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Effectiveness of combined targeted muscle botulinum toxin type A injection, electroacupuncture, and radiotherapy in improving pain and muscle tone in patients with post-stroke upper limb spasticity
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W. Wang   , S. Wang , T. Tang , Y. Zhao |
| Department of Neurology, Taizhou Fourth People's Hospital, Taizhou 225300, Jiangsu Province, China , jswwj1991@163.com |
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Abstract: (9 Views) |
Background: Post-stroke upper limb spasticity (ULS) significantly impairs motor function and quality of life. While botulinum toxin type A (BTX-A) injections reduce muscle tone peripherally, electroacupuncture modulates central neural activity, and radiotherapy offers anti-inflammatory and neuromodulatory effects. This study evaluates the synergistic efficacy of combining these modalities. Materials and Methods: In this randomized controlled trial, 112 patients with post-stroke ULS were allocated to an experimental group (AG: BTX-A + electroacupuncture + radiotherapy, n=56) or control group (BG: BTX-A + electroacupuncture, n=56). BTX-A (Botox, Allergan) was injected into targeted muscles, electroacupuncture applied at specific acupoints, and radiotherapy delivered using low-dose ionizing radiation (Beijing Huayu Radiotherapy System, China) at 2 Gy/fraction for 10 sessions. Primary outcomes: Modified Ashworth Scale (MAS) for muscle tone and Visual Analogue Scale (VAS) for pain. Secondary outcomes: Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and Modified Barthel Index (MBI). Assessments at baseline, 2, 4, and 12 weeks. Results: MAS scores improved significantly in AG vs. BG (mean difference at 12 weeks: 1.2 points, P=0.008). VAS scores reduced more in AG (mean reduction: 3.5 points at 12 weeks, P=0.005). FMA-UE total scores increased by 12.4 points in AG vs. 7.8 in BG (P=0.012). MBI scores showed greater gains in AG (mean increase: 15.2 points, P=0.010). Radiotherapy contributed to 25% additional improvement in tone and pain metrics. Adverse events were comparable (32% AG vs. 30% BG). Conclusion: The triple combination therapy markedly enhances muscle tone, pain relief, and motor function in post-stroke ULS, with radiotherapy providing key synergistic benefits. |
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| Keywords: Stroke, muscle spasticity, botulinum toxins, type A, electroacupuncture, radiotherapy. |
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Full-Text [PDF 1087 kb]
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Type of Study: Original Research |
Subject:
Radiation Biology
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