• Ana Mendigutía-Gómez, María T Quintana-García, Miriam Martín-Sevilla, Diego de Lorenzo-Barrientos, Jorge Rodríguez-Jiménez, César Fernández-de-Las-Peñas, and José L Arias-Buría.
• Department of Physical Therapy-Rehabilitation, Hospital Beata María Ana, Madrid, Spain.
• Acupunct Med. 2020 Jun 1; 38 (3): 150-157.

ObjectivesTo determine the presence of post-needling induced pain in subjects who had suffered a stroke and received trigger point (TrP) dry needling (DN), and to investigate the effects of including TrP-DN into a rehabilitation program for shoulder pain in this population.MethodsA randomized clinical trial was conducted. Sixteen patients who had suffered a stroke and presented with shoulder pain were randomly assigned to receive rehabilitation alone or rehabilitation combined with DN. Both groups received a neurorehabilitation session including modulatory interventions targeting the central nervous system. Patients in the DN group also received a single session of DN over active TrPs in the shoulder musculature. A numerical pain rating scale (NPRS, 0-10) was used to asses post-needling induced pain at 1 min, 24 h, and 72 h after needling. Shoulder pain (NPRS, 0-10) was assessed at baseline, and 3 and 7 days after DN in both groups.ResultsFive (62%) patients receiving TrP-DN reported post-needling induced pain. Post hoc analysis found that post-needling induced pain decreased significantly at 24 and 72 h (both p < 0.001) after DN. Patients receiving TrP-DN plus rehabilitation exhibited greater decreases in shoulder pain intensity at 3 days (Δ = -4.2, 95% confidence interval (CI) = -5.8 to -2.6) and 7 days (Δ = -4.3, 95% CI = -5.9 to -2.7) after the intervention compared with those receiving rehabilitation alone (all p < 0.001).ConclusionThis trial found that 50% of stroke patients receiving DN experienced post-needling induced pain, a side effect that almost disappeared 72 h after the intervention without any additional therapeutic action. In addition, the inclusion of TrP-DN into a rehabilitation session was effective at decreasing shoulder pain in these patients.

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