| Objective: To study the effect of botulinum toxin type A combined with acupuncture for muscle spasm after stroke and fMRI. Methods: Sixty patients with muscle spasm were randomly divided into three groups. Group A was given botulinum toxin type A combined with acupuncture, group B botulinum toxin type A alone, and group C conventional therapy. Fugl-Meyer, Wolf motor function test (WMFT), modified ashworth scale, length and thickness of musculus biceps brachii through ultrasound, and changes of the fMRI before and after the treatment were recorded respectively. Results: Scores of Fugl-Meyer, WMFT and modified ashworth scale in three groups after treatment were significantly increased as compared with those at 3rd week before treatment (P<0.05). The scores of Fugl-Meyer, WMFT and modified ashworth scale in group A were significantly higher than those of the remaining two groups after treatment (P<0.05), and those in group B were significantly higher than in group C after treatment (P<0.05). Length and thickness of musculus biceps brachii in groups A and B were significantly increased before treatment as compared with those after treatment (P<0.05). Thickness of musculus biceps brachii in quiescent condition and maximal isometric contraction showed no significant difference after treatment among the three groups (P>0.05). Flexor muscle strength of the biceps brachii in groups A and B after treatment were significantly increased as compared with those in group C and before treatment (P<0.05). SM1 activation areas and activation intensity were increased after treatment in groups A and B as compared with those before treatment, and there was no significant difference in SMA and cerebellum in groups A and B before and after treatment. Conclusion: The treatment of botulinum toxin type A combined with acupuncture can alleviate the muscle spasm of the upper limbs, and improve the motor function of the upper limbs and the activities of daily living after stroke. |
