Efficacy of dry needling in reducing spasticity after stroke: A systematic review and meta-analysis.

Objective

To assess the effectiveness of dry needling (DN) in reducing spasticity among post-stroke patients through meta-analysis. DATA SOURCES PubMed, Web of Science, PEDro, Cochrane Library, CINAHL, and Embase were searched up to April 2026, alongside manual searches of reference lists. STUDY SELECTION Randomized controlled trials (RCTs) involving adults (>18 years) with post-stroke spasticity, investigating DN alone or as part of a multimodal intervention, were included. DATA EXTRACTION Two reviewers independently extracted data, primarily focusing on changes in the Modified Ashworth Scale (MAS) and the Modified Modified Ashworth Scale (MMAS). DATA SYNTHESIS Eleven RCTs (276 patients) were included. Overall, DN significantly reduced spasticity compared to the control group (mean difference [MD] = -0.65). DN was effective for both upper (MD = -0.40) and lower limbs (MD = -1.02), with the most robust effect in ankle plantar flexors (MD = -1.05). Significant improvements occurred whether DN was compared to sham interventions (MD = -0.45) or added to conventional neurorehabilitation (MD = -0.76). While study quality was generally high (PEDro scores 5-9/10), GRADE certainty was Moderate to Low due to small sample sizes and blinding bias.

Conclusions

DN is an effective short-term intervention and a potent adjunct to standard rehabilitation for reducing post-stroke spasticity in both upper and lower extremities. Further research is needed to evaluate its long-term functional impact.