{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T11:03:14Z","timestamp":1771844594912,"version":"3.50.1"},"reference-count":44,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:00:00Z","timestamp":1771632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: Response heterogeneity limits the implementation of dry needling for spasticity in multiple sclerosis (MS). This secondary analysis aimed to identify early responders and explore predictors of response. Methods: We conducted a responder analysis of a pilot randomized, double-blind, sham-controlled trial (NCT05956119) including 18 ambulatory MS patients with spasticity, randomized to a single session of dry needling (n = 9) or sham (n = 9). Sensitive responder criteria were defined as improvement \u2265 2.0 s in Timed Up-and-Go, \u22655 points in MSQOL-54 physical component, or \u226510% in 25-Foot Walk Test at 4 weeks. Results: Using these criteria, 33.3% (3\/9) of dry needling recipients were classified as responders versus 0% (0\/9) in the sham group (p = 0.214). Responders were more frequently observed among participants with relapsing\u2013remitting MS (100% vs. 40%, p = 0.090) and lower baseline disability (Expanded Disability Status Scale 3.4 vs. 4.4). A positive association was observed between baseline pyramidal subscore and physical quality-of-life change, although this did not reach statistical significance (r = 0.52, p = 0.150) in the active group. Conclusions: Approximately one-third of participants met predefined responder criteria following dry needling; however, these findings should be interpreted as preliminary signals derived from an exploratory, underpowered pilot analysis. These results are hypothesis-generating and require confirmation in adequately powered trials.<\/jats:p>","DOI":"10.3390\/brainsci16020240","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T10:00:52Z","timestamp":1771840852000},"page":"240","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Identifying Early Responders to Dry Needling for Lower-Limb Spasticity in Multiple Sclerosis: A Secondary Responder Analysis of a Pilot Randomized Controlled Trial"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8742-5308","authenticated-orcid":false,"given":"Alberto","family":"Javier-Ormaz\u00e1bal","sequence":"first","affiliation":[{"name":"Division of Physiotherapy, Hospital Universitario de Canarias, Carretera Ofra S\/N, 38320 San Crist\u00f3bal de La Laguna, Santa Cruz de Tenerife, Spain"},{"name":"Physiotherapy Department, Universidad Europea de Canarias, C. Inocencio Garc\u00eda, 1, 38300 La Orotava, Santa Cruz de Tenerife, Spain"},{"name":"Department of Physical Medicine and Pharmacology, Universidad de La Laguna, C\/Sta. Mar\u00eda Soledad S\/N, 38071 La Laguna, Santa Cruz de Tenerife, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Gonz\u00e1lez-Sierra","sequence":"additional","affiliation":[{"name":"Physiotherapy Department, Universidad Europea de Canarias, C. Inocencio Garc\u00eda, 1, 38300 La Orotava, Santa Cruz de Tenerife, Spain"},{"name":"Division of Internal Medicine, Hospital Universitario de Canarias, Carretera Ofra S\/N, 38320 San Crist\u00f3bal de La Laguna, Santa Cruz de Tenerife, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1116-5241","authenticated-orcid":false,"given":"Montserrat","family":"Gonz\u00e1lez-Platas","sequence":"additional","affiliation":[{"name":"Division of Neurology, Hospital General de Fuerteventura Virgen de la Pe\u00f1a, Carretera del Aeropuerto, Km 1, 35600 Puerto del Rosario, Las Palmas, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1016\/S0140-6736(18)30481-1","article-title":"Multiple sclerosis","volume":"391","author":"Thompson","year":"2018","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1016\/S0140-6736(08)61620-7","article-title":"Multiple sclerosis","volume":"372","author":"Compston","year":"2008","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1056\/NEJMra1401483","article-title":"Multiple Sclerosis","volume":"378","author":"Reich","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1177\/0888439002250449","article-title":"Spasticity in multiple sclerosis","volume":"17","author":"Barnes","year":"2003","journal-title":"Neurorehabil. Neural Repair."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1191\/1352458504ms1085oa","article-title":"Prevalence and treatment of spasticity reported by multiple sclerosis patients","volume":"10","author":"Rizzo","year":"2004","journal-title":"Mult. Scler."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1097\/NPT.0b013e31822a8c40","article-title":"Influence of spasticity on mobility and balance in persons with multiple sclerosis","volume":"35","author":"Sosnoff","year":"2011","journal-title":"J. Neurol. Phys. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.pmr.2015.07.003","article-title":"Spasticity management after stroke","volume":"26","author":"Bethoux","year":"2015","journal-title":"Phys. Med. Rehabil. Clin. N. Am."