Effect Of Dry Needling On Post Stroke Spasticity By Using H Reflex: Randomised Control Trial

Abstract

Introduction: Dry needling (DN) is a type of therapy that is used to treat myofascial trigger points and a variety of pain conditions.

Need of study: Gap analysis suggested the need for understanding the exact mechanism of dry needling on spastic muscle in form of alpha motor neuro firing and its role in clinical & functional findings. Currently, need of objective evidence for the usefulness of DN in neurological diseases is required. 

Objective: The aim of this study was to investigate effect of dry needling on spasticity in stroke patients using the H reflex and modified Tardieu scale.

Methods: A randomised controlled trial was carried out. 81 stroke survivors were randomly assigned to one of two groups: one had six sessions of DN over the muscles with conventional treatment, while the other received conventional care. The H reflex and the modified Tardieu scale were used to assess spasticity. All outcome measures were analysed before (1), after (2), and two weeks later (3).

Results: After the intervention, people who received DN had less spasticity. H3-H1 is statistically significant (P = 0.42) in the experimental group against the control group. T3-T1 and T2-T3 are statistically significant (p = 0.00) in the experimental group against the control group.

Conclusions: The application of DN appears to have an immediate effect on lowering spastic muscle tone and local muscle stiffness. This could be because DN diminishes the nodular zone of spastic muscle and reduces the firing of alpha motor neurons. These findings are very encouraging in terms of lowering spasticity.

Clinical trial: CTRI/2020/03/024082.