Effects of dry needling on muscle spasticity in adults with neurological disorders: a systematic review

Background: Spasticity is a motor disorder often associated with decreased ROM, ADL performance, and QOL. DN has shown potential to improve spasticity by stimulating spastic muscle tissue with a stainless steel monofilament needle. Objective: To determine the effects of dry needling (DN) on muscle spasticity in adults with neurological disorders. Methods: Literature search of Cochrane, CINAHL, Google Scholar, and ProQuest was conducted. Search limits: English, journals, human subjects, 2009-2019. Selection criteria: Adults 18+ with neurological disorders and interventions included dry needling as treatment for spasticity. Two reviewers, for methodological quality based on Oxford Levels of Evidence, independently assessed each study. Results: Ten articles met the selection criteria, all showing reductions in spasticity. Secondary outcomes were reported with improvements at the impairment level including muscle length, range of motion, pain, and motor performance (Fugl-Meyer motor subscale); and at the functional level including hand dexterity (box and block test), balance (computerized dynamic posturography) and mobility (TUG). Conclusions: There is low to moderate evidence in support of using DN to decrease spasticity in adults with neurological disorders, specifically in those with a history of stroke. Limitations included lack of follow-up and small sample sizes. Further high-level research is required to determine long-term outcomes of DN in spastic muscles. There was a short-term decrease in spasticity of target muscles after the performance of DN. Evidence included improvements at the impairment and functional levels after the use of DN. DN poses as a safe, feasible option to improve spasticity and impact other targeted outcomes in adults with neurological disorders.