Babazadeh-Zavieh Seyedeh Saeideh, Ansari Noureddin Nakhostin, Ghotbi Nastaran, Naghdi Soofia, Jafar Haeri Seyed Mohammad, Shaw Brandon S, Shaw Ina
Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran.
Contemp Clin Trials Commun. 2022 May 5;28:100921. doi: 10.1016/j.conctc.2022.100921. eCollection 2022 Aug.
Spasticity is one of the most common problems after the first stroke. Dry needling (DN) has been presented as a new therapeutic approach used by physiotherapists for the management of post-stroke spasticity. This study aimed to determine whether the addition of exercise therapy to the DN results in better outcomes in wrist flexors spasticity, motor neuron excitability, motor function and range of motion (ROM) in patients with chronic stroke.
We will use a single-blind randomized controlled trial (RCT) in accordance with the CONSORT guidelines. A total of 24 patients with stroke will be included from the University Rehabilitation Clinics. The outcome measures will include Modified Modified Ashworth Scale, H/M ratio, H-reflex latency, Action Research Arm Test, Fugl-Meyer Assessment, and wrist extension active and passive range of motion. Patients in the DN and exercise therapy group will undergo 4 sessions of deep DN in flexor carpi radialis and flexor carpi ulnaris muscles on the affected upper limb and exercise therapy. Participants in the DN group will only receive DN for target muscles. Clinical and neurophysiological tests will be performed at baseline, after four therapy sessions, and at three weeks' follow-up.
This study will provide evidence for additional effects of exercise therapy to DN in comparison to DN alone on wrist flexors spasticity, motor neuron excitability, upper-limb motor function, and ROM in patients with chronic stroke.
痉挛是首次中风后最常见的问题之一。干针疗法（DN）已成为物理治疗师用于治疗中风后痉挛的一种新的治疗方法。本研究旨在确定在慢性中风患者中，在干针疗法基础上加用运动疗法是否能在腕屈肌痉挛、运动神经元兴奋性、运动功能和关节活动范围（ROM）方面取得更好的效果。
我们将根据CONSORT指南进行一项单盲随机对照试验（RCT）。将从大学康复诊所纳入总共24名中风患者。结局指标将包括改良的改良Ashworth量表、H/M比值、H反射潜伏期、动作研究上肢测试、Fugl-Meyer评估以及腕关节伸展主动和被动活动范围。干针疗法和运动疗法组的患者将在患侧上肢的桡侧腕屈肌和尺侧腕屈肌进行4次深层干针治疗并接受运动疗法。干针疗法组的参与者仅对目标肌肉进行干针治疗。将在基线、四个疗程后以及三周随访时进行临床和神经生理学测试。
本研究将提供证据，证明与单独使用干针疗法相比，在慢性中风患者中，运动疗法对干针疗法在腕屈肌痉挛、运动神经元兴奋性、上肢运动功能和关节活动范围方面具有额外的效果。
