Dry Needling for Muscle Spasms After Stroke

Overseen By Blair Dellenbach, MSOT

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Medical University of South Carolina

Disqualifiers: Cardiac conditions, Cognitive impairment, Diabetes, Epilepsy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 93

Duration: 1 day

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how dry needling, a technique using thin needles to relax tight muscles, affects the nervous system in individuals with muscle spasms after a stroke. The goal is to determine if this treatment can ease muscle stiffness and improve movement. The study lasts only two days. Individuals who have experienced muscle stiffness on one side of their body due to a stroke for over a year and have medical clearance may be suitable candidates for this trial. As an unphased trial, it offers participants the chance to contribute to pioneering research that could lead to new treatment options for stroke survivors.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the study team or your doctor.

What prior data suggests that dry needling is safe for treating muscle spasms after stroke?

Research shows that dry needling might help with muscle problems, such as those following a stroke. Some studies suggest it can reduce muscle stiffness and improve movement. However, the safety of dry needling for stroke patients remains unclear. Reviews indicate insufficient strong evidence to confirm its safety. While dry needling doesn't appear to cause major issues, the lack of solid data leaves some uncertainty. Consulting a healthcare provider is advisable for any concerns. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike the standard treatments for muscle spasms after a stroke, which often involve medications or physical therapy, dry needling is a hands-on technique that directly targets the muscle's trigger points. Researchers are excited about dry needling because it may offer faster relief from spasticity by altering how the nervous system communicates with the muscles, potentially improving movement more quickly than traditional methods. Additionally, dry needling is less invasive than surgical options and avoids the systemic side effects associated with medication.

What evidence suggests that dry needling is effective for muscle spasms after stroke?

Research has shown that dry needling can reduce muscle tightness in people who have had a stroke. One study found it lessened hand stiffness, a common post-stroke issue. Another study reported that a single session of dry needling in the legs reduced both muscle tightness and pain sensitivity. Additionally, dry needling has eased finger muscle tightness and improved movement in stroke patients. In this trial, one group of participants with spasticity from stroke will receive dry needling to relieve spasticity in the target muscle. Another group, consisting of individuals with no known neurological injury, will also receive dry needling to examine its effects on the nervous system. These studies suggest that dry needling might help manage muscle tightness and improve movement for those recovering from a stroke. ^{3 6 7 8 9}

Who Is on the Research Team?

Aiko K Thompson, PhD

Principal Investigator

Medical University of South Carolina

Are You a Good Fit for This Trial?

This trial is for adults over 18 years old with muscle stiffness from a stroke that happened more than a year ago and are medically stable. It's also for those without neurological injuries. People can't join if they have certain medical conditions like uncontrolled diabetes, bleeding issues, severe anxiety, metal allergies, or heart problems.

Inclusion Criteria

I am over 18 and do not have any known brain injuries or conditions.

I had a stroke over a year ago, have stable health, and experience stiffness in my ankle or wrist.

Exclusion Criteria

My diabetes is not under control.

My motor nerves are damaged and don't respond well to treatment.

I have a severe fear of needles.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 day

1 visit (in-person)

Treatment

Participants receive dry needling treatment and undergo assessments of reflexes and limb function

1 day

2 visits (in-person)

Follow-up

Participants are monitored for changes in reflexes, limb movement, pain levels, and brain activity after treatment

3 days

Assessments at baseline, immediately after, 90 minutes after, and 72 hours after treatment

What Are the Treatments Tested in This Trial?

Interventions

• Dry Needling

Trial Overview The study tests dry needling—a technique where a thin needle is used to relieve muscle knots and pain in people with spasticity after stroke. Participants will undergo this procedure once and then be evaluated on reflexes and limb function over two days.

How Is the Trial Designed?

Group I: Individuals with spasticity resulting from stroke Experimental Treatment 1 Intervention

This is an experimental intervention in which individuals will receive dry needling to relieve spasticity in the target muscle. The study team will examine the effects of this treatment on the nervous system by performing assessments just prior to, immediately after, 90 minutes after, and 72 hours after dry needling. These assessments will examine how you move your arm or leg and how your nervous system responds to non-invasive nerve stimulation.

Group II: Individuals with no known neurological injury Experimental Treatment 1 Intervention

This is an experimental intervention in which individuals will receive dry needling of an arm or leg muscle. The study team will examine the effects of this treatment on the nervous system by performing assessments just prior to, immediately after, 90 minutes after, and 72 hours after dry needling. These assessments will examine how you move your arm or leg and how your nervous system responds to non-invasive nerve stimulation.

Dry Needling is already approved in United Kingdom, United States for the following indications:

Approved in United Kingdom as Dry Needling for:

• Knee osteoarthritis pain management
• Muscle strength improvement
• Leg function enhancement

Approved in United States as Dry Needling for:

• Chronic knee pain relief
• Musculoskeletal pain management
• Myofascial pain syndrome treatment

Who Is Running the Clinical Trial?

