A Proposed Acupotomy Treatment Strategy for Post-Stroke Motor Impairments: An Anatomical Approach

Background: Post-stroke motor impairment is often characterized by abnormal synergy patterns, spasticity, and neuromuscular dysfunction.While acupuncture is widely used in stroke rehabilitation, acupotomy remains underutilized, and systematic treatment approaches are lacking.Methods: This study introduces a structured acupotomy-based treatment strategy for poststroke motor dysfunction, developed through anatomical and pathophysiological analysis.Hypertonic muscles were treated with needling perpendicular to muscle fibers to reduce excessive tone, whereas hypotonic muscles received insertions parallel to the fibers to support recovery.Peripheral nerve stimulation techniques were incorporated to activate weakened motor pathways and facilitate neuromuscular responsiveness.Results: The proposed strategy addresses key motor impairments by targeting pathological changes in muscle and nerve structures.Interventions begin with the cranio-cervical region, where suboccipital muscle release and superficial venous drainage are applied to improve postural control and modulate intracranial pressure.In the upper limb, spastic flexors and weakened extensors are selectively treated to restore functional balance.In the lower limb, excessive extensor tone is reduced, and weakened flexors are activated to support coordinated gait.Spinal and peripheral nerves innervating the affected muscles are also stimulated to enhance neuromuscular recovery.Conclusion: This anatomically guided acupotomy treatment strategy offers a dual-targeted approach focusing on both muscle tone and neural input.By addressing spasticity and weakness in a region-specific manner, it may help improve abnormal coordination patterns and support functional recovery.Further clinical studies are warranted to evaluate its therapeutic potential.