Dry needling for treating spasticity in multiple sclerosis.
María Del Pilar Pérez-Trujillo, Montserrat González-Platas, María Yaiza Pérez-Martín and 2 others
PMID 34219954WHAT IT FOUND
Pain, spasms, walking and quality-of-life scores improved in 12 people with relapsing-remitting MS after 4 months of lower-limb dry needling, but the gains were gone one month later.
Without a control group, dry needling cannot be shown to have caused them.
Key findings
01The paper reports statistically significant improvements after treatment in right-hand pegboard time, 25WT, TUG, EDSS, VAS pain, PSFS spasm frequency, and physical and mental quality of life.
02The significant changes disappeared when outcomes were compared one month after finishing therapy, so the improvement was not maintained.
03Right-hand pegboard time improved even though dry needling was performed only on lower limbs.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 12 patients were treated, and 1 dropped out, so the sample is very small. There was no randomised control group or sham comparison; each patient's own baseline was used, so natural fluctuation, practice effects or other unmeasured changes cannot be ruled out. The paper did not name a single primary outcome, and it tested many outcomes at once. Improvements were not maintained one month after treatment. The paper's treatment schedule is inconsistent: it says 3 sessions per month for 4 months but also lists assessments at 16 sessions. Reported sex counts differ: the methods say 9 females and 3 males, while Table 1 says 8 females. The paper states that the explorer was blind, but it does not say that participants or therapists were blinded. Upper-limb fine motor improvement occurred after lower-limb dry needling, and the authors say the cause is unknown.
Declared interests
The authors declare no conflicts of interest associated with the manuscript.
The easy way to misread this
Do not read the short-term improvements as proof that dry needling causes lasting relief of MS spasticity. This was a small uncontrolled before-after series, and the significant changes disappeared one month after treatment ended.