Hadi Sarafraz, Khadijeh Otadi, Hadian Mohammadreza, Niloofar Ayoobi Yazdi, Olyaei Gholamreza, Hossein Bagheri, Calvo Sandra, Herrero Pablo
a Department of Physiotherapy, School of Rehabilitation , International Campus, Tehran University of Medical Sciences (IC-TUMS) , Tehran , Iran.
b Students' Scientific Research Center (SSRC) , Tehran University of Medical Sciences , Tehran , Iran.
Top Stroke Rehabil. 2018 Jul;25(5):326-332. doi: 10.1080/10749357.2018.1460946. Epub 2018 Apr 23.
Objectives The objective of this study was to assess the short-term effects of dry needling on spasticity, gait, and muscle architecture of patients with chronic stroke. Methods A case series study was designed; and six chronic stroke patients with ankle spasticity and gait impairment received a single session of dry needling for gastrocnemius medialis, lateralis, and soleus muscles. The main outcome measures were the Modified Modified Ashworth Scale (MMAS), and Timed Up and Go test (TUG). In addition, ultrasonography measurements (e.g. thickness, pennation angle, and fascicle length) were performed for gastrocnemius medialis at baseline (T0), immediately after intervention (T1) and 30 min after intervention (T2), while the MMAS and TUG Test were only measured at T0 and T2. Results Based on the TUG test, there was a significant improvement in gait function (p = 0.023). Furthermore, the MMAS results (p = 0.014) showed a decrease in resistance to passive movements from plantar flexor muscles. Furthermore, a significant decrease in pennation angle (p = 0.014) and muscle thickness (p = 0.001), and also a significant increase in fascicle length of gastrocnemius medialis (p = 0.001) were observed after dry needling. Discussion & conclusions Based on the outcomes of this study, dry needling application seems to have short term effects in terms of reducing spasticity, improving gait, and muscle architecture of gastrocnemius medialis in patients with chronic stroke. The changes of muscle architecture may be interpreted as the positive effects of dry needling on the physical properties of hypertonic muscles.
目的 本研究的目的是评估干针疗法对慢性中风患者痉挛、步态和肌肉结构的短期影响。方法 设计了一项病例系列研究;六名患有踝关节痉挛和步态障碍的慢性中风患者接受了针对腓肠肌内侧头、外侧头和比目鱼肌的单次干针治疗。主要结局指标为改良的改良Ashworth量表(MMAS)和定时起立行走测试(TUG)。此外,在基线时(T0)、干预后即刻(T1)和干预后30分钟(T2)对腓肠肌内侧头进行超声测量(如厚度、羽状角和肌束长度),而MMAS和TUG测试仅在T0和T2测量。结果 基于TUG测试,步态功能有显著改善(p = 0.023)。此外,MMAS结果(p = 0.014)显示跖屈肌被动运动阻力降低。此外,干针治疗后观察到羽状角(p = 0.014)和肌肉厚度显著降低(p = 0.001),腓肠肌内侧头肌束长度也显著增加(p = 0.001)。讨论与结论 基于本研究的结果,干针疗法在减轻慢性中风患者的痉挛、改善步态和腓肠肌内侧头的肌肉结构方面似乎具有短期效果。肌肉结构的变化可能被解释为干针疗法对高张力肌肉物理特性的积极影响。