Dry Needling for Shoulder Pain in Stroke Patients

Study Overview
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Brief Summary
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Spasticity and pain, particularly int he shoulder region, are the most common impairments experienced by subjects who had experienced a stroke. There is preliminary evidence supporting the role of dry needling for spasticity in patients who had suffered from a stroke. Few data exists on the effects on shoulder pain. In addition, it has been shown that application of dry needling induces post-needling soreness in individuals with musculoskeletal pain. No previous study has investigated the presence and the duration of post-needling soreness in individuals who had experienced a stroke.

Official Title
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Dry Needling for Shoulder Pain and Presence of Post-needling Induced-Pain in PAtients Who Had Suffered a Stroke

Conditions
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Stroke

Intervention / Treatment
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* Other: Dry Needling
* Other: Physical Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: first-ever unilateral stroke; hemiplegia resulting from stroke; age between 30 and 60 years old; presence of hypertonicity in the upper extremity; pain symptoms in the shoulder active trigger points in the shoulder muscles reproducing the shoulder pain symptoms Exclusion Criteria: recurrent stroke; absence of active trigger points in the shoulder muscles reproducing shoulder symptoms previous treatment with nerve blocks, motor point injections with neurolytic agents for spasticity at any time; previous treatment with botulinum toxin-A in the 6 months prior the study; severe cognitive deficits; other neurologic diseases, underlying complex medical conditions, e.g., heart conditions, unstable hypertension, fracture fear to needles; any contraindication for deep dry needling, e.g., anticoagulants, infections, bleeding, or psychotic.

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dry needling<br>The experimental group will receive a single session of modulatory interventions combined with a single session of dry needling into the shoulder muscles which active trigger points will reproduce the shoulder pain symptoms. | Other: Dry Needling<br>* A single session of modulatory interventions combined with a single session of dry needling into the shoulder muscles which active trigger points will reproduce the shoulder pain symptoms.<br>|
| Active Comparator: Physical Therapy<br>This group will receive a single session of modulatory interventions targeting modulation of central nervous system. | Other: Physical Therapy<br>* A single session of modulatory interventions targeting modulation of central nervous system.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in post-dry needling pain intensity with a numerical pain rate scale before and after the intervention | A Numerical Pain Rate Scale (NPRS, 0-10) will be used to record post-dry needling soreness in the targeted area | Baseline, 24 hours (1 day) after and 72 hours (3 days) after treatment the intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in spontaneous shoulder pain with a numerical pain rate scale before and after the intervention | A Numerical Pain Rate Scale (NPRS, 0-10) will be used to assess spontaneous shoulder pain | Baseline, 72 hours (3 days) and 168 hours (7 days) after treatment the intervention | 
| Presence of active trigger points in the shoulder musculature | Manual palpation of active trigger points in the shoulder muscles will be conducted | Baseline, 72 hours (3 days) and 168 hours (7 days) after treatment the intervention |