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中风患者接受干针治疗后痉挛、广泛压痛敏感性和足印测量的变化:一项随机对照试验。

Changes in spasticity, widespread pressure pain sensitivity, and baropodometry after the application of dry needling in patients who have had a stroke: a randomized controlled trial.

作者信息

Salom-Moreno Jaime, Sánchez-Mila Zacarías, Ortega-Santiago Ricardo, Palacios-Ceña Maria, Truyol-Domínguez Sebastian, Fernández-de-las-Peñas César

机构信息

Professor, Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation of Universidad Rey Juan Carlos, Alcorcón, Spain; Professor, Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.

Clinician, Centro de Fisioterapia CRENE, Madrid, Spain.

出版信息

J Manipulative Physiol Ther. 2014 Oct;37(8):569-79. doi: 10.1016/j.jmpt.2014.06.003. Epub 2014 Sep 8.

Abstract

OBJECTIVE

The purpose of this study was to determine the effects of deep dry needling (DDN) on spasticity, pressure sensitivity, and plantar pressure in patients who have had stroke.

METHODS

A randomized controlled trial was conducted. Thirty-four patients who previously had a stroke were randomly assigned either an experimental group that received a single session of DDN over the gastrocnemius and tibialis anterior muscles on the spastic leg or a control group that received no intervention. Spasticity (evaluated with the Ashworth Scale); pressure pain thresholds over the deltoid muscle, second metacarpal, and tibialis anterior muscle; and plantar pressure (baropodometry) were collected by a blinded assessor before and 10 minutes after intervention.

RESULTS

A greater number of individuals receiving DDN exhibited decreased spasticity after the intervention (P < .001). The analysis of covariance showed that pressure pain thresholds increased bilaterally in patients receiving DDN compared with those who did not receive the intervention (P < .001). The analysis of covariance also found that patients receiving DDN experienced bilateral increases of support surface in the forefoot, unilateral increase of the support surface in the rear foot of the treated (affected) side, and bilateral decreases in mean pressure (all, P < .02) as compared with those who did not receive DDN.

CONCLUSIONS

Our results suggest that a single session of DDN decreases spasticity and widespread pressure sensitivity in individuals with poststroke spasticity. Deep dry needling also induced changes in plantar pressure by increasing the support surface and decreasing the mean pressure.

摘要

目的

本研究旨在确定深部干针疗法(DDN)对中风患者痉挛、压力敏感性和足底压力的影响。

方法

进行了一项随机对照试验。34名既往有中风病史的患者被随机分为实验组和对照组,实验组在患侧痉挛的腓肠肌和胫骨前肌上接受单次DDN治疗,对照组不接受任何干预。由一名盲法评估者在干预前和干预后10分钟收集痉挛情况(用Ashworth量表评估)、三角肌、第二掌骨和胫骨前肌的压痛阈值以及足底压力(足压计测量)。

结果

接受DDN治疗的患者在干预后痉挛程度降低的人数更多(P < .001)。协方差分析显示,与未接受干预的患者相比,接受DDN治疗的患者双侧压痛阈值升高(P < .001)。协方差分析还发现,与未接受DDN治疗的患者相比,接受DDN治疗的患者前足支撑面双侧增加,患侧后足支撑面单侧增加,平均压力双侧降低(均P < .02)。

结论

我们的结果表明,单次DDN治疗可降低中风后痉挛患者的痉挛程度和广泛的压力敏感性。深部干针疗法还通过增加支撑面和降低平均压力诱导足底压力发生变化。

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