Acupuncture plus robot therapy improves motor function in subacute stroke hemiplegia per meta-analysis
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Key Takeaway
Consider combined acupuncture and robot therapy may improve motor scores in subacute stroke, but evidence has limitations.
This systematic review and meta-analysis evaluated the efficacy of combining acupuncture with rehabilitation robot therapy versus control interventions for adults in the subacute phase of hemiplegia after ischemic stroke. It pooled data from 20 randomized controlled trials involving 1,594 patients. The specific control interventions and follow-up duration were not reported.
For the primary outcomes, combination therapy showed statistically significant improvements. The Fugl-Meyer Assessment for the upper extremity improved by a mean difference (MD) of 9.80 points (95% CI: 8.04–11.56). For the lower extremity, the MD was 4.00 points (95% CI: 2.79–5.21). Activities of daily living, measured by the Barthel Index, improved by an MD of 8.29 points (95% CI: 6.62–9.95). A secondary outcome, 'Effective Rate,' also favored combination therapy with a risk ratio of 1.17 (95% CI: 1.08–1.27).
Safety and tolerability data, including adverse events and discontinuations, were not reported. A key methodological limitation was heterogeneity attributed to differences in patients' baseline motor function across the included trials. Sensitivity analyses confirmed the robustness of the findings for the Fugl-Meyer and Barthel Index outcomes.
While this meta-analysis suggests a benefit for the combined modality in this specific subacute phase population, the evidence is tempered by the unreported safety profile and the noted heterogeneity. The findings support further investigation into integrated rehabilitation approaches but do not yet provide a definitive basis for widespread clinical adoption.
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View Original Abstract ↓
IntroductionEffective rehabilitation for persistent post-stroke motor impairment is a major clinical need. The efficacy of combining acupuncture with robot-assisted therapy for hemiplegia is unclear. This study aimed to evaluate the efficacy of combining acupuncture with rehabilitation robot (RR) for improving limb function in patients with hemiplegia after ischemic stroke.MethodsThis systematic review was conducted according to PRISMA guidelines. Eight electronic databases were searched up to November 29, 2025, for randomized controlled trials (RCTs) comparing combined acupuncture and RR therapy with control interventions in adults in the subacute phase of hemiplegia after ischemic stroke. Primary outcomes were motor function (Fugl-Meyer Assessment) and activities of daily living (Barthel Index). The risk of bias was assessed with the Cochrane RoB 2.0 tool. Meta-analyses were performed using R software (version 4.5.1).ResultsTwenty RCTs with 1,594 patients were included. Across all outcomes, combination therapy consistently proved superior: Fugl-Meyer Assessment of Upper Extremity [FMA-UE, mean difference (MD) = 9.80, 95% Confidence Interval (CI): 8.04–11.56], Fugl-Meyer Assessment of Lower Extremity (FMA-LE, MD = 4.00, 95% CI: 2.79–5.21), Barthel Index (BI, MD = 8.29, 95% CI: 6.62–9.95), and Effective Rate (risk ratio = 1.17, 95% CI: 1.08–1.27). Sensitivity analyses confirmed robust findings for FMA-UE, FMA-LE, and BI. Subgroup analysis revealed that baseline motor function contributed to heterogeneity; however, patients with poorer baseline function (FMA-UE
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