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta7400","article-title":"Treatments for spasticity and pain in multiple sclerosis: A systematic review","volume":"7","author":"Beard","year":"2003","journal-title":"Health Technol. Assess."},{"key":"ref_9","first-page":"CD012732","article-title":"Rehabilitation for people with multiple sclerosis: An overview of Cochrane Reviews","volume":"1","author":"Khan","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1016\/j.apmr.2013.04.020","article-title":"Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis","volume":"94","author":"Pilutti","year":"2013","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_11","unstructured":"Dommerholt, J., and Fern\u00e1ndez-de-las-Pe\u00f1as, C. (2018). Trigger Point Dry Needling: An Evidence and Clinical-Based Approach, Elsevier. [2nd ed.]."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1007\/s11916-013-0348-5","article-title":"Physiologic effects of dry needling","volume":"17","author":"Cagnie","year":"2013","journal-title":"Curr. Pain. Headache Rep."},{"key":"ref_13","unstructured":"S\u00e1nchez-Infante, J., Bravo-S\u00e1nchez, A., Jim\u00e9nez, F., and Abi\u00e1n-Vic\u00e9n, J. (2021). Effects of dry needling on muscle stiffness and neuromuscular properties. J. Clin. Med., 10."},{"key":"ref_14","first-page":"111","article-title":"Perturbation of the twitch contraction by trigger point dry needling","volume":"39","author":"Halle","year":"2016","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/j.apmr.2014.12.015","article-title":"Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain: A systematic review and meta-analysis","volume":"96","author":"Liu","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_16","first-page":"23","article-title":"Invasive Physiotherapy as a Treatment of Spasticity: A Systematic Review","volume":"12","year":"2022","journal-title":"Degener. Neurol. Neuromuscul. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Javier-Ormaz\u00e1bal, A., Gonz\u00e1lez-Platas, M., Jim\u00e9nez-Sosa, A., Herrero, P., and Lapuente-Hern\u00e1ndez, D. (2023). The Effectiveness of a Single Dry Needling Session on Gait and Quality of Life in Multiple Sclerosis: A Double-Blind Randomized Sham-Controlled Pilot Trial. Healthcare, 12.","DOI":"10.3390\/healthcare12010010"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3248","DOI":"10.1080\/09593985.2021.1978118","article-title":"Dry needling for the treatment of muscle spasticity in a patient with multiple sclerosis: A case report","volume":"38","author":"Khalifeloo","year":"2022","journal-title":"Physiother. Theory Pract."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Luque-Moreno, C., Granja-Dom\u00ednguez, A., Moral-Munoz, J.A., Izquierdo-Ayuso, G., Lucena-Anton, D., and Heredia-Rizo, A.M. (2020). Effectiveness of Dry Needling versus Placebo on Gait Performance, Spasticity, Electromyographic Activity, Pain, Range-of-Movement and Quality of Life in Patients with Multiple Sclerosis: A Randomized Controlled Trial Protocol. Brain Sci., 10.","DOI":"10.3390\/brainsci10120997"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s13256-024-04452-z","article-title":"Effects of dry needling on spasticity, cortical excitability, and range of motion in a patient with multiple sclerosis: A case report","volume":"18","author":"Choobsaz","year":"2024","journal-title":"J. Med. Case Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1589\/jpts.33.505","article-title":"Dry needling for treating spasticity in multiple sclerosis","volume":"33","year":"2021","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1212\/WNL.0000000000000560","article-title":"Defining the clinical course of multiple sclerosis: The 2013 revisions","volume":"83","author":"Lublin","year":"2014","journal-title":"Neurology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1001\/jama.2014.13128","article-title":"Minimal clinically important difference: Defining what really matters to patients","volume":"312","author":"McGlothlin","year":"2014","journal-title":"JAMA"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1177\/1352458517690823","article-title":"Multiple Sclerosis Outcome Assessments Consortium. Validity of the timed 25-foot walk as an ambulatory performance outcome measure for multiple sclerosis","volume":"23","author":"Motl","year":"2017","journal-title":"Mult. Scler."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"c332","DOI":"10.1136\/bmj.c332","article-title":"CONSORTGroup CONSORT2010 statement: Updated guidelines for reporting parallel group randomised trials","volume":"340","author":"Schulz","year":"2010","journal-title":"BMJ"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/j.apmr.2015.12.031","article-title":"Validity of the Timed Up and Go Test as a Measure of Functional Mobility in Persons with Multiple Sclerosis","volume":"97","author":"Sandroff","year":"2016","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_27","first-page":"181","article-title":"Spanish adaptation of the disease-specific questionnaire MSQOL-54 in multiple sclerosis patients","volume":"21","author":"Aymerich","year":"2006","journal-title":"Neurologia"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Meyer-Moock, S., Feng, Y.S., Maeurer, M., Dippel, F.W., and Kohlmann, T. (2014). Systematic literature review and validity evaluation of the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC) in patients with multiple sclerosis. BMC Neurol., 14.","DOI":"10.1186\/1471-2377-14-58"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.jphys.2023.08.004","article-title":"Clinimetrics: Multiple Sclerosis Walking Scale-12 (MSWS-12)","volume":"69","author":"Williams","year":"2023","journal-title":"J. Physiother."