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Neurophysiological and Structural-Mechanical Changes Associated with Dry Needling in Post-Stroke Spasticity: A
Bart Eeckhaut1, Steven Truijen1, Caroline Leroij1
1Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium.
Journal of Clinical Medicine
|June 12, 2026
Summary
Dry needling (DN) improves muscle properties and reduces reflex excitability in stroke survivors with spasticity. Mechanical changes are clearer than neural effects, but clinical scales don't fully reflect these improvements.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Physical Therapy
Background:
- Dry needling (DN) is increasingly used for post-stroke spasticity.
- The mechanisms underlying DN's effects on spasticity remain unclear.
- This review investigates DN's impact on muscle and neurophysiological properties.
Purpose of the Study:
- To systematically review the effects of DN on structural-mechanical muscle properties (SMMPs) and neurophysiological properties in post-stroke spasticity.
- To elucidate the mechanisms through which DN may alleviate spasticity.
Main Methods:
- Systematic literature search across major databases (Web of Science, PubMed, Scopus, Embase) following PRISMA guidelines.
- Inclusion of randomized controlled trials and case-control studies on adults with post-stroke spasticity treated with DN.
- Categorization of outcomes into SMMPs (e.g., passive range of motion, stiffness) and neurophysiological measures (e.g., H-reflex).
Main Results:
- Twelve studies were included, mostly assessing passive range of motion, which significantly increased post-DN.
- Limited studies examined structural characteristics (2) or neurophysiological outcomes (5).
- Weak correlations were found between mechanistic outcomes and clinical spasticity scores; emerging evidence suggests a potential neuroimmune role.
Conclusions:
- Dry needling appears to enhance SMMPs and moderately reduce reflex excitability in post-stroke spasticity.
- Mechanical adaptations are more consistently observed than neural changes, with neither proportionally reflected in clinical scales.
- Further research is needed due to limited evidence, small sample sizes, and methodological variability.
