Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran, Iran.
J Acupunct Meridian Stud. 2024 Aug 31;17(4):141-148. doi: 10.51507/j.jams.2024.17.4.141.
Stroke is a leading cause of disability worldwide and is often accompanied by complications such as spasticity. Static stretching (SS) is a common physiotherapy intervention for reducing spasticity, whereas dry needling (DN) is a novel approach. However, the combined effects of DN and SS on spasticity have not been thoroughly investigated. Given the pivotal effect of spasticity on daily activities, mitigating spasticity can significantly contribute to restoring patient independence.
This study will explore the impact of DN plus SS on spasticity, alpha motor neuron excitability, overall function, and quality of life in patients with chronic stroke.
DESIGN, SETTING, AND POPULATION: A double-blind, randomized, sham-controlled trial will be conducted in patients with post-stroke spasticity in the plantar flexor muscles. Twentyeight participants will be randomly assigned to either an intervention or control group. The intervention group will receive DN (60s × 3 days/week; 1 week) plus SS (20 min × 5 days/ week; 1 week). The control group will undergo sham DN (60s × 3 days/week; 1 week) and SS (20 min × 5 days/week; 1 week).
DN plus SS or sham DN plus SS.
Both groups will be assessed at baseline, immediately post-treatment, and after 1 week of follow-up. Outcome measures will include the Modified Modified Ashworth Scale, H-reflex latency, Hmax/Mmax ratio, active and passive ankle dorsiflexion range of motion, timed up and go test, and the EuroQol questionnaire.
Results from this randomized, sham-controlled study will provide evidence for the effectiveness of DN in combination with SS for spasticity.
The additional impact of DN in conjunction with SS, a widely used method for reducing muscle tone, remains unclear and warrants investigation. This study, with a high level of evidence, aims to address this knowledge gap.
卒中是全球范围内导致残疾的主要原因，常伴有痉挛等并发症。静态拉伸（SS）是一种常见的物理治疗干预方法，可用于减轻痉挛，而干针（DN）是一种新的方法。然而，DN 和 SS 联合治疗痉挛的效果尚未得到充分研究。鉴于痉挛对日常活动的关键影响，减轻痉挛可显著有助于恢复患者的独立性。
本研究旨在探讨 DN 加 SS 对慢性卒中后痉挛、α运动神经元兴奋性、整体功能和生活质量的影响。
设计、设置和人群：将在足底屈肌痉挛的卒中后患者中进行一项双盲、随机、假对照试验。28 名参与者将被随机分配到干预组或对照组。干预组将接受 DN（60s×3 天/周；1 周）加 SS（20min×5 天/周；1 周）。对照组将接受假 DN（60s×3 天/周；1 周）和 SS（20min×5 天/周；1 周）。
DN 加 SS 或假 DN 加 SS。
两组均在基线、治疗后即刻和治疗后 1 周随访时进行评估。评估指标包括改良改良 Ashworth 量表、H 反射潜伏期、Hmax/Mmax 比值、主动和被动踝关节背屈活动范围、计时起立行走测试和 EuroQol 问卷。
这项随机、假对照研究的结果将为 DN 结合 SS 治疗痉挛的有效性提供证据。
DN 结合 SS（一种广泛用于降低肌肉张力的方法）的额外影响尚不清楚，需要进一步研究。这项具有高证据水平的研究旨在解决这一知识空白。
