Dry Needling and Bobath Treatment Clinical Effects Focused on Stroke Patients
Condition: Ischemic Stroke; Spasticity
MeSH terms: Muscle Spasticity; Stroke; Ischemic Stroke
Study type: Interventional

Summary: 
      The investigators aim to determine if dry needling technique in a non myofascial trigger
      point area generate the same changes in spasticity, function and pain responses as with dry
      needling in a myofascial trigger point area.
    

Detailed description: 
      Spasticity is a consequence of multiple diseases that affect the Central Nervous System, such
      as stroke and other neurodegenerative diseases. Its pathophysiology is unclear and the
      variety of clinical symptoms is determined by the injury location. Several studies have
      suggested the possibility of active pain treatment effectiveness through myofascial trigger
      points management. One of these interventions is dry needling, which has been used in several
      scientific studies. However, these investigations have been based on spasm response or deep
      dry needling mechanisms always over a trigger point, but none of the participants compare the
      possible mechanical effects of the insertion of a needle into a spastic muscle without
      targeting specifically a trigger point. Therefore, the aim of this study is to evaluate the
      effects on spasticity, pain and motor function after a dry needling intervention versus the
      insertion of a needle into a non trigger point area in patients who had experienced a stroke.
    

Intervention name(s): Dry needling in a myofascial trigger points area plus physical therapy based on Bobath concept; Dry needling in a non myofascial trigger points area plus physical therapy based on Bobath concept
Intervention type(s): Other; Other
Intervention description(s): Other: Dry Needling Participants will receive dry needling application over a myofascial trigger point by an experienced physical therapist with clinical experience in neurological patients, that will be inserted into taut bands of the following shoulder spastic muscles (when a trigger point was present): upper trapezius, supraspinatus, infraspinatus and deltoid anterior.
Other: Physical Therapy
Participants will receive physical therapy treatment based on the modulating Bobath technique. This technique will be applied using the general parameters, carrying out similar action protocols with every patient, based on the aim of normalizing upper limb muscle tone.
Device: stainless steel needles (0.3mm x 50mm); Other: Dry Needling Participants will receive dry needling application carried out over a non trigger point area by an experienced physical therapist with clinical experience in neurological patients, that will be inserted into a non trigger point spastic muscle of the shoulder area: upper trapezius, supraspinatus, infraspinatus and deltoid anterior.
Other: Physical Therapy Participants will receive physical therapy treatment based on the modulating Bobath technique. This technique will be applied using the general parameters, carrying out similar action protocols with every patient, based on the aim of normalizing upper limb muscle tone.
Device: stainless steel needles (0.3mm x 50mm)
Allocation: Randomized
Intervention model: Crossover Assignment
Intervention model description: In this study patients will receive dry needling intervention in shoulder muscles. The following muscles will be addressed: upper trapezius, supraspinatus, deltoid anterior fibers and infraspinatus.
They will also receive physical therapy based on Bobath concept. All the subjects belong to Madrid Polibea Sur neurorehabilitation clinic. The sample of the study is estimated to consist of twenty patients, with a washout period of forty five days after the intervention.
The data will be collected by an external physical therapist. All the therapists belong to Polibea Sur neurological clinic and Madrid Rey Juan Carlos University departments of physical therapy, occupational therapy, rehabilitation and physical medicine, experts in neurological treatment and trained in dry needling.
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Muscle Spasticity; Dry Needling; Stroke