Comparison of the Effects of Extracorporeal Shock Wave Therapy and Dry Needing on Spasticity in Poststroke Patients: A Randomized Controlled Trial

Introduction: The effective treatment of spasticity following a stroke is a critical and pressing concern. Various
therapeutic approaches, such as physiotherapy (7, 8) and medication (9, 10), have been employed. In recent years, external corporeal shockwave therapy (ESWT) and dry needling (DN) have gained popularity for managing spasticity and post-stroke pain. This study aims to conduct a comparative analysis of the effectiveness of ESWT and DN in addressing spasticity, pain, as well as upper limb function and sensation in individuals with hemiplegia.
Methods: In this study, individuals with hemiplegia were randomly assigned in a 1:1 ratio to either the External
Corporeal Shockwave Therapy (ESWT) group (n = 10) or the Dry Needling (DN) group (n = 10). We assessed Upper Extremity Functions, Sensation, Spasticity, and Pain. All measurement indicators were evaluated before treatment and immediately after a single treatment session. To determine the presence of a group *time interaction effect on the treatment's impact for each outcome variable, we used mixed-model repeated-measures ANOVAs. The between-subjects variable was the group, and time served as the within-subjects variable.
Results: Both Dry Needling (DN) and External Corporeal Shockwave Therapy (ESWT) demonstrated significant
reductions in spasticity within the biceps brachii muscle, along with notable improvements in upper extremity function tests. Moreover, both DN and ESWT led to significant enhancements in the forearm, arm, and finger; however, the same level of improvement was not observed for the hand. Tactile sensitivity, pain sensation, and light touch did not show significant improvements in either treatment group. Nonetheless, both groups experienced a significant reduction in pain levels. When we conducted a comparative analysis between these two treatment groups across all measures, no significant differences were observed (p > 0.05).
Conclusion: In individuals with hemiplegia, both External Corporeal Shockwave Therapy (ESWT) and Dry Needling (DN) have demonstrated the ability to effectively reduce pain and spasticity while enhancing upper extremity function. As a result, these treatments may be regarded as viable alternative methods for addressing the needs of individuals with hemiplegia.