Acupuncture-related therapies for post-stroke pain management: a scoping review and evidence map

Post-stroke pain (PSP) is a common symptom among patients with stroke, and acupuncture-related therapies can provide pain relief. This study aimed to summarize the current status of research by mapping the evidence from clinical research on acupuncture therapies for PSP, to identify existing gaps, and to provide a foundation for future research.

A systematic search was conducted of eight databases for randomized controlled trials (RCTs) and systematic reviews/meta-analyses (SRs/MAs), from database inception to October 22, 2024. The characteristics of the RCTs, including publication profiles, study populations, intervention protocols, and outcome measures, were analyzed and explained with a combination of text and graphics. The methodological quality of RCTs and SRs/MAs was evaluated using the risk of bias (ROB) and AMSTAR2 checklists, respectively.

A total of 346 studies (339 RCTs and 7 SRs/Mas) were included in the evidence map. The earliest study was published in 1994 and the number of publications peaked in 2021. Most studies were published in China, with a limited number of studies published in English. The majority of the studies were conducted on patients in the recovery phase, with shoulder pain being the most frequently reported condition. The most widely used study design compared a combined acupuncture with rehabilitation intervention with rehabilitation alone. The most frequently used interventions were body acupuncture, electroacupuncture, scalp acupuncture, moxibustion, and warm needling. The most frequently used acupoints were Jianyu (LI15), Jianliao (SJ14), and Quchi (LI11). The most frequently involved meridians were the Stomach Meridian of Foot-Yangming (LI) and Triple Energizer Meridian of Hand-Shaoyang (TE). The forearm-upper arm region and the Eight Confluent Points-Luo-Connecting Points were the most frequently targeted area and specific acupoint, respectively. Outcome measures primarily focused on pain relief. The systematic reviews confirmed the effectiveness of acupuncture for PSP.

Acupuncture-related therapies are effective interventions for PSP relief. However, the overall research quality was low, with large evidence gaps. To promote the evidence-based practice, future studies should implement strict inclusion and exclusion criteria and standardize research procedures to ensure high quality and methodological rigor of systematic reviews.