International Journal of Radiation Research

en 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 Radiation Biology Radiation Biology تحقيق بديع Original Research <div style="text-align: justify;">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.</div> Stroke, muscle spasticity, botulinum toxins, type A, electroacupuncture, radiotherapy. 591 597 http://ijrr.com/browse.php?a_code=A-10-1-1545&slc_lang=en&sid=1 W. Wang 7900319475328460034092 7900319475328460034092 No Department of Rehabilitation Medicine, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou 225300, Jiangsu Province, China S. Wang 7900319475328460034093 7900319475328460034093 No Department of Rehabilitation Medicine, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou 225300, Jiangsu Province, China T. Tang 7900319475328460034094 7900319475328460034094 No Department of Traditional Chinese Medicine, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou 225300, Jiangsu Province, China Y. Zhao jswwj1991@163.com 7900319475328460034095 7900319475328460034095 Yes Department of Neurology, Taizhou Fourth People's Hospital, Taizhou 225300, Jiangsu Province, China