Immediate Neurophysiological effect of electrical stimulation via dry needling on H-reflex in post stroke spasticity.

Autor:	Al Amin R; Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon., Ali AS; Department of Physical Therapy for Neurology, Faculty of Physical Therapy, Cairo University, Egypt., Saab IM; Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon., Abbas RL; Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.
Jazyk:	angličtina
Zdroj:	Physiotherapy theory and practice [Physiother Theory Pract] 2024 Jul; Vol. 40 (7), pp. 1412-1420. Date of Electronic Publication: 2023 Feb 27.
DOI:	10.1080/09593985.2023.2182655
Abstrakt:	Background: Many non-pharmacological interventions have been proposed for spasticity modulation in spastic stroke subjects. Objective: To investigate the immediate effect of dry needling (DN), electrical stimulation (ES), and dry needling with intramuscular electrical stimulation (DN+IMES) on H-reflex in post-stroke spasticity. Methods: Spastic subjects with stroke (N = 90) (55-85 years) were evaluated after 1 month of stroke onset using Modified Ashworth Scale (MAS) score ≥1. Subjects were randomly allocated to receive one session of DN - Soleus (N = 30), ES - posterior lateral side of the leg with 100 Hz and 250 μs pulse width (N = 30), or DN+IMES - Soleus (N = 30). MAS, H-reflex, maximum latency, H-amplitude, M-amplitude and H/M ratio, were recorded before and after one session of intervention. Relationships for each variable within group or the difference among groups were calculated by effect size. Results: Significant decrease in H/M ratio in Gastrocnemius and Soleus at post-treatment within DN group ( P = .024 and P = .029, respectively), large effect size ( d = 0.07 and 0.62, respectively); and DN+IMES group ( P = .042 and P = .001, respectively), large effect size ( d = 0.69 and 0.71, respectively). No significant differences in all variables at pre-treatment and post-treatment was recorded among ES, DN, and DN+IMES groups. Significant decrease in MAS was recorded at post-treatment compared to pre-treatment within ES group ( P = .002), DN group ( P = .0001), and DN+IMES group ( P = .0001), but not significant ( P > .05) among three groups at pre-treatment ( P = .194) and post-treatment ( P = .485). Conclusions: Single session of DN, ES, and the DN+IMES can significantly modulate post-stroke spasticity by possible bottom-up regulation mechanisms.
Databáze:	MEDLINE
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