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Ebrahimzadeh M, Nakhostin Ansari N, Abdollahi I, Akhbari B, Dommerholt J. Changes in Corticospinal Tract Consistency after Dry Needling in a Stroke Patient. Case Rep Neurol Med 2024; 2024:5115313. [PMID: 39309410 PMCID: PMC11416164 DOI: 10.1155/2024/5115313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 06/25/2024] [Accepted: 09/06/2024] [Indexed: 09/25/2024] Open
Abstract
Background Dry needling (DN) is a technique employed to mitigate spasticity and enhance functionality in stroke patients. We report the impact of DN on both corticospinal tract (CST) consistency and wrist flexors spasticity of an individual affected by stroke. Case The participant was a 57-year-old male who had experienced an ischemic stroke 9 months prior. The primary outcome measures included fractional anisotropy (FA), asymmetry FA (aFA), ratio FA (rFA), and Modified Modified Ashworth Scale (MMAS). Additionally, secondary outcomes encompassed wrist extension range of motion (ROM) and performance in the box and block test (BBT). These measurements were taken both before and after the administration of DN treatment. Results After the application of DN, the mean FA of the ipsilesional CST increased from 0.35 to 0.39, concomitantly with a decline in aFA from 0.18 to 0.13. Notably, the rFA exhibited a pre-DN value of 0.69, which subsequently rose to 0.76 post-DN. Moreover, a significant reduction in MMAS scores was detected, from a score of "3" prior to DN application to a post-DN score of "1". In terms of wrist mobility, both active and passive extension ROM exhibited favorable improvements, with an increase of 12° for active extension and 16° for passive extension. Furthermore, there was a substantial improvement in the BBT score, an indicator of manual dexterity, ascending from 12 to 24. Conclusion Enhancements in CST consistency suggest it as a potential mechanism contributing to the observed improvements following DN in this stroke case.
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Affiliation(s)
- Masoome Ebrahimzadeh
- School of MedicineHormozgan University of Medical Sciences, Bandar Abbas, Iran
- Department of PhysiotherapyUniversity of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Department of PhysiotherapySchool of RehabilitationTehran University of Medical Sciences, Tehran, Iran
- Research Center for War-affected PeopleTehran University of Medical Sciences, Tehran, Iran
| | - Iraj Abdollahi
- Department of PhysiotherapyUniversity of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Behnam Akhbari
- Department of PhysiotherapyUniversity of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Jan Dommerholt
- Bethesda Physiocare, Bethesda, MD, USA
- Myopain Seminars, Bethesda, MD, USA
- Department of Physical Therapy and Rehabilitation ScienceSchool of MedicineUniversity of Maryland, Baltimore, MD 21201, USA
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Honarpishe R, Naghdi S, Ansari NN, Dommerholt J, Hassanabadi M. The Effect of Ankle Muscles Dry Needling on Brain Activity Map Based on fMRI: a Study Protocol for Randomized Controlled Trial. J Acupunct Meridian Stud 2024; 17:94-99. [PMID: 38898646 DOI: 10.51507/j.jams.2024.17.3.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/15/2024] [Accepted: 04/03/2024] [Indexed: 06/21/2024] Open
Abstract
Importance Neuromodulation may be one of the underlying mechanisms of dry needling (DN); however, the mechanism has not yet been fully clarified. Objective This randomized controlled trial is designed to evaluate DN stimulation of the tibialis anterior and peroneus longus muscles in chronic ankle instability (CAI) and healthy subjects, employing functional magnetic resonance imaging (fMRI). Design Clinical study protocol, SPIRIT compliant. Setting Brain Mapping Laboratory. Population A total of thirty participants aged between 18 and 40 years old will be included in this study. Twenty healthy participants will be randomized into 2 groups (real DN and sham DN). Ten patients with CAI will also be recruited to the third group and receive only real DN for comparison. Exposures Real and sham DN. Main Outcomes and Measures The voxel count, coordinates of peak activation, and peak intensity will be obtained as primary outcomes to report brain map activation. Measurements will be taken before, during, and after DN treatment. The strength of the ankle dorsiflexors, active dorsiflexion range of motion, and McGill pain questionnaire short-form will be used as secondary outcome measures. Results The results from this study will be published in peer-reviewed journals and disseminated as presentations at national and international congresses. Conclusion This trial will explore brain responses to real and sham DN in healthy participants and to real DN in CAI patients. Overall, our results will provide preliminary evidence of the neural mechanism of DN.
