Expert consensus on the application of dry needling in stroke patients: A modified delphi method

Area of Science:

• Neurology
• Physical Therapy
• Rehabilitation Medicine

Background:

• Spasticity is a common challenge in stroke rehabilitation.
• Dry needling is an emerging therapeutic modality for neurological conditions.
• Expert consensus is needed to guide the effective application of dry needling in stroke care.

Purpose of the Study:

• To establish an expert consensus on the use of dry needling for treating spasticity in stroke patients.
• To define the optimal application of dry needling across different phases of stroke recovery.
• To identify key indicators and techniques for successful dry needling interventions in stroke.

Main Methods:

• A modified Delphi technique involving four rounds of expert evaluation.
• 102 international experts in stroke rehabilitation and dry needling participated.
• 35 key questions were rated on a 6-point Likert scale, with 70% consensus required.

Main Results:

• High consensus (87-91%) for dry needling in early spasticity and hypertonia phases.
• Limited consensus for dry needling application in hypotonia.
• Local twitch responses identified as critical success indicators; ultrasound-guided dry needling endorsed for precision. Effects last 48-72 hours.

Conclusions:

• Provides clear recommendations for using dry needling in stroke patients, especially during early spasticity.
• Highlights short-term benefits and the need for further research on treatment frequency and hypotonia.
• Aims to assist healthcare professionals in integrating dry needling into stroke rehabilitation programs.