Dry Needling and Neurodevelopmental Therapy versus Neurodevelopmental Therapy Alone on Spasticity and Functions in Patients with Stroke: A Randomized Controlled Trial

Abstract

Background: Dry needling is suggested as a novel and promising method for treating spasticity and functions after stroke. Objectives: To understand the effects of dry needling and neurodevelopmental therapy (NDT) compared to NDT alone on post-stroke spasticity and functions.Materials and Methods: Forty-two patients with post-stroke spasticity were randomized into two groups: NDT and dry needling (n=21) or NDT alone (n=21). Dry needling was applied over the study group's gastrocnemius, quadriceps femoris, flexor carpi radialis, and biceps brachii muscles. The Modified Ashworth Scale and range of movement (ROM) assessment were used to assess spasticity before treatment (T1), immediately after the 1st session (T2), and after the 12th session (T3), while Nine Hole Peg Test (NHPT), 10-Meter Walk Test (10MWT), and Fullerton Advanced Balance (FAB) Scale were used to assess functions at T1 and T3. Results: Dry needling and NDT were more effective in improving the gastrocnemius muscle tone (χ 2 =9.31; p=.025) than NDT alone. Compared to NDT alone group the improvement was higher on all ROM measurements in the dry needling and NDT group, which was more remarkable at T2 than T3. The dry needling and NDT group exhibited more significant improvements in the upper extremity (NHPT; F=88.316, p<.001, η 2 =.694), lower extremity (10 MWT; F=7.075, p=.011, η2 =.495), and balance (FAB; F=58.435, p<.001, η 2 =.600) functions compared to the NDT alone group. Conclusion: Dry needling and NDT effectively reduce spasticity but only significantly in the gastrocnemius muscle. Dry needling and NDT is also more effective than NDT alone in improving upper and lower limb and balance functions in stroke patients.Trial Registration : The trial was registered to ClinicalTrials. gov (identifier: NCT03863678) on March 5, 2019.