Effects of dry needling on spasticity in multiple sclerosis evaluated through the rate-dependent depression of the H Reflex: a case report

León, Felix ; Manzo, Leticia ; Kababie, Rebeca ; Figueroa, Jimena ; Cuellar, Carlos ; Herrero, Pablo (Universidad de Zaragoza)

Resumen: 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.

Idioma: Inglés

DOI: 10.2147/IMCRJ.S391201

Año: 2023

Publicado en: International Medical Case Reports Journal Volume 16 (2023), 293-302
ISSN: 1179-142X

Factor impacto CITESCORE: 1.4 - Medicine (all) (Q2)

Factor impacto SCIMAGO: 0.267 - Medicine (miscellaneous) (Q3)

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Fisioterapia (Dpto. Fisiatría y Enfermería)