Combining Acupuncture Techniques with Rehabilitation Improves Outcomes in Post-Stroke Hemiplegia, Though Optimal Method Varies by Goal

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This systematic review and network meta-analysis examined the effectiveness of pairing different acupuncture techniques with rehabilitation therapy for people living with hemiplegia — partial paralysis on one side of the body — following a stroke. Researchers searched eight databases and identified 71 randomised controlled trials involving 6,121 patients, comparing nine different intervention combinations using Bayesian network meta-analysis methods.

The results showed that all acupuncture-plus-rehabilitation combinations outperformed rehabilitation alone, but the best-performing combination depended on the outcome being measured. For motor function, assessed using the Fugl-Meyer Assessment scale, warm needle moxibustion combined with rehabilitation was ranked the most likely optimal treatment. For activities of daily living measured by the Barthel Index, scalp acupuncture combined with rehabilitation ranked first. For the Modified Barthel Index, floating acupuncture combined with rehabilitation showed the highest efficacy, though this finding was based on only a single study. For muscle spasticity, measured by the Modified Ashworth Scale, scalp acupuncture combined with rehabilitation again performed best, though only five studies reported this outcome, limiting confidence in the result.

The authors note that evidence quality varied across comparisons and that further well-designed trials are needed to confirm these findings, particularly for less-studied combinations.

Conclusion: Current evidence supports combining acupuncture with rehabilitation therapy for post-stroke hemiplegia, with warm needle moxibustion and scalp acupuncture emerging as particularly promising options depending on the clinical goal being prioritised.

Source: Wang H, Tang X, Li P and colleagues. Frontiers in neurology (2026). View on PubMed (PMID 42870838) · doi:10.3389/fneur.2026.1878287

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