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Spasticity is a common and disabling complication following stroke, causing muscle stiffness and limiting recovery of movement and daily function. Acupuncture has been increasingly used as a complementary approach to address post-stroke spasticity, but the relative effectiveness of different acupuncture types and dosing strategies has not been well established.
Researchers conducted a systematic review and network meta-analysis, searching eight major databases for randomised controlled trials published up to December 2025. A total of 34 trials involving 3,383 patients were included. Five acupuncture modalities were examined: manual acupuncture, warm acupuncture, scalp acupuncture, fire acupuncture, and electroacupuncture. The analysis assessed outcomes including muscle spasticity scores, upper and lower limb motor function, and ability to perform daily activities.
All acupuncture types significantly improved spasticity, motor function, and independence in daily living compared with control conditions. Network meta-analysis suggested that warm acupuncture and higher treatment doses were most likely to produce the greatest reductions in spasticity. Reported adverse events were mild and included pain at the needle site, nausea, and dizziness. The certainty of the evidence was rated as limited, partly due to statistical heterogeneity across the included trials.
Conclusion: Acupuncture appears to benefit post-stroke spasticity, motor function, and daily living, with warm acupuncture at higher doses showing the strongest probability of optimal effect, though the overall quality of evidence remains limited and further high-quality trials are needed.
Source: Xiong Z, Dong J, Hua Y et al. Frontiers in neurology (2026). View on PubMed (PMID 42266579) · doi:10.1631/jzus.B2100999