Tehran University Medical Journal

Background: Spasticity is one of the most important symptoms of stroke, which leads to movement constraints and disability. The presence of spasticity in the ankle and toe plantar flexor muscles disturbs the balance and gait of patients with stroke. Dry needling has been introduced as a new method for the treatment of spasticity. The aim of this study was to investigate the immediate effects of the ankle and toe plantar flexors dry needling on spasticity and balance in patients with stroke.
Methods: This study was a clinical pretest-posttest study. Twenty patients with stroke (12 males and 8 females), the mean age of 56.5±13 years were included. The assessments were performed before dry needling, immediately after dry needling and 15 minutes after that. Dry needling was used to treat gastrocnemius (ankle plantar flexor) muscles, flexor digitorum longus, and flexor digitorum brevis of the affected lower limb of the patients, for one session. Each muscle was needled for one minute with fast in-fast out technique. The outcome measures of the study were modified modified Ashworth scale (MMAS) for the assessment of the severity of muscle spasticity, timed up and go test and one leg stance test, for balance evaluation. The study was conducted in neurological physical therapy, Clinic of Rehabilitation School, Tehran University of Medical Sciences in Iran, from April 2017 to April 2018.
Results: The results showed a significant decrease in the ankle and toe plantar flexor muscles spasticity both immediately after dry needling and at 15 minutes follow-up (P=0.001). The duration of timed up and go test (P=0.001) and one leg stance test (P=0.001) improved significantly after dry needling and this improvement persisted for 15 minutes after dry needling. The effect size for timed up and go test and one leg stance test was small (Cohen'sd=0.33 and 0.32 respectively).
Conclusion: This study suggests that dry needling is effective in improving spasticity of ankle and toe plantar flexor muscles and the balance of patients with stroke. Further research with larger sample size and control group is necessary.

Background: Studies have shown that 75% of men and 35% of women over the age of 10 have hamstring tightness. Hamstring tightness is one of the major causes of hamstring injury and loss of function. Dry needling which is a common intervention used by physiotherapists for the treatment of common various conditions can improve hamstring flexibility in less time than other interventions. So, the present study aimed to investigate the effect of dry needling on flexibility and electrophysiological indices in healthy men with hamstring tightness.
Methods: In this two-way blind clinical trial with a control group, which was performed from November 2018 to February 2019 in the laboratory of the Faculty of Rehabilitation of Tehran University of Medical Sciences, 30 healthy men with hamstring tightness were randomly divided into two groups of dry needling (n=15) and sham needle (n=15). In both groups, dry needling and sham needle, three points of hamstring muscle were needled, each point for one minute during a single session. Outcome measures included flexibility based on passive knee extension test, H-reflex latency, and motor neuron excitability, which were measured three times: before the intervention, immediately after the intervention, and one week after the intervention.
Results: The results revealed that the mean of passive knee extension test (P=0.54), the mean delay time of H-reflex (P=0.84) and the mean of excitability of the motor neuron (P=0.41) didn’t have significant different between two groups after intervention.
Conclusion: The findings of this study showed that dry needling had no effect on hamstring flexibility and electrophysiological indices recorded in the soleus muscle of healthy individuals with hamstring tightness.

Background: Ankle sprain is one of the most common sports injuries and accounts for 10 to 30 percent of sports injuries, especially in athletes. This injury can lead to pain, imbalance, and movement restriction, and therefore has a significant impact on athletes' performance. Therefore, the aim of this study was to investigate the effect of dry needling on tissue repair of ligamentous injury in the acute phase of ankle sprain.
Methods: This double-blind clinical trial study was conducted on 52 patients with ankle sprains at Imam Reza Hospital in 2023. Patients were divided into two groups: control and intervention. The control group received conventional treatment including medication and splints, while the intervention group received dry needling in addition to conventional treatments. Data analysis was performed using SPSS version 21 software and descriptive statistics and inferential statistical tests at a significance level of P<0.05.
Results: The results showed that the intervention group showed significant improvement in pain (P=0.002), activities of daily living (P<0.001), sports activities (P<0.001), plantar flexion (P=0.027), dorsiflexion (P=0.003), inversion (P=0.012), and edema (P=0.005) compared to the control group. However, there was no significant difference in symptom severity (P=0.752) and quality of life (P=0.348) between the two groups. Overall patient change analysis showed that most patients in the intervention group improved, while only 7.7% in the control group improved.
Conclusion:  A combination of splinting, medication, and dry needling can be effective in improving pain, daily activities, exercise and recreation, range of motion, and edema in patients with ankle sprains. These findings can provide a basis for implementing new treatment protocols for the management of ankle sprains in athletes and other injured patients. It is recommended that further studies be conducted on the long-term effects of dry needling and other therapeutic interventions to further identify their potential to accelerate the recovery process in patients.