sessions, one per week, of 45min of physical therapy including mobilizations of the scapular region, manual therapies targeted to decrease muscle tone, neuromodulatory techniques for spasticity and proprioceptive exercises for the upper extremity. In addition, during this intervention patients will also receive deep dry needling with disposable stainless steel needles (0.3mm x 50mm) that will be inserted into the skin over taut bands of the spastic musculature of the shoulder area: upper trapezius, subscapularis, infraspinatus, and pectoralis mayor

Treatment:

Device: stainless steel needles (0.3mm x 50mm)

Other: Dry needling

Other: Physical Therapy

Control intervention

Active Comparator group

Description:

The control intervention will consist of 3 sessions, one per week, of 45min of physical therapy including mobilizations of the scapular region, manual therapies targeted to decrease muscle tone, neuromodulatory techniques for spasticity and proprioceptive exercises for the upper extremity.

Treatment:

Other: Physical Therapy