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Dry needling significantly reduces upper and lower limb spasticity in patients with post-stroke conditionsDry Needling Shows Promise for Reducing Post-Stroke Muscle Stiffness

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Key Takeaway
Consider dry needling as a potent adjunct to standard rehabilitation to reduce post-stroke spasticity.

This meta-analysis evaluated the efficacy of dry needling (DN) for managing post-stroke spasticity in 276 adults. The analysis compared DN against sham interventions or conventional neurorehabilitation, focusing on Modified Ashworth Scale (MAS) and Modified Modified Ashworth Scale (MMAS) scores.

Findings indicate that dry needling results in a significant reduction in overall spasticity (MD = -0.65). Specific improvements were noted for upper limb spasticity (MD = -0.40) and lower limb spasticity (MD = -1.02). Additionally, a reduction was observed in ankle plantar flexor spasticity (MD = -1.05). When compared specifically to sham interventions, DN showed significant improvement (MD = -0.45).

When dry needling was added to conventional neurorehabilitation, the results showed significant improvement (MD = -0.76). The authors note that while DN is an effective short-term intervention and a potent adjunct to standard rehabilitation, the evidence is limited by small sample sizes and potential blinding bias. Consequently, the GRADE certainty of these findings is rated as Moderate to Low.

How this fits prior evidence

This meta-analysis addresses a gap in managing physical complications of stroke by evaluating dry needling for spasticity. While prior evidence indicates that sarcopenia is associated with significantly higher risk of poor functional prognosis in stroke patients, and combined rTMS and mirror therapy significantly improves upper limb function, this study specifically addresses the role of dry needling as a short-term intervention to reduce spasticity in both upper and lower extremities.

Researchers looked at how dry needling affects muscle stiffness, known as spasticity, in adults who have had a stroke. This type of treatment involves needles to target specific muscles. The study looked at 276 patients to see if dry needling worked better than sham treatments or standard physical therapy.

The results showed that dry needling led to a significant reduction in overall muscle stiffness. Specifically, it helped reduce stiffness in the upper limbs, lower limbs, and the ankle area. When dry needling was added to standard rehabilitation programs, patients saw even more improvement in their muscle tension.

Because the study involved small sample sizes and had some issues with how participants were grouped, the evidence is not yet certain. It is also unclear if these improvements last over a long period of time. For now, dry needling is seen as a helpful short-term tool to add to standard care, but you should talk to your doctor to see if it is right for your specific needs.

What this means for you:
Dry needling may help reduce muscle stiffness in the limbs of stroke survivors as a short-term treatment.

Common questions

What is dry needling and how does it help after a stroke?

Dry needling is a treatment used to target muscles. In this study of 276 adults, it was used to reduce spasticity, which is the muscle stiffness that often follows a stroke. The results showed it could help reduce stiffness in both the upper and lower limbs, as well as in the ankle area.

Is dry needling better than standard physical therapy?

The study found that dry needling is an effective addition to standard rehabilitation. When dry needling was combined with conventional therapy, it showed a significant improvement in reducing muscle stiffness compared to standard care alone. It is considered a helpful short-term tool for patients.

Is it safe to use dry needling for muscle stiffness?

The study did not report any specific adverse events or safety concerns during the review. However, the evidence is currently of moderate to low certainty because of small sample sizes. You should consult with a medical professional to discuss the safety and benefits for your specific condition.

Study Details

Study typeMeta analysis
Sample sizen = 276
EvidenceLevel 1
Follow-up216.0 mo
PublishedOct 2026
View Original Abstract ↓
OBJECTIVE: To assess the effectiveness of dry needling (DN) in reducing spasticity among post-stroke patients through meta-analysis. DATA SOURCES: PubMed, Web of Science, PEDro, Cochrane Library, CINAHL, and Embase were searched up to April 2026, alongside manual searches of reference lists. STUDY SELECTION: Randomized controlled trials (RCTs) involving adults (>18 years) with post-stroke spasticity, investigating DN alone or as part of a multimodal intervention, were included. DATA EXTRACTION: Two reviewers independently extracted data, primarily focusing on changes in the Modified Ashworth Scale (MAS) and the Modified Modified Ashworth Scale (MMAS). DATA SYNTHESIS: Eleven RCTs (276 patients) were included. Overall, DN significantly reduced spasticity compared to the control group (mean difference [MD] = -0.65). DN was effective for both upper (MD = -0.40) and lower limbs (MD = -1.02), with the most robust effect in ankle plantar flexors (MD = -1.05). Significant improvements occurred whether DN was compared to sham interventions (MD = -0.45) or added to conventional neurorehabilitation (MD = -0.76). While study quality was generally high (PEDro scores 5-9/10), GRADE certainty was Moderate to Low due to small sample sizes and blinding bias. CONCLUSIONS: DN is an effective short-term intervention and a potent adjunct to standard rehabilitation for reducing post-stroke spasticity in both upper and lower extremities. Further research is needed to evaluate its long-term functional impact.
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