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Effects of Dry Needling on Gastrocnemius Muscle Spasticity and Gait in Patients With Multiple Sclerosis: A Pilot Randomized Controlled Trial Publisher



Motamedzadeh O1, 2 ; Nakhostin Ansari N1, 2, 3 ; Naghdi S1 ; Azimi A4 ; Mahmoudzadeh A5 ; Salehi S1 ; Bahadorani N1 ; Calvo S6 ; Herrero P6
Authors
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Authors Affiliations
  1. 1. Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. MS, Research Center, Neurosciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Musculoskeletal Research Center, Faculty of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
  6. 6. Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain

Source: Medical Acupuncture Published:2024


Abstract

Objective: Spasticity is a common complication in patients with multiple sclerosis (pwMS). The present study aimed to evaluate the clinical, biomechanical, and functional effects of dry needling (DN) in treating gastrocnemius muscle spasticity in pwMS. Materials and Methods: A pilot single-blinded randomized controlled trial was carried out. Eleven patients were randomly allocated to the DN group, and 10 to the waiting list control group. A single session of DN for 2 minutes was performed for the gastrocnemius muscle. Primary outcome measures were the modified Modified Ashworth Scale (MMAS), the passive resistive torque (PRT), and the foot pressure distribution of podography. The secondary outcome measures were the active and passive ankle dorsiflexion range of motion (ROM) and timed up-and-go (TUG) test. Outcomes were measured at baseline, immediately after the intervention, and at one-week follow-up. Results: Twenty-one pwMS with a mean age of 39.52 ± 7.24 years and MS duration of 166.86 ± 5.66 months participated in the study. There were no significant changes in all outcomes for pwMS in the control group. In the DN group, the median gastrocnemius MMAS spasticity significantly decreased after the intervention, and the improvement remained at 1-week follow-up (median decrease from “3” to “2”, p = 0.004). The analysis of covariance between-group analysis showed that the PRT (effect size = 0.65) and ankle active (effect size = 0.62) and passive ROM (effect size = 0.8) improved significantly after DN. There were no significant improvements in contact area, but small effect sizes were observed for the maximum plantar force (0.28) and maximum peak pressure at follow-up. The effect size for the TUG test was moderate (0.49). Conclusions: These findings show that a single session of DN applied for 2 min was effective in improving gastrocnemius spasticity, PRT, active and passive ankle ROM, and dynamic balance, but walking did not improve meaningfully. Copyright 2024, Mary Ann Liebert, Inc., publishers.
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