Article Text

Effects of dry needling on post-stroke spasticity, motor function and stability limits: a randomised clinical trial
  1. Zacarías Sánchez-Mila1,
  2. Jaime Salom-Moreno2,3,
  3. César Fernández-de-las-Peñas2,3
  1. 1 Alumno de Doctorado, Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Alcorcon, Spain
  2. 2 Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcon, Spain
  3. 3 Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Spain
  1. Correspondence to Dr César Fernández-de-las-Peñas, César Fernández de las Peñas, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón 28922, Spain; cesarfdlp{at}


Objective To determine the effects of inclusion of deep dry needling into a treatment session following the Bobath concept on spasticity, motor function and postural control after a stroke.

Methods 26 patients who had suffered a stroke were randomly assigned to one of two treatment groups: Bobath only, or Bobath plus dry needling. Both groups received a session including strengthening, stretching and reconditioning exercises following the principles of the Bobath concept. Patients in the Bobath plus dry needling group also received a single session of ultrasound-guided dry needling of the tibialis posterior. Spasticity (Modified Modified Ashworth Scale), function (Fugl-Meyer Scale) and stability limits (computerised dynamic posturography using the SMART EquiTest System) were collected before and 10 min after treatment by a blinded assessor. The parameters of the stability limits included movement velocity (MVL), maximum excursion (MXE), end-point excursion (EPE) and directional control (DCL).

Results A greater number of individuals receiving Bobath plus dry needling exhibited a decrease in spasticity after treatment (P<0.001). Analysis of covariance (ANCOVA) showed that patients receiving Bobath plus dry needling exhibited greater improvements in the balance (0.8, 95% CI 0.2 to 1.4), sensory (1.7, 95% CI 0.7 to 2.7) and range of motion (3.2, 95% CI 2.0 to 4.4) domains of the Fugl-Meyer Scale than those receiving Bobath only. ANCOVA also found that subjects receiving dry needling showed a greater increase in MVL non-affected forward direction, EPE non-affected direction, MXE backward and MXE affected/non-affected, DCL backward and DCL affected backward direction, than those who did not receive it.

Conclusions The inclusion of deep dry needling into a treatment session following the Bobath concept was effective at decreasing spasticity and improving balance, range of motion and the accuracy of maintaining stability in patients who had experienced a stroke.

Trial registration number NCT02579291.

  • stroke
  • acupuncture

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  • Contributors All authors contributed to the study concept and design. CF-d-l-P did the main statistical analysis. ZS-M and JS-M contributed to the literature review and interpretation of the data. ZS-M and JS-M contributed to drafting the report. CF-d-l-P provided administrative, technical and material support, and supervised the study. All authors revised the text for intellectual content and have read and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Universidad Rey Juan Carlos, Madrid-Spain (URJC 07/2015)

  • Provenance and peer review Not commissioned; externally peer reviewed.

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