Network meta-analysis of different acupuncture methods for post-stroke upper-limb spasticity

Introduction: Currently, acupuncture therapy is widely used for post-stroke upper-limb spasticity. However, the available evidence remains insufficient to determine the relative effectiveness of different acupuncture protocols. Methods: This study retrieved relevant databases and systematically reviewed randomized controlled trials (RCTs) on acupuncture treatment for post-stroke upper-limb spasticity. A total of 28 trials involving 14 acupuncture treatment protocols were included. A network meta-analysis was performed using Stata 18 software. Results: The results indicated that the Balanced Yin-Yang Acupuncture + Rehabilitation yielded the best outcomes in improving Fugl-Meyer Assessment scores, while Luan's Three-Needle Technique combined with Meridian Sinew Cluster Needling + Rehabilitation was most effective in reducing modified Ashworth scale scores. Discussion: A comparison of efficacy indicators across 14 different acupuncture methods combined with rehabilitation showed that Balanced Yin-Yang Acupuncture + Rehabilitation and Luan's Three-Needle Technique combined with Meridian Sinew Cluster Needling + Rehabilitation were more effective in treating post-stroke upper-limb spasticity. Owing to limitations in the current body of research, these conclusions need to be further verified by more high-quality randomized controlled trials. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO, identifier CRD420251110982.