Evidence map›Paper›PMID 41504817›Full record

Trial reportIrish journal of medical science2026

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.

Ranim Al Amin, Rami L Abbas, Ahmed S Ali, Ibtissam M Saab, Salma AlKhatib, Ahmed M El Melhat

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Irish journal of medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ranim Al AminDepartment of Physical Therapy, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.
Rami L AbbasDepartment of Physical Therapy, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon. r.abbas@bau.edu.lb.ORCID http://orcid.org/0000-0002-6520-4069
Ahmed S AliDepartment of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Jouf University, Al-Qurayyat, Saudi Arabia.
Ibtissam M SaabDepartment of Physical Therapy, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.
Salma AlKhatibKansas City University - College of Osteopathic Medicine, Kansas City, MO, USA.
Ahmed M El MelhatDepartment of Physical Therapy, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStroke 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.

aimsThis 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.

methodsSixty 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.

resultsBoth 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).

conclusionSurface 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. CLINICAL TRIAL REGISTRY NUMBER: Pan African clinical trial registry (PACTR202101475345034) /Date of Approval: 28 Jan 2021.

Indexed as

Dry NeedlingElectric Stimulation TherapyMuscle, SkeletalMuscle SpasticityStrokeStroke RehabilitationAdultAgedElectromyographyFemaleH-ReflexHumansMaleMiddle AgedTreatment OutcomeElectromyographyNeuromuscular stimulationNeuroplasticityRehabilitationSpasticity management

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.