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Affiliation(s)
- Roshanak Honarpishe
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Soofia Naghdi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Jan Dommerholt
- Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Marzieh Hassanabadi
- Department of Physiotherapy, Rehabilitation Faculty, Semnan University of Medical Sciences, Semnan, Iran
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Malfait I, Gijsbers S, Smeets A, Hanssen B, Pick A, Peers K, Schillebeeckx F. Safety of dry needling in stroke patients: a scoping review. Eur J Phys Rehabil Med 2024; 60:225-232. [PMID: 38502557 PMCID: PMC11114159 DOI: 10.23736/s1973-9087.24.08224-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/20/2023] [Accepted: 02/16/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION Spasticity is a common problem in stroke patients. Treatments of spasticity often have side effects or are insufficiently effective. Dry needling (DN) has been proposed as a potential additional option to consider in the multimodal treatment of post-stroke spasticity, although questions about its safety remain. The goal of this study is to assess the safety of DN in stroke patients. EVIDENCE ACQUISITION A systematic search in Medline, Embase, The Cochrane Library, Web of Science, CIHNAL and PEDro was conducted in June 2023. Two reviewers independently screened abstracts according to the eligibility criteria. EVIDENCE SYNTHESIS Twenty-five articles were included in this review. Only six studies reported adverse events, all of which were considered minor. None of the included studies reported any serious adverse events. In four of the included studies anticoagulants were regarded as contra-indicative for DN. Anticoagulants were not mentioned in the other included studies. CONCLUSIONS There is a paucity of literature concerning the safety of DN in stroke patients. This review is the first to investigate the safety of DN in stroke patients and based on the results there is insufficient evidence regarding the safety of DN in stroke patients. CLINICAL REHABILITATION IMPACT Although DN could be a promising treatment in post-stroke spasticity, further research is indicated to investigate its mechanism of action and its effect on outcome. However, before conducting large clinical trials to assess outcome parameters, the safety of DN in stroke patients must be further investigated.
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Affiliation(s)
- Iris Malfait
- Unit of Physical Medicine and Rehabilitation, Department of Development and Regeneration, University Hospital of Leuven, Leuven, Belgium
| | - Sabien Gijsbers
- Unit of Physical Medicine and Rehabilitation, Department of Development and Regeneration, University Hospital of Leuven, Leuven, Belgium
| | - Annemie Smeets
- Unit of Physical Medicine and Rehabilitation, Department of Development and Regeneration, University Hospital of Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, KU Leuven, Leuven, Belgium
| | - Britta Hanssen
- Unit of Physical Medicine and Rehabilitation, Department of Development and Regeneration, University Hospital of Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, KU Leuven, Leuven, Belgium
| | - Anton Pick
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Koen Peers
- Unit of Physical Medicine and Rehabilitation, Department of Development and Regeneration, University Hospital of Leuven, Leuven, Belgium
| | - Fabienne Schillebeeckx
- Unit of Physical Medicine and Rehabilitation, Department of Development and Regeneration, University Hospital of Leuven, Leuven, Belgium -
