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Background. Dry needling (DN) is a technique employed to mitigate spasticity and enhance functionality in stroke patients. We report the impact of DN on both corticospinal tract (CST) consistency and wrist flexors spasticity of an individual affected by stroke. Case. The participant was a 57‐year‐old male who had experienced an ischemic stroke 9 months prior. The primary outcome measures included fractional anisotropy (FA), asymmetry FA (aFA), ratio FA (rFA), and Modified Modified Ashworth Scale (MMAS). Additionally, secondary outcomes encompassed wrist extension range of motion (ROM) and performance in the box and block test (BBT). These measurements were taken both before and after the administration of DN treatment. Results. After the application of DN, the mean FA of the ipsilesional CST increased from 0.35 to 0.39, concomitantly with a decline in aFA from 0.18 to 0.13. Notably, the rFA exhibited a pre‐DN value of 0.69, which subsequently rose to 0.76 post‐DN. Moreover, a significant reduction in MMAS scores was detected, from a score of "3" prior to DN application to a post‐DN score of "1". In terms of wrist mobility, both active and passive extension ROM exhibited favorable improvements, with an increase of 12° for active extension and 16° for passive extension. Furthermore, there was a substantial improvement in the BBT score, an indicator of manual dexterity, ascending from 12 to 24. Conclusion. Enhancements in CST consistency suggest it as a potential mechanism contributing to the observed improvements following DN in this stroke case. [ABSTRACT FROM AUTHOR]

Objectives It seems that psycho-physical factors of stroke patients undergoing Transcranial direct current stimulation (tDCS) treatment can affect implicit motor learning process in patient with stroke. The aim of this study was to determine the effects and adverse effects of tDCS on motor learning process in chronic unilateral stroke patients. Methods & Materials This crossover, sham-controlled, randomized, blinded study was conducted in 2020 on 12 patients with chronic unilateral stroke (Mean±SD age, 60.33±1.87 years), (The Mean±SD time elapsed since the onset of the disease, 1.96±1.36 years) referred to Mobasher Kashani clinic in Hamadan, Iran who were selected using a convenience sampling technique. Patients were randomly divided in to 2 groups: experimental (dual tDCS+SRTT) (n=6) and sham (sham tDCS+SRTT) (n=6) groups. After 3 weeks of washing out period, patients in each group were treated in other brain stimulation group again. Data were collected using the record of reaction time and error of sequenced blocks by related software. Also, adverse effects of tDCS, pain or discomfort, attention and fatigue of patients were assessed by visual analogue scale (VAS) questionnaire. The data were analyzed using linear mixed effects. Results Data analysis showed a considerable improvement in implicit motor learning in both brain stimulation groups. The most reported sensations were itching and tingling, which continued during all stimulation sessions. The pain or discomfort of the patients was negligible during the intervention sessions. Moreover, the type of brain stimulation, the time and their interaction had no significant effect on the fatigue, attention and pain of the patients (P>0.05). Conclusion Dual-tDCS technique does not cause serious adverse effects in patients with stroke. It can be used as an effective and useful therapeutic strategy for increase in implicit motor learning in chronic stroke patients. [ABSTRACT FROM AUTHOR]

Aims The primary aim of this study is to assess the reliability of rehabilitative sonography as a non-invasive imaging technique for measuring the visible cross-sectional area (CSA) of the deep suboccipital muscles. Objectives Objectives involve determining both the intra-rater and inter-rater reliability of sonographic measurements to ensure consistent and reproducible results across different sessions and examiners. The ultimate goal is to validate rehabilitative sonography as a reliable tool for clinical and research applications in the assessment and management of musculoskeletal (MSK) conditions involving the deep suboccipital muscles. Design and setting Seventeen participants, including nine women and eight men without neck or vertebral pain, were evaluated using MSK sonography. The visible CSA of suboccipital muscles was assessed using real-time B-mode sonography in a sitting position with a linear probe (5 cm, 7.5 MHz) aligned perpendicularly to the muscle fibers of the rectus capitis posterior minor (RCPM) in one sonogram and the obliquus capitis inferior (OCI) and rectus capitis posterior major (RCPMJ) in another. Two experienced examiners performed sonography measurements, and the procedure was repeated one hour and again one day later. Results Intra-class correlation coefficient (ICC) values for Examiner 1 were 0.84 and 0.79 for RCPM, 0.84 and 0.71 for RCPMJ, and 0.86 and 0.77 for OCI at the one-hour and one-day repetitions, respectively. ICC values for Examiner 2 were 0.86 and 0.77 for RCPM, 0.77 and 0.86 for RCPMJ, and 0.61 and 0.64 for OCI at the one-hour and one-day repetitions, respectively. Inter-rater ICC values were 0.77 for RCPM, 0.82 for RCPMJ, and 0.68 for OCI. Standard error of measurement (SEM) values for Examiner 1 were 11.63 and 13.92 mm² for RCPM, 10.30 and 7.91 mm² for RCPMJ, and 22.84 and 34.61 mm² for OCI. SEM values for Examiner 2 were 11.82 and 13.40 mm² for RCPM, 11.91 and 7.04 mm² for RCPMJ, and 39.20 and 37.73 mm² for OCI. SEM values between examiners were 13.74 mm² for RCPM, 10.36 mm² for RCPMJ, and 36.03 mm² for OCI. Conclusions These findings suggest that sonography is a reliable method for measuring the CSA of the RCPM, RCPMJ, and OCI muscles, provided that the examiners are well-trained and consistent in their techniques and that the average of three measurements is used., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethics Committee of University of Social Welfare and Rehabilitation Sciences issued approval IR.USWR.REC.1401.237. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Masoudi et al.)