What is it about?

Spasticity is a disabling complication of upper motor neuron syndrome that causes conditions such as traumatic brain injury. Spasticity must be controlled; otherwise, it can result in difficulties in performing daily activities.1,2 Multiple management strategies exist for severe spasticity including physiotherapy, medications, exercises, functional electrical stimulation, botulinum injection, hydrotherapy and surgery.3–5 Based on the considerable financial burden and societal costs associated with the long-term management of patients with spasticity, it is important to seek effective treatments.3 Dry needling (DN) is a relatively new intervention that has been recently suggested for the control of spasticity following stroke. Here, we report the effects of DN on a patient with a brain tumor resulting in hemiplegia after surgery, who was suffering from upper and lower limb spasticity

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Why is it important?

Based on the comparisons pre- and post-treatment, it appears that DN was effective at improving the performance of a patient with spasticity and hemiplegia due to a brain tumor. To the best of our knowledge, this is the first case report describing the use of DN in this particular clinical scenario. The mechanism of decreased spasticity induced by DN is not clear; however, a few potential explanations exist. For example, it may have been the result of central modulation such as changes in excitability of spinal reflexes, or localised changes in structure and reduction of overlap between actin and myosin filaments. Moreover, studies with a control group are required to examine the specific and non-specific effects of DN, and separate their potential placebo effects as well as natural history of the condition and regression to the mean.

Perspectives

Future studies on the effects of DN on spasticity in individuals with other types of central nervous system damage are also warranted.

Dr Ardalan Shariat
Tehran University of Medical Sciences

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This page is a summary of: The effect of dry needling on upper and lower limb spasticity in a patient with a brain tumor, Acupuncture in Medicine, March 2019, SAGE Publications,
DOI: 10.1177/0964528419830401.
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