DRY NEEDLING V/S SHAM ACUPUNCTURE [PLACEBO EFFECT] ALONG WITH CONVENTIONAL PHYSIOTHERAPY IN POST-STROKE SURVIVORS WITH SPASTICITY IN THE UPPER EXTREMITY – A COMPARATIVE STUDY

Abstract

Background-

Stroke, a cerebrovascular accident resulting from vascular injury within the central nervous system, ranks as the second leading cause of global mortality and disability. In India, stroke incidence has surged over recent decades, with varying rates. Hemorrhagic and ischemic strokes are the two main types, characterised by intra-cerebral haemorrhage and thrombi formation, respectively.

Spasticity, a motor disorder marked by increased muscle tone and resistance to stretch, is prevalent in upper motor neuron disorders. It manifests as non-reflex or reflex-mediated spasticity, the latter resulting from damage to upper motor neurons. Dry needling, an invasive therapeutic technique, targets myofascial trigger points within muscles to alleviate musculoskeletal pain and dysfunction. Mechanisms include inducing stretch within spastic tissue, altering sarcomere structure, and modulating afferent pathways.

Sham acupuncture, serving as a placebo control, involves inserting needles into non-points to evaluate the true effects of needling interventions.

Aim:

To identify the effectiveness of dry needling for the management of spasticity and identify the             connection and contrast between dry needling and Sham acupuncture (placebo effect) for the treatment of spasticity.

Methodology: Convenient sampling was done for 30 individuals. The participants were taken in the age range of 35-65 years as per inclusion criteria. Participants were randomly assigned in two groups. The group A participants were given Dry Needling and Conventional Therapy and group B received Sham Acupuncture and Conventional Physiotherapy. Pre-intervention assessment was taken for spasticity, and both groups received two sessions per week over a span of five weeks. Pre-intervention and post-intervention assessment was analyzed by paired and unpaired t test using Instat software.

Outcome Measure:

Spasticity was assessed using Modified Ashworth Scale (MAS)

Results:

Both groups demonstrated significant difference in decreasing the muscle tone in 5 weeks of intervention when compared within group. Unpaired t test was done between the groups and the results showed dry needling was extremely significant, whereas Sham Acupuncture was considered moderately significant when compared between groups.

Conclusion:

The study concluded that while both the interventions showed significant differences, dry needling appears to be a promising technique for post-stroke spasticity management, its comparative efficacy with Sham acupuncture showed comparatively lesser significance