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Choobsaz H, Ghotbi N, Ansari NN. Effects of dry needling on spasticity, cortical excitability, and range of motion in a patient with multiple sclerosis: a case report. J Med Case Rep 2024; 18:125. [PMID: 38521912 PMCID: PMC10960986 DOI: 10.1186/s13256-024-04452-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 02/08/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Dry needling is an intervention used by physiotherapists to manage muscle spasticity. We report the effects of three sessions of dry needling on ankle plantar flexor muscle spasticity and cortical excitability in a patient with multiple sclerosis. CASE PRESENTATION The patient was a 40-year-old Iranian woman with an 11-year history of multiple sclerosis. The study outcomes were measured by the modified modified Ashworth scale, transcranial magnetic stimulation parameters, and active and passive ankle range of motion. They were assessed before (T0), after three sessions of dry needling (T1), and at 2-week follow-up (T2). Our result showed: the modified modified Ashworth scale was improved at T2 from, 2 to 1. The resting motor threshold decreased from 63 to 61 and 57 at T1 and T2, respectively. The single test motor evokes potential increased from 76.2 to 78.3. The short intracortical inhibition increased from 23.6 to 35.4 at T2. The intracortical facilitation increased from 52 to 76 at T2. The ankle active and passive dorsiflexion ROM increased ~ 10° and ~ 6° at T2, respectively. CONCLUSION This case study presented a patient with multiple sclerosis who underwent dry needling of ankle plantar flexors with severe spasticity, and highlighted the successful use of dry needling in the management of spasticity, ankle dorsiflexion, and cortical excitability. Further rigorous investigations are warranted, employing randomized controlled trials with a sufficient sample of patients with multiple sclerosis. Trial registration IRCT20230206057343N1, registered 9 February 2023, https://en.irct.ir/trial/68454.
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Affiliation(s)
- Haniyeh Choobsaz
- School of Rehabilitation, Department of Physiotherapy, Tehran University of Medical Sciences, Tehran, Iran
| | - Nastaran Ghotbi
- School of Rehabilitation, Department of Physiotherapy, Tehran University of Medical Sciences, Tehran, Iran.
| | - Noureddin Nakhostin Ansari
- School of Rehabilitation, Department of Physiotherapy, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran, Iran
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Babazadeh-Zavieh SS, Ansari NN, Ghotbi N, Naghdi S, Jafar Haeri SM. Dry needling combined with exercise therapy: Effects on wrist flexors spasticity in post-stroke patients - A randomized controlled trial. NeuroRehabilitation 2024; 54:399-409. [PMID: 38393926 DOI: 10.3233/nre-230081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
BACKGROUND The positive contribution of dry needling (DN) in conjunction with exercise therapy for patients with stroke and spasticity remains uncertain. OBJECTIVE To examine the effects of DN combined with exercise therapy on wrist flexor spasticity and motor function in patients with stroke. METHODS Twenty-four participants with stroke were randomly assigned to either the DN and exercise therapy group or the DN alone group. Assessments were conducted at baseline, after the 4th treatment session, and 3 weeks post-treatment. RESULTS A significant Group×Time interaction was observed for wrist active range of motion (ROM) (P = 0.046), favoring the DN with exercise therapy group (∼10° at baseline, ∼15° immediately after the 4th session, and 15.4° at follow-up). The improvements in spasticity, passive ROM, and H-reflex latency were sustained during follow-up. However, there were no significant between-group differences in any outcome at any measurement time point. CONCLUSION The combined DN and exercise therapy did not exhibit superiority over DN alone concerning spasticity severity and motor function. However, it demonstrated additional advantages, particularly in improving motor neuron excitability and wrist passive extension.
