Deep Dry Needling for the Management of Post-stroke Spasticity

CHANGES IN SPASTICITY, WIDESPREAD PRESSURE PAIN SENSITIVITY, AND BAROPODOMETRY AFTER DRY NEEDLING IN STROKE PATIENTS

Stroke is the leading cause of physical disability, particularly due to the presence of spasticity. Different needling techniques, including the use of Botulinum Toxin A are proposed for the management of spasticity. The presence of spasticity in the lower extremity implies several impairments for standing and walking inducing high disability. No study has investigated the effects of deep dry needling inserted into the targeted spastic musculature in patients with stroke. The investigators will conduct a randomized controlled trial investigating the effects of a single session of deep dry needling over the musculature of the leg on spasticity, widespread pressure pain sensitivity and plantar pressures (baropodometry) in individuals with chronic stroke. The investigators hypothesize that patients receiving a single session of dry needling would exhibit a greater reduction in spasticity and pressure sensitivity than those who will not receive the intervention.

Inclusion Criteria:

• First-ever unilateral stroke;
• hemiplegia resulting from stroke;
• unilateral equinovarus gait with independent walk;
• able to ambulate without supporting devices.

Exclusion Criteria:

• recurrent stroke;
• previous treatment with nerve blocks, motor point injections with neurolytic agents for spasticity at any time, or with BTX-A in the previous 6 months
• not independent in the basic activities of daily living
• severe cognitive deficits;
• progressive or severe neurologic diseases;
• fear to needles;
• any contraindication for dry needling, e.g., anticoagulants, infections, bleeding, or psychotic.