Network meta-analysis reviews acupuncture for post-stroke spasticity
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Key Takeaway
Consider that acupuncture may improve post-stroke spasticity, but evidence certainty requires careful interpretation.
This publication is a systematic review and exploratory network meta-analysis. Its scope is to evaluate the efficacy of various acupuncture techniques for post-stroke spasticity. The analysis included a total sample size of 3,383 patients.
The authors synthesized evidence on manual acupuncture, warm acupuncture, scalp acupuncture, fire acupuncture, and electro-acupuncture. The primary outcome was the Fugl-Meyer Assessment (FMA). The main finding was that acupuncture significantly improved the Fugl-Meyer Assessment, with a mean difference of 0.87 (95% CI 0.68, 1.07). The direction of effect was improvement.
The review employed the GRADE framework to assess the reliability and certainty of the evidence. Adverse events related to acupuncture were collected, but serious adverse events, discontinuations, and overall tolerability were not reported.
The authors did not report specific limitations, funding, or conflicts of interest. The practice relevance was not reported. This synthesis provides a qualitative conclusion based on the available network meta-analysis, and the findings should be interpreted with caution given the exploratory nature of the analysis.
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View Original Abstract ↓
Background and purposeAcupuncture has shown good therapeutic potential in post-stroke spasticity (PSS). We aimed to evaluate the clinical efficacy and optimal acupuncture type and dose of acupuncture for PSS.MethodsA comprehensive literature search was conducted across 8 databases (PubMed, Embase, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Databases (VIP), Chinese Biomedical Literature database (Sinomed), and Wan Fang database) to search randomized controlled trials (RCTs) of acupuncture for PSS from their inception to December 1, 2025. Data analysis and network meta-analysis (NMA) were conducted using StataMP 18 software. The risk of bias was evaluated using RevMan 5.3 software. Adverse events (AEs) related to acupuncture were collected to assess the safety of acupuncture therapy. The optimal type and dose of acupuncture for anti-spasticity effects were evaluated by using the acupuncture dose-effect relationship evaluation model. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) were employed to assess evidence reliability and certainty.ResultsThis meta-analysis included 34 trials and 3,383 PSS patients, with manual acupuncture (MA), warm acupuncture (WA), scalp acupuncture (SA), fire acupuncture (FA), and electro-acupuncture (EA). The findings showed that acupuncture significantly improved the Fugl-Meyer Assessment (FMA) [FMA-U: MD = 0.87, 95% CI (0.68, 1.07), p
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