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Published on: October 11, 2024
Systematic review and network meta-analysis of optimal acupuncture modalities for post-stroke upper limb motor
Hanyi Ye1, Sulin Tang1, Yijun Li1
1Department of Acupuncture, The Affiliated Yangming Hospital of Ningbo University, Ningbo, Zhejiang, China.
Purpose:
This study seeks to assess optimal acupuncture modalities in improving motor function (MF), activities of daily living (ADL), spasticity, and other sequelae.
Methods:
As 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.
Results:
This 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%).
Conclusion:
No 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 Registration:
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024589860 in PROSPERO, CRD42024589860.
