Deep dry needling to reduce spasticity in patients who have suffered a cerebrovascular accident. Systematic review
Keywords:
Cerebrovascular accident, muscle spasticity, dry needling, deep dry needling, treatment, systematic reviewAbstract
Background: Cerebrovascular accident is the fourth cause of death in Europe, represents one of the most common causes of disability and involves considerable social and health costs in a short and long term. Spasticity is one of the main complications in cerebrovascular accident survivors. The principal treatment is physiotherapy, however, recently the use of deep dry needling has been suggested in these patients.
Objective: To evaluate the effectiveness of deep dry needling to reduce spasticity in patients who have suffered a cerebrovascular accident.
Methodology: Randomized controlled clinical trials, conducted in humans in the last 10 years, were selected. The principal database used was PubMed, through the "National Library of Medicine" platform.
Results: Deep dry needling is effective in reducing spasticity after cerebrovascular accident. The total sample was 229 patients across six clinical trials. The number of sessions oscillated between 1 and 6, different muscles were used depending on the study, the application was safe and no severe adverse effects occurred.
Conclusions: Deep dry needling reduces spasticity, improves balance, gait, muscle function, range of motion and accuracy to maintain stability in patients who have suffered a cerebrovascular accident.
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References
1. Guzik A, Bushnell C. Stroke Epidemiology and Risk Factor Management. Continuum (Minneap Minn) [Internet]. 2017 [cited 2023 Jan 20];23(1 Cerebrovascular Disease):15-39. Disponible en: https://doi.org/10.1212/CON.0000000000000416
2. Kuriakose D, Xiao Z. Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives. Int J Mol Sci [Internet]. 2020 [cited 2023 Jan 20];21(20). Disponible en: https://doi.org/10.3390/ijms21207609
3. Saini V, Guada L, Yavagal DR. Global Epidemiology of Stroke and Access to Acute Ischemic Stroke Interventions. Neurology [Internet]. 2021 [cited 2023 Jan 20];97(20suppl.2):S6-S16. Disponible en: https://doi.org/10.1212/WNL.0000000000012781
4. Knight-Greenfield A, Nario JJQ, Gupta A. Causes of Acute Stroke: A Patterned Approach. Radiol Clin North Am [Internet] 2019 [cited 2023 Jan 20];57(6):1093-108. Disponible en https://doi.org/10.1016/j.rcl.2019.07.007
5. Barthels D, Das H. Current advances in ischemic stroke research and therapies. Biochim Biophys Acta Mol Basis Dis [Internet]. 2020 [cited 2023 Apr 6];1866(4):165260. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981280/pdf/nihms-1506868.pdf
6. Mead GE, Sposato LA, Sampaio SG, Yperzeele L, Wu S, Kutlubaev M, et al. A systematic review and synthesis of global stroke guidelines on behalf of the World Stroke Organization. Int J Stroke [Internet]. 2023 [cited 2023 Dec 22];18(5):499-531. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10196933/pdf/10.1177_17474930231156753.pdf
7. Tater P, Pandey S. Post-stroke Movement Disorders: Clinical Spectrum, Pathogenesis, and Management. Neurol India [Internet]. 2021 [cited 2023 Apr 6];69(2):272-83. Disponible en: https://journals.lww.com/neur/fulltext/2021/69020/post_stroke_movement_disorders__clinical_spectrum,.6.aspx
8. Malik AN, Tariq H, Afridi A, Rathore FA. Technological advancements in stroke rehabilitation. J Pak Med Assoc [Internet]. 2022 [cited 2023 Dec 22];72(8):1672-4. Disponible en: https://www.archive.jpma.org.pk/PdfDownload/11472
9. Stinear CM, Lang CE, Zeiler S, Byblow WD. Advances and challenges in stroke rehabilitation. Lancet Neurol [Internet]. 2020 [cited 2023 Apr 6];19(4):348-60. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S1474-4422(19)30415-6
10. Gattie E, Cleland JA, Snodgrass S. The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther [Internet]. 2017 [cited 2023 Jan 20];47(3):133-49. Disponible en: https://www.jospt.org/doi/epdf/10.2519/jospt.2017.7096
11. Rodríguez-Huguet M, Vinolo-Gil MJ, Góngora-Rodríguez J. Dry Needling in Physical Therapy Treatment of Chronic Neck Pain: Systematic Review. J Clin Med [Internet]. 2022 [cited 2023 Apr 6];23;11(9):2370. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9105967/pdf/jcm-11-02370.pdf
12. Dunning J, Butts R, Mourad F, Young I, Flannagan S, Perreault T. Dry needling: a literature review with implications for clinical practice guidelines. Phys Ther Rev [Internet]. 2014 [cited 2023 Apr 6];19(4):252-65. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117383/pdf/ptr-19-04-252.pdf
