Immediate Effect of Ultrasound-Guided Dry Needling on Soleus Muscle Spasticity in Stroke Survivors
Authors
Sanjivani Kamble
Physiotherapy, Dr. D. Y. Patil College of Physiotherapy, Pune, IND
Divya Gohil
Physiotherapy, Dr. D. Y. Patil College of Physiotherapy, Pune, IND
Pravin Pisudde
Community Medicine, All India Institute of Medical Sciences, Bhatinda, IND
Shweta Telang-Chaudhari
Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy (AYUSH), Maharashtra University of Health Sciences, Nashik, IND
Gaurang Baxi
Physiotherapy, Dr. D. Y. Patil College of Physiotherapy, Pune, IND
Tushar Palekar
Physiotherapy, Dr. D. Y. Patil College of Physiotherapy, Pune, IND
Background: Dry needling (DN) is commonly used to treat various neuromuscular syndromes. It is effective in reducing spasticity in stroke and other neurological conditions. The current study explores the immediate effect of ultrasound-guided dry needling on soleus muscle spasticity and thickness in individuals with stroke.
Methods: Approval was obtained from the Institutional Sub-ethics Committee of Dr. D. Y. Patil College of Physiotherapy, Pune. The trial was registered with the Clinical Trials Registry of India. Thirty stroke survivors having soleus muscle spasticity ranging from grade 1 to 4 on the Modified Modified Ashworth Scale (MMAS) were selected. Spasticity was also assessed using the Modified Tardeau Scale (MTS) and H-reflex. Soleus muscle architecture was assessed by using ultrasonography (USG). Participants received a single session of DN for the spastic soleus muscle. Pre and immediate post-DN outcome measures were assessed.
Results: Based on USG findings, the thickness of the soleus muscle significantly increased by 2.67 mm (p<0.001) after dry needling treatment. The MMAS showed decreased spasticity by 1.47 (p<0.001) for ankle plantar flexors. A significant reduction of H-reflex values by 1.4 mV (p<0.001) was noted. The MTS also showed a significant increase in the range of ankle motion by 2.7 (p<0.001). All these indicate an immediate reduction of spasticity following DN.
Conclusion: Based on the findings of the current study, we can conclude that a single session of USG-guided DN has an immediate beneficial effect on reducing soleus muscle spasticity and increased muscle thickness in individuals with stroke.
Keywords: ultrasonography, modified tardieu scale, stroke, spasticity, modified modified ashworth scale, dry needling
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