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. 2024 Nov 7:5:1464502.
doi: 10.3389/fresc.2024.1464502. eCollection 2024.

Efficacy of acupuncture combined with mirror therapy in the treatment of post-stroke limb movement disorders: a systematic review and meta-analysis of randomised controlled trials

Weihao Ke  1 , Hongxin Cheng  1 , Xiaoxuan Ren  2 , Liang Yang  1 , Xiaomin Lai  1 , Zhenyu Wang  3
Affiliations

Efficacy of acupuncture combined with mirror therapy in the treatment of post-stroke limb movement disorders: a systematic review and meta-analysis of randomised controlled trials

Weihao Ke et al. Front Rehabil Sci. .

Abstract

Objective: To investigate whether the combination of acupuncture and mirror therapy can improve motor impairment in stroke patients.

Design: A systematic review and meta-analysis of randomised controlled trials.

Data sources: CNKI, Wanfang, PubMed, Embase, Vip, web of since, Cochrane database and CBM database.

Eligibility criteria for selecting studies: The included randomized controlled trials compared the efficacy of acupuncture therapy (AT) combined with mirror therapy (MT) against AT, MT, and conventional rehabilitation therapy on limb motor impairment in stroke patients, with independent data extraction and study quality assessment conducted. A META analysis using fixed-effect and random-effect models was performed to calculate the mean difference (MD) in motor scores and the Total effective rate RR (Risk ratio) between the AT combined with MT group and the control group.

Main outcome measures: The Fugl-Meyer Assessment (FMA) for motor function includes the FMA-T (total FMA), FMA-UE (upper extremity FMA), and FMA-L (lower extremity FMA).

Results: A total of 42 randomized controlled trials were included, involving 3,340 patients with post-stroke motor impairment. AT combined with MT was more favorable for FMA-UE (mean difference [MD] = 6.67, 95% CI [5.60-7.93], Z = 11.42, P < 0.0001), FMA-L [MD = 3.37, 95% CI (2.99-3.76), Z = 17.31, P < 0.001], and FMA-T [MD = 6.84, 95% CI (5.92-7.77), Z = 14.48, P < 0.001]. The combined AT and MT treatment was more favorable for the Modified Barthel Index (MBI) score in post-stroke motor impairment [MD = 10.82, 95% CI (8.52-13.12), Z = 9.22, P < 0.001]. AT combined with MT was more favorable for the Modified Ashworth Scale (MAS) [MD = -0.34, 95% CI (-0.66 to -0.03), Z = 14.48, P < 0.001]. AT combined with MT was more favorable for the Total effective rate in treating post-stroke motor impairment (relative risk = 1.27, 95% confidence interval [CI] [1.19-1.37], Z = 6.54, P < 0.001).

Conclusions: AT combined with MT can effectively improve patients' motor function and daily living abilities.

Systematic review registration: PROSPERO, identifier, CRD42024559992.

Keywords: acupuncture; meta-analysis; mirror therapy; motor impairment; stroke.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of study selection for the meta-analysis.
Figure 2
Figure 2
Forest plot of FMA-T outcomes comparing AT + MT with control interventions.
Figure 3
Figure 3
Forest plot of FMA-UE outcomes comparing AT + MT with control interventions.
Figure 4
Figure 4
Forest plot of FMA-L outcomes comparing AT + MT with control interventions.
Figure 5
Figure 5
Subgroup analysis of treatment duration on FMA-L outcomes.
Figure 6
Figure 6
Subgroup analysis of treatment duration on FMA-UE outcomes.
Figure 7
Figure 7
Subgroup analysis of AT type (SA vs. BA) on FMA-UE outcomes.
Figure 8
Figure 8
Subgroup analysis of AT type (SA vs. BA) on FMA-L outcomes.
Figure 9
Figure 9
Subgroup analysis of disease stage (OP vs. SP) on FMA-L outcomes.
Figure 10
Figure 10
Subgroup analysis of disease stage (OP vs. SP) on FMA-UE outcomes.
Figure 11
Figure 11
Forest plot of MBI outcomes comparing AT + MT with control interventions.
Figure 12
Figure 12
Forest plot of MAS outcomes comparing AT + MT with control interventions.
Figure 13
Figure 13
Forest plot of total effective rate comparing AT + MT with control interventions.
Figure 14
Figure 14
Subgroup analysis of treatment duration on MBI outcomes.
Figure 15
Figure 15
Subgroup analysis of treatment duration on MAS upper limb outcomes.
Figure 16
Figure 16
Subgroup analysis of AT type (SA vs. BA) on MBI outcomes.
Figure 17
Figure 17
Subgroup analysis of disease stage (OP vs. SP) on MBI outcomes.
Figure 18
Figure 18
Subgroup analysis of disease stage (OP vs. SP) on Total effective rate outcomes.
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