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Affiliation(s)
- Seyedeh Saeideh Babazadeh-Zavieh
- Department of Physiotherapy, School of Rehabilitation Sciences, Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Nastaran Ghotbi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Soofia Naghdi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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Javier-Ormazábal A, González-Platas M, Jiménez-Sosa A, Herrero P, Lapuente-Hernández D. The Effectiveness of a Single Dry Needling Session on Gait and Quality of Life in Multiple Sclerosis: A Double-Blind Randomized Sham-Controlled Pilot Trial. Healthcare (Basel) 2023; 12:10. [PMID: 38200916 PMCID: PMC10778988 DOI: 10.3390/healthcare12010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Gait disorders are a major cause of disability and reduced health-related quality of life in people with multiple sclerosis (pwMS). Dry needling (DN) has demonstrated positive results to improve gait parameters in patients with stroke. The main aim of this study was to evaluate the effect of a single session of DN in the gait performance of pwMS. METHODS A double-blind parallel randomized sham-controlled pilot trial was conducted. Study participants received a single session of active DN or sham DN in the gastrocnemius medialis muscle. Pre-treatment and immediately post-treatment measurements were taken, as well as at one and four weeks after the intervention. Outcomes related to gait performance (Timed 25-Foot Walk), self-perceived walking capacity (Multiple Sclerosis Walking Scale), risk of falls (Timed Up and Go test), disability level (Expanded Disability Status Score) and quality of life (Multiple Sclerosis Quality of Life-54 questionnaire and Analogic Quality of Life scale) were evaluated. RESULTS 18 patients who had multiple sclerosis participated in the study. The group who received active DN showed within-group significant statistical differences immediately after treatment for gait performance (p = 0.008) and risk of falls (p = 0.008), as well as for self-perceived walking capacity at one week (p = 0.017) and four weeks (p = 0.011) and quality of life at four weeks (p = 0.014). Regarding the comparison between groups, only significant results were obtained in the physical domain of the quality of life at four weeks (p = 0.014). CONCLUSIONS DN seems to be a promising therapeutic tool for the treatment of gait disorders in pwMS. However, when results were compared with sham DN, no differences were found.
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Affiliation(s)
- Alberto Javier-Ormazábal
- Division of Physiotherapy, Hospital Universitario de Canarias, Carretera Ofra S/N, 38320 San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
- Research Institute of Biomedical and Health Sciences, Universidad de Las Palmas de Gran Canaria, C. Juan de Quesada 30, 35001 Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Montserrat González-Platas
- Research Institute of Biomedical and Health Sciences, Universidad de Las Palmas de Gran Canaria, C. Juan de Quesada 30, 35001 Las Palmas de Gran Canaria, Las Palmas, Spain
- Division of Neurology, Hospital Universitario de Canarias, Carretera Ofra S/N, 38320 San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - Alejandro Jiménez-Sosa
- Research Unit, Hospital Universitario de Canarias, Carretera Ofra S/N, 38320 San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - Pablo Herrero
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Zaragoza, Spain
- iHealthy Research Group, IIS Aragon, Avda San Juan Bosco 13, 50009 Zaragoza, Zaragoza, Spain
| | - Diego Lapuente-Hernández
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Zaragoza, Spain
- iHealthy Research Group, IIS Aragon, Avda San Juan Bosco 13, 50009 Zaragoza, Zaragoza, Spain
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Zarrin M, Nakhostin Ansari N, Naghdi S, Hasson S, Forogh B, Rezaee M. Dry Needling for Arthrogenic Muscle Inhibition of Quadriceps Femoris in Patients after Reconstruction of Anterior Cruciate Ligament: a Protocol for a Randomized Controlled Trial. J Acupunct Meridian Stud 2023; 16:193-202. [PMID: 37885255 DOI: 10.51507/j.jams.2023.16.5.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/23/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
Background : Dry needling (DN) is recommended as a therapeutic modality for various neuromusculoskeletal disorders. No study has been performed on the impact of DN on arthrogenic muscle inhibition (AMI) after anterior cruciate ligament reconstruction (ACLR). This study protocol is aimed to investigate the impacts of DN on AMI of quadriceps femoris, corticomotor, and spinal reflex excitability in patients with ACLR. Methods : A double-blind, between-subject, randomized, controlled trial will be conducted to measure changes in AMI after DN. Twenty-four subjects with ACLR will be recruited to receive a DN or a sham DN, providing that they met the inclusion criteria. Three sessions of DN on the quadriceps femoris will be applied during a one-week period. The primary outcome measures are the active motor threshold, motor evoked potential, and Hmax - Mmax ratio. The secondary outcomes are the International Knee Documentation Committee subjective knee form questionnaire score and maximum quadriceps isometric torque. Data will be collected at baseline, immediately after the first session, after the third session, and at the one-month follow-up visit. Discussion : The results of this study will provide preliminary evidence regarding the effects of DN on AMI of quadriceps femoris in patients with ACLR.
