Effect of Dry Needling on Spasticity, Shoulder Range of Motion, and Pressure Pain Sensitivity in Patients With Stroke: A Crossover Study

J Manipulative Physiol Ther. 2016 Jun;39(5):348-358. doi: 10.1016/j.jmpt.2016.04.006. Epub 2016 May 7.


Objective: The purpose of this study was to determine the effects of the inclusion of deep dry needling (DDN) in spastic shoulder muscles into a rehabilitation program on spasticity, pressure pain sensitivity, and shoulder range of motion in subjects who had experienced a stroke.

Methods: A controlled, repeated-measures, crossover, double-blinded, randomized trial was conducted. Twenty patients who have had a stroke were randomly assigned to receive rehabilitation alone or rehabilitation combined with DDN over the upper trapezius, infraspinatus, subscapularis, and pectoralis mayor muscles on the spastic shoulder. Subjects received both interventions separated at least 15 days apart. Each intervention was applied once per week over 3 weeks. Spasticity (Modified Ashworth Scale), pressure pain thresholds over the deltoid and infraspinatus muscles and C5-C6 zygapophyseal joint, and shoulder range of motion were collected 1 week before and 1 week after each intervention by a blinded assessor.

Results: Reduction in spasticity was similar after both conditions for the upper trapezius, pectoralis major, and subscapularis muscles. A greater number of individuals receiving DDN exhibited decreased spasticity within the infraspinatus muscle. The analysis of covariance showed that all pressure pain thresholds, shoulder abduction, and external rotation of the shoulder increased significantly more after DNN intervention (P < .05). Shoulder flexion showed similar changes after both conditions.

Conclusions: Our results suggest that inclusion of DDN into a multimodal rehabilitation program was effective for decreasing localized pressure sensitivity and improving shoulder range of motion in individuals who had experienced stroke; however, we did not observe significant differences in muscle spasticity.

Keywords: Muscle Spasticity; Pain Threshold; Range of Motion; Shoulder; Stroke.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Acupuncture Points*
  • Acupuncture Therapy / methods*
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Spasticity / etiology
  • Muscle Spasticity / therapy*
  • Pain Threshold
  • Pressoreceptors
  • Stroke / therapy*
  • Stroke Rehabilitation*