DRY NEEDLING WITH INTRAMUSCULAR ELECTRICAL STIMULATION IMPROVES UPPER-LIMB IMPAIRMENTS AFTER CHRONIC ISCHEMIC STROKE: A RANDOMIZED CONTROLLED TRIAL
DOI:
https://doi.org/10.18623/rvd.v23.n4.5055Keywords:
Stroke, Muscle Hypertonia, Spasticity, Electrical Stimulation Therapy, Dry NeedlingAbstract
Background: Dry needling is increasingly being used to manage post-stroke upper-limb spasticity, but evidence remains limited for protocols that deliver electrical stimulation through dry-needling. Objective: The study determined whether adding dry needling with intramuscular electrical stimulation to conventional physical therapy improves spasticity and motor outcomes in patients with chronic ischemic stroke. Methods: In this assessor-blinded randomized controlled trial, 64 participants were allocated to DN+ES+CPT or CPT alone for 6 weeks. Spasticity (Modified Ashworth Scale) was the primary outcome. Secondary outcomes were upper-limb motor impairment (Fugl–Meyer Assessment Scale), H-reflex latency, and the Hmax/Mmax ratio. Assessments were conducted at baseline, week 3, and week 6. Results: By week 6, the DN+ES+CPT group achieved greater motor improvement than CPT (FMAS Δ=+8.95 vs +4.60; p=0.002; d=0.73) and reduction in spasticity (MAS Δ=−1.56 vs −0.80; p<0.001; d=−1.63). Although, Hmax/Mmax ratio decreased more in the intervention arm, but between-group differences were not significant (p=0.090). Latency also improved similarly in both groups (between group p=0.581). Conclusion: Adding dry needling with electrical stimulation to CPT produced superior reductions in spasticity and greater motor recovery than CPT alone in chronic ischemic stroke. The combined approach appears feasible and clinically useful.
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