13. Page M J, McKenzie J E, Bossuyt P M, Boutron I, Hoffmann T C, Mulrow C D et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews BMJ [Internet]. 2021 [cited 2023 Jan 20];372(71). Disponible en: https://www.bmj.com/content/bmj/372/bmj.n71.full.pdf
14. da Costa Santos CM, de Mattos Pimenta CA, Cuce Nobre MR. The PICO strategy for the research question construction and evidence research. Rev Latino-Am Enfermagem [Internet]. 2007 [cited 2023 Jan 20];15(3):508-11. Disponible en: https://www.scielo.br/j/rlae/a/CfKNnz8mvSqVjZ37Z77pFsy/?format=pdf&lang=en
15. Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, Thomas J. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev. 2019 [cited 2023 Jan 20]; 10(10):ED000142. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284251/pdf/ED000142.pdf
16. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a weband mobile app for systematic reviews. Syst Rev. 2016 [cited 2023 Dec 22];5(1). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139140/pdf/13643_2016_Article_384.pdf
17. Salom-Moreno J, Sánchez-Mila Z, Ortega-Santiago R, Palacios-Ceña M, Truyol-Domínguez S, Fernández-de-las-Peñas C. Changes in spasticity, widespread pressure pain sensitivity, and baropodometry after the application of dry needling in patients who have had a stroke: a randomized controlled trial. J Manipulative Physiol Ther [Internet]. 2014 [cited 2023 Jan 20];37(8):569-79. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0161475414001699?via%3Dihub
18. Fakhari Z, Ansari NN, Naghdi S, Mansouri K, Radinmehr H. A single group, pretest-posttest clinical trial for the effects of dry needling on wrist flexors spasticity after stroke. Neuro Rehabilitation [Internet]. 2017 [cited 2023 Jan 20];40(3):325-36. Disponible en: https://content.iospress.com/articles/neurorehabilitation/nre1420
19. Ghannadi S, Shariat A, Ansari NN, Tavakol Z, Honarpishe R, Dommerholt J, Noormohammadpour P, Ingle L. The Effect of Dry Needling on Lower Limb Dysfunction in Poststroke Survivors. J Stroke Cerebrovasc Dis [Internet]. 2020 [cited 2023 Apr 6];29(6). Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1052305720301981?via%3Dihub
20. Sánchez-Mila Z, Salom-Moreno J, Fernández-de-Las-Peñas C. Effects of dry needling on post-stroke spasticity, motor function and stability limits: a randomised clinical trial. Acupunct Med [Internet]. 2018 [cited 2023 Dec 22];36(6):358-66. Disponible en: https://journals.sagepub.com/doi/10.1136/acupmed-2017-011568?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
21. Cuenca Zaldívar JN, Calvo S, Bravo-Esteban E, Oliva Ruiz P, Santi-Cano MJ, Herrero P. Effectiveness of dry needling for upper extremity spasticity, quality of life and function in subacute phase stroke patients. Acupunct Med [Internet]. 2021 [cited 2023 Jan 20];39(4):299-308. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32815384/
22. Sánchez Milá Z, Velázquez Saornil J, Campón Chekroun A, Barragán Casas JM, Frutos Llanes R, Castrillo Calvillo A, et al. Effect of Dry Needling Treatment on Tibial Musculature in Combination with Neurorehabilitation Treatment in Stroke Patients: Randomized Clinical Study. Int J Environ Res Public Health [Internet]. 2022 [cited 2023 Apr 6];19(19):12302. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9564520/pdf/ijerph-19-12302.pdf
23. Fernández-de-Las-Peñas C, Pérez-Bellmunt A, Llurda-Almuzara L, Plaza-Manzano G, De-la-Llave- Rincón AI, Navarro-Santana MJ. Is Dry Needling Effective for the Management of Spasticity, Pain, and Motor Function in Post-Stroke Patients? A Systematic Review and Meta-Analysis. Pain Med [Internet]. 2021 [cited 2023 Apr 6];22(1):131-41. Disponible en: https://academic.oup.com/painmedicine/article-lookup/doi/10.1093/pm/pnaa392
24. Valencia-Chulián R, Heredia-Rizo AM, Moral-Munoz JA, Lucena-Anton D, Luque-Moreno C. Dry needling for the management of spasticity, pain, and range of movement in adults after stroke: A systematic review. Complement Ther Med [Internet]. 2020 [cited 2023 Apr 6];52. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0965229920305586?via%3Dihub
25. Núñez-Cortés R, Cruz-Montecinos C, Latorre-García R, Pérez-Alenda S, Torres-Castro R. Effectiveness of Dry Needling in the Management of Spasticity in Patients Post Stroke. J Stroke Cerebrovasc Dis [Internet]. 2020 [cited 2023 Jan 6];29(11). Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1052305720306546?via%3Dihub
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