Dry Needling and Bobath Treatment Clinical Effects Focused on Stroke Patients

Changes in Clinical Outcomes After Application of Physical Therapy and Dry Needling Intervention in Stroke Patients

The investigators aim to determine if dry needling technique in a non myofascial trigger point area generate the same changes in spasticity, function and pain responses as with dry needling in a myofascial trigger point area.

Spasticity is a consequence of multiple diseases that affect the Central Nervous System, such as stroke and other neurodegenerative diseases. Its pathophysiology is unclear and the variety of clinical symptoms is determined by the injury location. Several studies have suggested the possibility of active pain treatment effectiveness through myofascial trigger points management. One of these interventions is dry needling, which has been used in several scientific studies. However, these investigations have been based on spasm response or deep dry needling mechanisms always over a trigger point, but none of the participants compare the possible mechanical effects of the insertion of a needle into a spastic muscle without targeting specifically a trigger point. Therefore, the aim of this study is to evaluate the effects on spasticity, pain and motor function after a dry needling intervention versus the insertion of a needle into a non trigger point area in patients who had experienced a stroke.

Inclusion Criteria:

• Medical diagnosis of unilateral ischemic Stroke
• Unilateral hemiplegia resulting from Stroke
• Evolution of at least 6 months since the Stroke
• Age between 35 and 81 years of age
• Presence of hypertonia in the upper extremity
• Restricted shoulder range of motion

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
• Cognitive deficits
• Progressive or severe neurological diseases, eg, heart conditions, unstable hypertension, fractures or implants in upper extremity
• Belonephobia (fear to needles)
• Have received pharmacological treatment for shoulder pain 3 months before the study
• Existence of peripheral nerve injury
• Previous history of fracture in the gleno-humeral joint
• Episodes of epilepsy in the year prior to participation in the study