Kim Jiwoo, Ahn Taeseok, Moon Jihyun, So Youngjo, Cho Hyeon-Gyu, Ji Sangho, Oh Myungjin, Lee Sangkwan, Kim Cheol-Hyun
Department of Internal Medicine, College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea.
VARO Korean Medicine Clinic, Seoul 07714, Republic of Korea.
Life (Basel). 2025 May 10;15(5):766. doi: 10.3390/life15050766.
Post-stroke equinovarus foot (EVF) impairs gait stability, increases the risk of secondary injuries, and contributes to elevated healthcare costs. However, effective targeted interventions for EVF remain limited.
Two patients with chronic EVF-a 63.5-year-old male (9.7 months post-stroke) and a 35.7-year-old female (24.5 months post-stroke)-presented with ankle deformity, gait asymmetry, and impaired balance, all of which interfered with daily activities.
Both patients underwent ultrasound-guided acupotomy targeting spastic ankle muscles, administered over four sessions within two weeks. A quantitative gait analysis revealed substantial improvements in step length ratios (Case 1: 0.61 → 0.86; Case 2: 0.67 → 0.88), as well as enhancements in walking velocity, lateral symmetry, postural balance, and Modified Ashworth Scale scores. No adverse events were reported. Protocol proposal: Based on these observations, a prospective randomized controlled trial is planned to compare ultrasound-guided acupotomy plus conventional therapy versus conventional therapy alone. Outcomes will be assessed quantitatively using gait analysis. Lessons and implications: Ultrasound-guided acupotomy may offer a minimally invasive, targeted approach to releasing spastic muscles while preserving neurovascular structures, thereby improving gait function in patients with post-stroke EVF.
中风后马蹄内翻足（EVF）会损害步态稳定性，增加二次受伤风险，并导致医疗成本上升。然而，针对EVF的有效靶向干预措施仍然有限。
两名慢性EVF患者——一名63.5岁男性（中风后9.7个月）和一名35.7岁女性（中风后24.5个月）——出现踝关节畸形、步态不对称和平衡受损，所有这些都干扰了日常活动。
两名患者均接受了针对痉挛性踝关节肌肉的超声引导针刀治疗，在两周内分四次进行。定量步态分析显示步长比有显著改善（病例1：0.61 → 0.86；病例2：0.67 → 0.88），同时步行速度、侧向对称性、姿势平衡和改良Ashworth量表评分也有所提高。未报告不良事件。方案提议：基于这些观察结果，计划进行一项前瞻性随机对照试验，比较超声引导针刀治疗联合传统疗法与单纯传统疗法。将使用步态分析对结果进行定量评估。经验与启示：超声引导针刀治疗可能提供一种微创、靶向的方法来松解痉挛性肌肉，同时保留神经血管结构，从而改善中风后EVF患者的步态功能。
