The study team is recruiting 20 adults with spasticity due to chronic stroke and 20 adults with no neurological injuries for a 2 day study. In people with chronic stroke, one of the most common and disabling problems is spasticity (increased muscle tone or muscle stiffness). The purpose of this research study is to examine effects of dry needling on the nervous system (pathways between the muscle, spinal cord, and brain) in people with spasticity due to chronic stroke. Dry needling is a procedure in which a thin, stainless steel needle is inserted into your skin to produce a muscle twitch response. It is intended to release a knot in your muscle and relieve pain. The total study duration is 2 days. The first visit will take about 3 hours, during which dry needling will take place, and the second visit will take about 1 hour. During both visits you will be asked to participate in examinations of reflexes (muscle responses to non-invasive nerve stimulation) and arm/leg function.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
32
Dry needling is a procedure in which a thin, stainless steel needle is inserted into the skin to produce a muscle twitch response. It is intended to release a knot in a muscle and relieve pain.
Medical University of South Carolina
Charleston, South Carolina, United States
Changes in the H-reflex amplitude in response to nerve stimulation
H-reflex amplitude (mV) reflects the excitability of its reflex pathway. Changes in the H-reflex amplitude indicate that DDN influences the spinal reflex excitability. In the lower extremity this will be measured in the tibialis anterior and the triceps surae. In the upper extremity this will be measured in flexor carpi ulnaris and flexor carpi radialis.
Time frame: baseline, immediately after DDN, 90 minutes after DDN, and 72 hours after DDN
2. Changes in cutaneous reflexes elicited by non-noxious stimulation of cutaneous or mix nerves
Changes in the cutaneous reflex amplitudes would indicate that DDN can influence the spinal processing of cutaneous information.
Time frame: baseline, immediately after DDN, 90 minutes after DDN, and 72 hours after DDN
3. Changes in perception of cutaneous stimuli as measured by perception and radiating threshold of cutaneous nerve stimulation
Changes in thresholds of cutaneous nerve stimulation would imply that DDN can affect the perception of cutaneous input.
Time frame: baseline, immediately after DDN, 90 minutes after DDN, and 72 hours after DDN
Change in ability to move the arm or leg as measured by the Fugl-Meyer Assessment (FMA)
An increase in the FMA score indicates better movement of the arm or leg.
Time frame: baseline, 90 minutes after DDN, and 72 hours after DDN
Change in spasticity as measured by the Modified Ashworth Scale (mAS)
The mAS score ranges from 0: normal muscle tone to 4: rigid in flexion or extension. A decrease in mAS indicates decreased spasticity.
Time frame: baseline, 90 minutes after DDN, and 72 hours after DDN
Change in the ability to move the limb as measured by range of motion (ROM)
ROM is measured in degrees using a standard goniometer. Increased ROM, which will be measured both passively (moved by the assessor) and actively (participant moves the arm themselves), indicates improved ability to move the limb.
Time frame: baseline, immediately after DDN, 90 minutes after DDN, and 72 hours after DDN
Change in pain level as measured by the visual analog scale (VAS) for pain
Pain is rated by the participant on a scale from 0 (no pain) to 10 (worst pain imaginable). Decreased score on the VAS for pain indicates decreased pain.
Time frame: baseline, immediately after DDN, 90 minutes after DDN, and 72 hours after DDN
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