Effectiveness of scalp acupuncture therapy combined with training on limb movement disorders after stroke: A systematic review and meta-analysis

Abstract

Introduction

Stroke patients often suffer from different degrees of disability, among which limb movement disorders (LMDs) are the most prevalent. Scalp acupuncture (SA) therapy combined with training has been widely used for LMD treatment after stroke. Whether SA therapy combined with training is superior to monotherapy or other therapies remains unknown. This review aimed to evaluate the effectiveness and safety of SA therapy combined with training for LMDs after stroke.

Methods

PubMed, EMBASE, Web of Science, and Cochrane Library databases were thoroughly searched for studies from inception to November 23, 2024. Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS), Berg Balance Scale (BBS), and Modified Barthel Index (MBI) were used to evaluate the effectiveness of SA therapy combined with training in treating LMDs after stroke. Weighted mean differences (WMDs) were calculated.

Results

A total of 4345 records were initially identified, and 26 studies were finally included. Compared to simple training, SA therapy combined with training had significant effects in the total score of FMA (WMD= 10.01, 95 %CI= 2.24, 17.78), the upper-extremity score of FMA (WMD= 6.35, 95 %CI=4.11, 8.59), the lower-extremity score of FMA (WMD= 2.69, 95 %CI= 1.49, 3.90), MAS (WMD= -0.47, 95 %CI= -0.72, -0.22), BBS (WMD= 3.52, 95 %CI= 0.55, 6.48), and MBI (WMD= 7.72, 95 %CI= 4.97, 9.56). No significant difference was found in adverse events (RR= 6.97, 95 %CI= 2.10, 23.11, P = 0.33). More significant effects in FMA-L and MAS were revealed after 12 weeks of treatment (all P _interaction<0.01).

Conclusion

SA therapy combined with training can significantly improve FMA, MAS, BBS, and MBI to enhance limb function, with favorable safety profiles. 12 weeks of SA therapy combined with training often yields better improvements in lower limb motor function and limb spasticity. More RCTs of higher quality are needed to provide reliable support for these conclusions.