Therapeutic Impact of Electrical Stimulation Versus Intramuscular Electrical Stimulation Via Dry Needling on Tibialis Anterior Muscle on Reducing Spasticity in Stroke Survivors: A Randomized Controlled Trial
Document Type
Article
Publication Title
Irish Journal of Medical Science
Abstract
Background
Stroke often leads to spasticity, complicating motor function recovery. Surface Electrical stimulation (ES) and intramuscular electrical stimulation (IMES) are promising interventions for modulating spasticity in stroke-affected muscles.
Aims
This study evaluated and compared the immediate effects of surface ES and IMES on spasticity in stroke survivors, focusing on the tibialis anterior muscle and its effects on the Gastrocnemius and Soleus muscles.
Methods
Sixty stroke survivors were randomly assigned to either the surface ES or IMES groups. Each intervention was applied for 30 min. Spasticity was assessed using the Modified Ashworth Scale (MAS) and H-reflex parameters, including maximum latency, H-amplitude, M-amplitude, and the H/M ratio, measured before and after a single intervention session. Electromyographic data were analyzed to capture changes in spasticity markers, and effect sizes were calculated to evaluate within-group changes and between-group differences. Statistical analysis was conducted using MANOVA.
Results
Both surface ES and IMES groups showed significant improvements in MAS scores and increased H-reflex latency in the Gastrocnemius and Soleus muscles (P = 0.02, effect size = 0.34). The IMES group uniquely reduced H-amplitude in the Gastrocnemius muscle with small effect size = 0.26. No significant differences were found between the groups across spasticity measures (P > 0.05).
Conclusion
Surface ES and IMES effectively reduce post-stroke spasticity, with IMES showing additional neurophysiological benefits in the Gastrocnemius muscle. Both techniques are viable for immediate spasticity reduction, though further research is needed to explore long-term effects and underlying mechanisms.
DOI
10.1007/s11845-025-04261-3
Publication Date
1-8-2026
Keywords
Electromyography, Neuromuscular stimulation, Neuroplasticity, Rehabilitation, Spasticity management
ISSN
1863-4362
Recommended Citation
Al Amin R, Abbas RL, Ali AS, Saab IM, AlKhatib S, El Melhat AM. Therapeutic Impact of Electrical Stimulation Versus Intramuscular Electrical Stimulation Via Dry Needling on Tibialis Anterior Muscle on Reducing Spasticity in Stroke Survivors: A Randomized Controlled Trial. Irish Journal of Medical Science. 2026; . doi: 10.1007/s11845-025-04261-3.
