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.