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1186\/1745-6215-11-85","article-title":"Assessing and reporting heterogeneity in treatment effects in clinical trials: A proposal","volume":"11","author":"Kent","year":"2010","journal-title":"Trials"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1136\/bmj.329.7472.966","article-title":"Individual response to treatment: Is it a valid assumption?","volume":"329","author":"Senn","year":"2004","journal-title":"BMJ"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1212\/01.wnl.0000311391.00944.c4","article-title":"Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: Botulinum neurotoxin for the treatment of spasticity (an evidence-based review): Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology","volume":"70","author":"Simpson","year":"2008","journal-title":"Neurology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1177\/0269215507072772","article-title":"Early physiotherapy after injection of botulinum toxin increases the beneficial effects on spasticity in patients with multiple sclerosis","volume":"21","author":"Giovannelli","year":"2007","journal-title":"Clin. Rehabil."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1111\/j.1748-1716.2006.01652.x","article-title":"The spinal pathophysiology of spasticity--from a basic science point of view","volume":"189","author":"Nielsen","year":"2007","journal-title":"Acta Physiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/S1474-4422(07)70193-X","article-title":"Spastic movement disorder: Impaired reflex function and altered muscle mechanics","volume":"6","author":"Dietz","year":"2007","journal-title":"Lancet Neurol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/j.1532-5415.1991.tb01616.x","article-title":"The timed \u201cUp & Go\u201d: A test of basic functional mobility for frail elderly persons","volume":"39","author":"Podsiadlo","year":"1991","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/BF02260859","article-title":"A health-related quality of life measure for multiple sclerosis","volume":"4","author":"Vickrey","year":"1995","journal-title":"Qual. Life Res."},{"key":"ref_38","first-page":"645197","article-title":"Gait variability and multiple sclerosis","volume":"2013","author":"Socie","year":"2013","journal-title":"Mult Scler Int."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.gaitpost.2011.11.026","article-title":"Body-worn motion sensors detect balance and gait deficits in people with multiple sclerosis who have normal walking speed","volume":"35","author":"Spain","year":"2012","journal-title":"Gait Posture"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"481574","DOI":"10.1155\/2015\/481574","article-title":"Functional and Structural Brain Plasticity Enhanced by Motor and Cognitive Rehabilitation in Multiple Sclerosis","volume":"2015","author":"Prosperini","year":"2015","journal-title":"Neural Plast."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/S0895-4356(99)00206-1","article-title":"Methods for assessing responsiveness: A critical review and recommendations","volume":"53","author":"Husted","year":"2000","journal-title":"J. Clin. Epidemiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/1477-7525-3-23","article-title":"Assessing sensitivity to change: Choosing the appropriate change coefficient","volume":"3","author":"Stratford","year":"2005","journal-title":"Health Qual Life Outcomes"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1191\/1352458503ms871oa","article-title":"The use of quality of life measures in multiple sclerosis research","volume":"9","author":"Nortvedt","year":"2003","journal-title":"Mult. Scler."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1002\/mus.20284","article-title":"Pathophysiology of spastic paresis. I: Paresis and soft tissue changes","volume":"31","author":"Gracies","year":"2005","journal-title":"Muscle Nerve"}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/2\/240\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T10:18:38Z","timestamp":1771841918000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/2\/240"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,21]]},"references-count":44,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["brainsci16020240"],"URL":"https:\/\/doi.org\/10.3390\/brainsci16020240","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,21]]}}}