• Complement Ther Med · Aug 2020

    Dry needling for the management of spasticity, pain, and range of movement in adults after stroke: A systematic review.

    • Rafael Valencia-Chulián, Alberto M Heredia-Rizo, Jose A Moral-Munoz, David Lucena-Anton, and Carlos Luque-Moreno.
    • Department of Nursing and Physiotherapy Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain.
    • Complement Ther Med. 2020 Aug 1; 52: 102515.

    ObjectiveTo summarise the available evidence about the effectiveness of deep dry needling (DN) on spasticity, pain-related outcomes, and range-of-movement (ROM) in adults after stroke.DesignA computer search of Web of Science, Scopus, Medline, Cochrane Library, Cinahl, and Physiotherapy Evidence Database (PEDro) was conducted. A hand search of the reference lists of the selected studies and other relevant publications was also undertaken. Studies were assessed by two independent reviewers and included if they complied with the following criteria: (1) participants were adults after a stroke, (2) use of DN alone or within a multimodal approach, compared to no intervention or other treatments; (3) assessment of spasticity, pain, or joint ROM as a primary or secondary outcome. We included randomised controlled trials (RCTs), case series, and case reports. Data were extracted using a standardised protocol. The methodological quality of the studies was assessed with the Checklist for Measuring quality.ResultsA total of sixteen studies, 7 of which were RCTs, were selected. All studies generally reported an improvement of spasticity level, pain intensity, and ROM after the use of DN, alone or combined with other interventions, in stroke survivors.ConclusionThe management of adults after stroke with DN may impact positively on spasticity, pain, and ROM. However, there was significant heterogeneity across trials in terms of sample size, control groups, treated muscles, and outcome measures, and a meta-analysis was not feasible. Further research should include proper blinding, sham placebo DN as control intervention, and investigate long-term effects.Copyright © 2020 Elsevier Ltd. All rights reserved.

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