Interventions, findings, conclusions and comments
| Study | Intervention | Outcome measures | Results | Conclusion/Comments |
|---|---|---|---|---|
| McDowell et al., 2015 [28] | Dry needling at the L4 level to the multifidus; gluteus maximus, gluteus medius and gluteus minimus; right upper trapezius muscle | Subjective reports of fecal incontinence, lower limb heaviness and increased fatigue | After dry needling treatment, fecal incontinence seizure and a feeling that starts as a “cotton wool” feeling in the legs and turns into a “heavy leg” | It describes fecal incontinence, lower limb heaviness and increased fatigue shortly after dry needling was performed in a patient with MS and emphasizes that special care should be taken in the treatment of dry needling in these patients with MS |
| Miller et al., 2022 [27] | 2 days a week for 12 weeks, 1–4 weeks intramuscular electrical stimulation to the medial and lateral heads of the gastrosoleus followed by functional electrical stimulation assisted treadmill treatment combination application, 5–12 weeks only functional electrical stimulation assisted treadmill treatment combination application | Timed 25-foot walk (T25FW), 6-minute walk test (6MWT), Berg balance scale (BBS), Modified Ashworth Scale (MAS), 10-second foot tap test, heel raises until fatigue, modified fatigue impact scale (MFIS) | Significant increase in 6MWT results, significant decrease in T25FW results, significant increase in the number of heel raises to exhaustion, significant decrease in MAS, improvement in fatigue levels measured by MFIS in (56%) of participants | The applied treatment combination has the potential to reduce spasticity and increase walking speed and endurance in patients with MS |
| Luque-Moreno et al., 2020 [26] | Once a week for 2 weeks, dry needling with the “fast in fast out” technique on the midpoint of the muscle body of the rectus femoris and gastrocnemius medialis until at least 3–4 local twitch responses are obtained | Visual analog scale (VAS), algometer, MAS, ROM, 2MWT, MS international quality of life questionnaire (MusiQoL) | Decrease in pain in the rectus femoris muscle according to VAS, increase in pain tolerance in the gastrocnemius medialis muscle and decrease in the rectus femoris muscle in algometer measurements, decrease in spasticity in both muscles according to the MAS, improvement in gait speed, increase in quality of life score | The authors imply a functional improvement in walking even in the case of progressive disease, but changes in perceived pain and ROM are not conclusive. Continued research in this area is needed to obtain more evidence |
| Khalifeloo et al., 2022 [29] | Single session of 1 min dry needling application to the long head of the biceps femoris muscle and semitendinosus muscle using the “fast in fast out” technique | T25FW, MAS, hamstring stiffness | A 43% improvement in the T25FW, a 31% decrease in muscle stiffness and a reduction in spasticity for both muscles | It shows that treatment using dry needling has a positive effect on spastic muscles and improves mobility in this patient with MS. Further research is needed to evaluate the effects of dry needling in MS patients with spasticity |
| Javier-Ormazábal et al., 2023 [25] | Single session, ultrasound-guided percutaneous neuromodulation with dry needling on the median nerve between the two heads of the pronator teres muscle | 9-hole peg test (9HPT), grip strength measured with a dynamometer | A significant increase in grip strength immediately after treatment and a gradual increase at day 1 and day 4 follow-up, improvement in hand function immediately after treatment and this improvement was maintained at 4-day follow-up | It shows that a single session of ultrasound-guided percutaneous neuromodulation may be effective to improve hand function and grip strength in a patient with MS. The application of dry needling and percutaneous neuromodulation in patients with neurological impairment should be investigated with larger samples and randomized controlled trials |
| Del Pilar Pérez-Trujillo et al., 2021 [24] | Dry needling only on the lower extremities (muscles not specified) for 4 months, 3 times a month | The Penn spasm frequency scale (PSFS), VAS of spasticity, EDSS score, The timed-up and go (TUG) test, T25FW, 9HPT, multiple sclerosis quality of life-54 (MSQoL-54) | Reduction in spasticity in the lower extremities in treated muscles, improvement in upper extremity function despite no treatment, improvement in EDSS score, improvement in T25FW and TUG test, improvement in PSFS and VAS scores, improvement in quality of life (Significant changes disappeared in all tests one month after treatment) | Dry needling in patients with MS is reported to contribute to improvements in spasticity, upper limb function, mobility, pain and quality of life, but the effect is not permanent. A larger sample is needed to predict long-term outcomes in MS patients and to validate the application of the technique |
| León et al., 2023 [30] | The protocol consisted of seven dry needling sessions, once per week. Dry needling was performed bilaterally in the vastus lateralis, vastus medialis, biceps femoris, and semitendinosus muscles | Baseline data of the RDD of the H reflex, 10MWT, and the 6MWT were evaluated in the first session before dry needling | 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 dry needling. Walking distance is increased at 6MWT | The RDD of the H reflex could be used as a biomarker of spasticity. A larger sample is warranted for evaluating the RDD of the H reflex to study central and peripheral nervous mechanisms of dry needling on spasticity |