Medical University of South Carolina

Lead Sponsor

Trials

994

Recruited

7,408,000+

Published Research Related to This Trial

In a study involving nine rabbits, dry needling of myofascial trigger points significantly reduced spontaneous electrical activity (SEA) in the treated muscle, indicating its effectiveness in relieving myofascial pain.

The results suggest that eliciting local twitch responses during dry needling is crucial for reducing SEA, highlighting that this response, rather than just the needling itself, plays a key role in the treatment's efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Inhibitory effect of dry needling on the spontaneous electrical activity recorded from myofascial trigger spots of rabbit skeletal muscle. Chen, JT., Chung, KC., Hou, CR., et al.[2019]

A case study of a 62-year-old male with chronic shoulder spasticity post-stroke showed significant improvement in spasticity and shoulder range of motion after 9 sessions of dry needling targeting specific muscle trigger points.

The results suggest that dry needling can be an effective treatment for alleviating chronic post-stroke shoulder spasticity, providing a non-drug intervention option for patients with similar conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dry needling at myofascial trigger points mitigates chronic post-stroke shoulder spasticity. Tang, L., Li, Y., Huang, QM., et al.[2020]

Dry needling is generally safe and well tolerated for treating myofascial pain, but there is a risk of severe complications, such as an acute spinal epidural hematoma, as highlighted in this case report.

Healthcare providers should exercise caution when performing dry needling near the spine, and any sudden neuropathic pain following the procedure should be evaluated immediately with advanced imaging to ensure spinal cord integrity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute Spinal Epidural Hematoma as a Complication of Dry Needling: A Case Report. Berrigan, WA., Whitehair, CL., Zorowitz, RD.[2020]

Dry needling (DN) significantly reduced wrist flexor spasticity in stroke patients, as evidenced by a decrease in Modified Modified Ashworth Scale (MMAS) scores from a median of 2 at baseline to 1 immediately after treatment and one hour later.

The study, involving 29 stroke patients, also showed improvements in other measures of muscle function and excitability, indicating that DN may effectively lower muscle stiffness and enhance movement shortly after treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A single group, pretest-posttest clinical trial for the effects of dry needling on wrist flexors spasticity after stroke. Fakhari, Z., Ansari, NN., Naghdi, S., et al.[2018]

In a study involving 39 physiotherapists and 7629 treatments, trigger point dry needling (TrP-DN) was found to have a high incidence of mild adverse events (AEs), with 1463 reported cases, but no significant AEs occurred, indicating a very low risk of serious complications (≤ 0.04%).

Common mild AEs included bruising (7.55%) and bleeding (4.65%), but the overall safety profile suggests that TrP-DN is a safe treatment option for myofascial pain when performed by trained physiotherapists.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events following trigger point dry needling: a prospective survey of chartered physiotherapists. Brady, S., McEvoy, J., Dommerholt, J., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8585994/

Immediate Effect of Dry Needling at Myofascial Trigger Point ... In our clinical trial, DN could effectively relieve different degrees of hand spasticity in patients with stroke after each treatment. It also ...

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1052305720306546

Effectiveness of Dry Needling in the Management ... A single session of DNT in lower extremities has been shown to reduce spasticity and sensitivity to pressure pain in stroke patients.12,13 Furthermore, this ...

3. jospt.org jospt.org/doi/10.2519/jospt.2017.7096

The Effectiveness of Trigger Point Dry Needling for ... Studies provided evidence that dry needling may decrease pain and increase pressure pain threshold when compared to control/sham or other treatment.

4. explorationpub.com explorationpub.com/Journals/ent/Article/100421

Combined effects of dry needling and exercises therapy on ... Conclusions: DN combined with exercise therapy improved muscle spasticity and motor function in patients with chronic stroke. Further investigations with a ...

5. frontiersin.org frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00078/full

Are There Trigger Points in the Spastic Muscles ... In our study, dry needling effectively and immediately reduced finger flexor spasticity, improved resting joint position and active range of motion in chronic ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11114159/

Safety of dry needling in stroke patients: a scoping review - PMC This review is the first to investigate the safety of DN in stroke patients and based on the results there is insufficient evidence regarding the safety of DN ...

7. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0965229920305586

Dry needling for the management of spasticity, pain, and ... This is the first review assessing dry needling efficacy in stroke survivors. · Current evidence suggests a positive, but inconclusive effect of dry needling.

8. frontiersin.org frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.745618/full

Immediate Effect of Dry Needling at Myofascial Trigger ... In our clinical trial, DN could effectively relieve different degrees of hand spasticity in patients with stroke after each treatment. It also ...

9. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9917679/

Clinical Effectiveness of Dry Needling in Patients with ... One high quality SR with MA showed that DN could significantly improve headache frequency, health-related quality of life, trigger point tenderness, and ...