Effects of Dry Needling on Connectivity of Corticospinal Tract, Spasticity, and Function of Upper Extremity in People with Stroke: Study Protocol for a Randomized Controlled Trial

Abstract

Spasticity is a common motor disorder in adult stroke patients. Injury to the corticospinal tract (CST) is associated with spasticity. Dry needling (DN) has positive impacts on spasticity reduction and improvement in the range of motion (ROM) in strokepatients. This study aims to investigate the effectiveness of DN on the connectivity of theCST and the level of spasticity in adult stroke patients.Methods: This double-blind randomized controlled trial will enroll and randomly assignstroke patients to either the experimental group, for receiving three sessions of DN forthe spastic wrist flexors, or the control group, for sham needling. The primary outcomemeasures will be diffusion tensor imaging and the Modified Modified Ashworth Scale scoreto assess CST connectivity and wrist flexor spasticity, respectively. The Box and BlockTest and standard goniometry are the secondary outcome measures to assess handdexterity and active and passive wrist ROM, respectively. Measurements will be takenboth before and after the intervention.Discussion: The results of this study will provide important evidence of the effects of DNon CST connectivity, spasticity, and arm function in adult stroke patients.Trial registration: This trial is registered in the Iranian Registry of Clinical Trials (IRCT)(https://www.irct.ir;IRCT20191208045649N1)