Effectiveness of Dry Needling versus Placebo on Gait Performance, Spasticity, Electromyographic Activity, Pain, Range-of-Movement and Quality of Life in Patients with Multiple Sclerosis: A Randomized Controlled Trial Protocol.

Carlos Luque-Moreno,David Lucena-Anton,Guillermo Izquierdo-Ayuso,Anabel Granja-Domínguez,Alberto Marcos Heredia-Rizo,Jose A Moral-Munoz

doi:10.3390/brainsci10120997

Carlos Luque-Moreno, David Lucena-Anton + Show 4 more

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https://doi.org/10.3390/brainsci10120997

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Abstract

Dry needling (DN) is an emerging technique commonly used in neurological and musculoskeletal pain conditions, but there have been no previous studies in patients with multiple sclerosis (pwMS). This trial aims to assess the efficacy of deep DN, compared with sham placebo DN, on gait performance, spasticity level, pain, electromyographic activity, range-of-movement (ROM) and quality of life in pwMS. Forty adults with MS were randomly assigned to one study group. The DN group will undergo 2 sessions (once per week) using DN over the rectus femoris (RF) and gastrocnemius medialis (GM) muscles at the lower extremity with higher spasticity. The placebo group will receive the same protocol using a sham placebo needle (Dong Bang needle). Outcome measures will include gait performance, using the GaitRite® system, spasticity level with the Modified Ashworth Scale, superficial electromyographic activity of RF and GM, pain (pressure algometer), ROM (goniometer), and quality of life (Musiqol). This study is the first investigating the short-term effect of DN, compared with placebo, in pwMS, and taking into account the possible changes in the electromyographic activity of the lower limb. Therefore, the results may help to understand the suitability of using this technique in the clinical setting for this population. Trial registration: ACTRN12619000880145.

Highlights

Multiple sclerosis (MS) is one of the most common and disabling neurologic conditions among early adults, affecting approximately 2.3 million people worldwide [1], and with a higher prevalence in women (3:1 ratio) [2]
Given the difficulty that many patients with MS have to walk for 6 min, we propose the 2MWT in the present protocol
Upon completion of the study, telephone follow-up will be conducted to check for any possible adverse effects after the last treatment session. This innovative study will evaluate the impact of Dry needling (DN) on gait performance, spasticity level, electromyographic activity, pain, ROM, and QoL in patients with multiple sclerosis (pwMS)

Summary

Introduction

Multiple sclerosis (MS) is one of the most common and disabling neurologic conditions among early adults, affecting approximately 2.3 million people worldwide [1], and with a higher prevalence in women (3:1 ratio) [2]. Persons with MS (pwMS) suffer from varying cognitive and sensory-motor impairments that affect their functional capacity, including impaired gait performance [4]. This is reported as a major complaint in up to 85% of pwMS [5], and seems to be. Brain Sci. 2020, 10, 997; doi:10.3390/brainsci10120997 www.mdpi.com/journal/brainsci. Brain Sci. 2020, 10, 997 closely related to increased fall risk [6]. Spasticity and muscle weakness are present from the initial stages of the disease and have been associated with abnormal gait patterns [8], which may worsen other symptoms and impact on the quality of life (QOL)

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