Ebrahimzadeh Masoome, Nakhostin Ansari Noureddin, Abdollahi Iraj, Akhbari Behnam, Dommerholt Jan
School of Medicine Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Department of Physiotherapy University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Case Rep Neurol Med. 2024 Sep 14;2024:5115313. doi: 10.1155/2024/5115313. eCollection 2024.
Dry needling (DN) is a technique employed to mitigate spasticity and enhance functionality in stroke patients. We report the impact of DN on both corticospinal tract (CST) consistency and wrist flexors spasticity of an individual affected by stroke.
The participant was a 57-year-old male who had experienced an ischemic stroke 9 months prior. The primary outcome measures included fractional anisotropy (FA), asymmetry FA (aFA), ratio FA (rFA), and Modified Modified Ashworth Scale (MMAS). Additionally, secondary outcomes encompassed wrist extension range of motion (ROM) and performance in the box and block test (BBT). These measurements were taken both before and after the administration of DN treatment.
After the application of DN, the mean FA of the ipsilesional CST increased from 0.35 to 0.39, concomitantly with a decline in aFA from 0.18 to 0.13. Notably, the rFA exhibited a pre-DN value of 0.69, which subsequently rose to 0.76 post-DN. Moreover, a significant reduction in MMAS scores was detected, from a score of "3" prior to DN application to a post-DN score of "1". In terms of wrist mobility, both active and passive extension ROM exhibited favorable improvements, with an increase of 12° for active extension and 16° for passive extension. Furthermore, there was a substantial improvement in the BBT score, an indicator of manual dexterity, ascending from 12 to 24.
Enhancements in CST consistency suggest it as a potential mechanism contributing to the observed improvements following DN in this stroke case.
干针疗法（DN）是一种用于减轻中风患者痉挛并增强其功能的技术。我们报告了干针疗法对一名中风患者皮质脊髓束（CST）一致性和腕部屈肌痉挛的影响。
参与者是一名57岁男性，9个月前经历了缺血性中风。主要结局指标包括分数 anisotropy（FA）、不对称FA（aFA）、比率FA（rFA）和改良的改良Ashworth量表（MMAS）。此外，次要结局包括腕部伸展活动范围（ROM）以及箱块测试（BBT）中的表现。这些测量在DN治疗前后均进行。
应用DN后，患侧CST的平均FA从0.35增加到0.39，同时aFA从0.18下降到0.13。值得注意的是，rFA在DN治疗前的值为0.69，DN治疗后升至0.76。此外，检测到MMAS评分显著降低，从DN应用前的“3”分降至DN治疗后的“1”分。在腕部活动度方面，主动和被动伸展ROM均有良好改善，主动伸展增加了12°，被动伸展增加了16°。此外，作为手部灵巧性指标的BBT评分有大幅提高，从12分升至24分。
CST一致性的增强表明它是导致该中风病例中DN治疗后观察到的改善的潜在机制。