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Affiliation(s)
- Milad Zarrin
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Tehran University of Medical Sciences, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Soofia Naghdi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Scott Hasson
- Department of Physical Therapy, Augusta University, Augusta, GA, USA
| | - Bijan Forogh
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Rezaee
- Department of Orthopedics, School of Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
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León F, Manzo L, Kababie R, Figueroa J, Cuellar C, Herrero P. Effects of Dry Needling on Spasticity in Multiple Sclerosis Evaluated Through the Rate-Dependent Depression of the H Reflex: A Case Report. Int Med Case Rep J 2023; 16:293-302. [PMID: 37223109 PMCID: PMC10202111 DOI: 10.2147/imcrj.s391201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 12/20/2022] [Indexed: 05/25/2023] Open
Abstract
Background Spasticity is a common symptom of multiple sclerosis (MS) which affects mobility. Dry Needling (DN) has shown a reduction in spasticity in neuromuscular conditions such as stroke and spinal cord injury although the mechanism of action is still unclear. In spastic individuals, the Rate-Dependent Depression (RDD) of the H reflex is decreased as compared to controls and analyzing the effects of DN in the RDD may help to understand its mechanism of action. Objective To evaluate the effect of Dry Needling on spasticity measured by the Rate-dependent Depression (RDD) of the H reflex in an MS patient. Methods Three time points were evaluated: Pre-intervention (T1), Post-intervention assessments were carried out in the seventh week at two-time points: Before DN (T2) and After DN (T3). Main outcomes included the RDD and latency of the H reflex in the lower limbs at stimulation frequencies of 0.1, 1, 2, and 5 Hz in a five consecutive pulses protocol. Results An impairment of the RDD of the H reflex at frequencies ≥1 Hz was found. Statistically significant differences were found when comparing the mean RDD of the H reflex in Pre-intervention compared to Post-intervention at 1, 2, and 5 Hz stimulation frequencies. Mean latencies were statistically lower when comparing Pre- vs Post-intervention. Conclusion Results suggest a partial reduction in spasticity represented by decrease of the excitability of the neural elements involved in the RDD of the H reflex following DN. The RDD of the H reflex could be implemented as an objective tool to monitor changes in spasticity in larger DN trials.
