Post-Stroke Upper Limb Spasticity Treated with Complex Korean Medicine Including Acupotomy – Case Report

Background: Post-stroke spasticity is a common and debilitating complication that significantly impairs motor function and quality of life.It occurs in approximately 25% of stroke survivors, with the upper limb being one of the most commonly affected areas.Upper limb spasticity leads to reduced flexibility, joint contractures, and pain, resulting in impaired functional capacity and delayed rehabilitation.While conventional treatments such as muscle relaxants, physical therapy, and botulinum toxin injections are standard, their effectiveness may be limited in chronic cases.Acupotomy, a traditional Korean medical technique involving knife-shaped needles to mechanically release pathological soft tissue adhesions, has shown potential benefits, but clinical evidence for post-stroke spasticity remains limited.Case Presentation: A 56-year-old woman with right upper limb spasticity persisting for 2 years and 7 months following a left basal ganglia hemorrhage was treated over 8 weeks with a complex Korean medicine protocol centered on acupotomy.The treatment included 16 outpatient sessions involving acupotomy, acupuncture, electroacupuncture, and cupping therapy, while conventional rehabilitation therapy was maintained unchanged.Outcomes: Clinical evaluations using the Modified Ashworth Scale (MAS), Range of Motion (ROM), Stroke-Specific Quality of Life (SS-QoL), and EQ-5D Visual Analog Scale (VAS) showed improvements, with ROM improving by the 4th treatment and other measures by the 12th.MAS scores decreased (e.g., elbow flexion/extension: 21+), shoulder ROM improved (flexion: 150170), and quality of life scores increased (SS-QoL: 117125, EQ-5D VAS: 3070).Minor adverse effects, such as temporary local pain and bruising, resolved spontaneously within 2 days.Conclusion: This case suggests that acupotomy-centered traditional Korean medicine may be a beneficial adjunctive intervention for chronic upper limb spasticity unresponsive to standard rehabilitation.The results support further clinical research into the integration of acupotomy in spasticity management protocols.