DRY NEEDLING WITH INTRAMUSCULAR ELECTRICAL STIMULATION IMPROVES UPPER-LIMB IMPAIRMENTS AFTER CHRONIC ISCHEMIC STROKE: A RANDOMIZED CONTROLLED TRIAL

Background: Dry needling is increasingly being used to manage post-stroke upper-limb spasticity, but evidence remains limited for protocols that deliver electrical stimulation through dry-needling. Objective: The study determined whether adding dry needling with intramuscular electrical stimulation to conventional physical therapy improves spasticity and motor outcomes in patients with chronic ischemic stroke. Methods: In this assessor-blinded randomized controlled trial, 64 participants were allocated to DN+ES+CPT or CPT alone for 6 weeks. Spasticity (Modified Ashworth Scale) was the primary outcome. Secondary outcomes were upper-limb motor impairment (Fugl–Meyer Assessment Scale), H-reflex latency, and the Hmax/Mmax ratio. Assessments were conducted at baseline, week 3, and week 6. Results: By week 6, the DN+ES+CPT group achieved greater motor improvement than CPT (FMAS Δ=+8.95 vs +4.60; p=0.002; d=0.73) and reduction in spasticity (MAS Δ=−1.56 vs −0.80; p