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Affiliation(s)
- Felix León
- Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México, Campus Norte, Huixquilucan, Estado de México, México
| | - Leticia Manzo
- Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México, Campus Norte, Huixquilucan, Estado de México, México
| | - Rebeca Kababie
- Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México, Campus Norte, Huixquilucan, Estado de México, México
| | - Jimena Figueroa
- Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México, Campus Norte, Huixquilucan, Estado de México, México
| | - Carlos Cuellar
- School of Sport Sciences, Universidad Anáhuac México, Campus Norte, Huixquilucan, Estado de México, México
| | - Pablo Herrero
- IIS Aragon, University of Zaragoza, Department of Physiatry and Nursing, Faculty of Health Sciences, Zaragoza, CP 50009, Spain
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Asadi B, Cuenca-Zaldivar JN, Nakhostin Ansari N, Ibáñez J, Herrero P, Calvo S. Brain Analysis with a Complex Network Approach in Stroke Patients Based on Electroencephalography: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:666. [PMID: 36900671 PMCID: PMC10000667 DOI: 10.3390/healthcare11050666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/18/2023] [Accepted: 02/22/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND AND PURPOSE Brain function can be networked, and these networks typically present drastic changes after having suffered a stroke. The objective of this systematic review was to compare EEG-related outcomes in adults with stroke and healthy individuals with a complex network approach. METHODS The literature search was performed in the electronic databases PubMed, Cochrane and ScienceDirect from their inception until October 2021. RESULTS Ten studies were selected, nine of which were cohort studies. Five of them were of good quality, whereas four were of fair quality. Six studies showed a low risk of bias, whereas the other three studies presented a moderate risk of bias. In the network analysis, different parameters such as the path length, cluster coefficient, small-world index, cohesion and functional connection were used. The effect size was small and not significant in favor of the group of healthy subjects (Hedges'g = 0.189 [-0.714, 1.093], Z = 0.582, p = 0.592). CONCLUSIONS The systematic review found that there are structural differences between the brain network of post-stroke patients and healthy individuals as well as similarities. However, there was no specific distribution network to allows us to differentiate them and, therefore, more specialized and integrated studies are needed.
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Affiliation(s)
- Borhan Asadi
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain
| | - Juan Nicolás Cuenca-Zaldivar
- Grupo de Investigación en Fisioterapia y Dolor, Departamento de Enfermería y Fisioterapia, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
- Physical Therapy Unit, Primary Health Care Center “El Abajón”, 28231 Las Rozas de Madrid, Spain
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute—Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain
| | - Noureddin Nakhostin Ansari
- Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran P.O. Box 14155-6559, Iran
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran P.O. Box 14155-6559, Iran
| | - Jaime Ibáñez
- BSICoS Group, IIS Aragón, Universidad de Zaragoza, 50018 Zaragoza, Spain
- Department of Bioengineering, Imperial College, London SW7 2AZ, UK
| | - Pablo Herrero
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain
| | - Sandra Calvo
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain
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Javier-Ormazábal A, Herrero P, González-Platas M. Ultrasound-Guided Percutaneous Neuromodulation in Multiple Sclerosis: A Case Report. Degener Neurol Neuromuscul Dis 2023; 13:15-20. [PMID: 36733290 PMCID: PMC9888012 DOI: 10.2147/dnnd.s395082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/18/2023] [Indexed: 01/28/2023] Open
Abstract
Multiple sclerosis is a degenerative inflammatory disease that causes different musculoskeletal problems. Its impact has led to the study of treatment alternatives such as the use of invasive physiotherapy. In this study, we analyze the effects of ultrasound-guided percutaneous neuromodulation to a 51-year-old man suffering from multiple sclerosis and an associated hemiparesis in the left upper limb. A dry needling needle was placed in contact with the median nerve under ultrasound guidance and 10 trains of 10 seconds of electrostimulation with a frequency of 10 Hz and an impulse width of 240 µs were applied, with 10 seconds of pause between them. There was a significant improvement in the grip strength immediately after the treatment which increased progressively at 24 hours and at 4 days follow-up. There was also an improvement in the hand function, with a decrease in the time necessary to perform the 9 Hole Peg Test immediately after the treatment, which was maintained at 24 hours and at 4 days follow-up. Future studies with larger samples are needed to further test the effects of this invasive physiotherapy technique as well as its possible applications to other neurological conditions.
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Affiliation(s)
- Alberto Javier-Ormazábal
- Neurology Service, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain,Biomedicine Department, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Pablo Herrero
- IIS Aragon, Universidad de Zaragoza, Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Zaragoza, Spain,Correspondence: Pablo Herrero, IIS Aragon, Universidad de Zaragoza, Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, C/ Domingo Miral s/n CP, Zaragoza, 50009, Spain, Email
| | - Montserrat González-Platas
- Neurology Service, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain,Biomedicine Department, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
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