Network meta-analysis ranks acupuncture modalities for post-stroke upper limb dysfunction.

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Frontiers in Medicine Published April 22, 2026 Medically reviewed April 25, 2026 DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Consider acupuncture as an adjunctive option for post-stroke upper limb dysfunction, noting optimal modalities differ by treatment duration.

This is a systematic review and network meta-analysis of 103 studies including 9,351 patients with post-stroke upper limb motor dysfunction. The review synthesized evidence on various acupuncture modalities combined with physical therapy, ranking their effectiveness for motor function, activities of daily living, and upper limb hypertonia.

For treatment durations greater than one month, conventional physical therapy plus body acupuncture plus electroacupuncture (CP_BA_EA) was ranked most effective for motor function (SUCRA = 79.67%), while CP_BA_EA was superior for activities of daily living (SUCRA = 99.13%). For upper limb hypertonia, conventional physical therapy plus scalp acupuncture plus body acupuncture (CP_SA_BA) was most effective (SUCRA = 81.53%).

For treatment durations of one month or less, a traditional Chinese medicine combined with a new minimally invasive acupuncture method (CM_NM) was ranked best for motor function (SUCRA = 99.96%), CP_SA_BA was optimal for activities of daily living (SUCRA = 96.43%), and CP_SA_BA was also optimal for upper limb hypertonia (SUCRA = 87.77%).

The authors note inherent methodological limitations and that major international guidelines adopt a cautious stance. Safety data were not reported. The review concludes that acupuncture should be regarded as a potential adjunctive intervention rather than an independent therapy, with optimal interventions varying by treatment duration.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedApr 2026

View Original Abstract ↓

PurposeThis study seeks to assess optimal acupuncture modalities in improving motor function (MF), activities of daily living (ADL), spasticity, and other sequelae.MethodsAs of August 29, 2024, we searched eight databases (PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure, SinoMed, China Science and Technology Journal Database, Wanfang). The searched reports were screened, and related data were extracted. Study quality was assessed via Cochrane RoB 2.0. Data analyses were performed using R 4.4.2 and Stata 15.ResultsThis analysis included 103 studies (9,351 patients). Our analysis indicated that conventional physical therapy (CP) plus body acupuncture (BA) plus electroacupuncture (EA) (CP_BA_EA) (SUCRA = 79.67%) was the most effective for improving MF with treatment > one month. For treatment duration ≤ one month, traditional Chinese medicine (CM) combined with a new minimally invasive acupuncture method (NM) (CM_NM) (SUCRA = 99.96%) was more beneficial. In enhancing ADL, for treatment duration > one month, CP_BA_EA (SUCRA = 99.13%) was superior; (CP_SA_BA(SUCRA=96.43%) was optimal for treatment duration ≤ one month. Regarding upper limb hypertonia, CP plus scalp acupuncture (SA) plus BA (CP_SA_BA) was most effective when the treatment duration exceeded one month (SUCRA = 81.53%); for the treatment duration ≤ one month, CP_SA_BA was optimal (SUCRA = 87.77%).ConclusionNo monotherapy comprehensively relieves upper limb motor dysfunction, while combination therapies appear to be promising. Optimal interventions vary by treatment duration even for identical outcomes. However, in light of the cautious stance adopted by major international guidelines and the inherent methodological limitations, acupuncture should be regarded as a potential adjunctive intervention rather than an independent therapy.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024589860 in PROSPERO, CRD42024589860.

Network meta-analysis ranks acupuncture modalities for post-stroke upper limb dysfunction.

Study Details

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Network meta-analysis ranks acupuncture modalities for post-stroke upper limb dysfunction.

Study Details

Intravenous tenecteplase improves functional outcomes but increases hemorrhage risk in non-large vessel occlusion acute ischemic stroke.

Tenecteplase improves stroke recovery but increases bleeding risk in late treatment window

Clinical research that matters. Delivered to your inbox.

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