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Meta-Analysis
. 2025 May 7;20(5):e0312918.
doi: 10.1371/journal.pone.0312918. eCollection 2025.

Efficacy of acupuncture on lower limb motor dysfunction following stroke: A systematic review and meta-analysis of randomized controlled trials

Peng Chen  1 , Xing Jin  2   3   4 , Debiao Yu  2   3   4 , Xiaoting Chen  5 , Yaoyu Lin  5 , Fuchun Wu  2   3   4 , Bin Shao  1   2   3   4
Affiliations
Meta-Analysis

Efficacy of acupuncture on lower limb motor dysfunction following stroke: A systematic review and meta-analysis of randomized controlled trials

Peng Chen et al. PLoS One. .

Abstract

Background: Acupuncture is widely used for Lower Limb Motor Dysfunction Following Stroke (LLMD) in China, though its effectiveness remains unclear. This meta-analysis aims to evaluate the effectiveness of acupuncture for LLMD.

Methods: We searched eight databases, including PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang, VIP, and CBM, up to December 2023. Randomized controlled trials on acupuncture therapy for LLMD after stroke were included in this study. Outcome measures included motor function, balance function, walking ability, and daily living activities. Two researchers conducted independent literature screening, data extraction, and quality assessment in accordance with Cochrane Collaboration network's standards. Review Manager 5.3 and Stata 17.0 were used in data analysis. Results were presented as mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (95% CI).

Results: Twelve studies involving 1318 patients, most of which showed low or unclear risk of bias, were included in this review. Meta-analysis results indicate that compared with conventional treatment, acupuncture intervention can improve scores in Fugl-Meyer Assessment for lower scale (SMD = -0.48, 95% CI [-0.92, -0.04], Z = 2.16, P = .03), Berg Balance Scale (SMD = -0.86, 95%CI [-1.65, -0.07], Z = 2.14, P = .03), Functional Ambulation Category scale (SMD = -0.74, 95%CI [-2.33, 0.84], Z = 0.92, P = .36), and Modified Barthel Index Scale (SMD = 0.27, 95%CI [-0.30, 0.84], Z = 0.94, P = .35).

Conclusion: The results of this study suggest that acupuncture combined rehabilitation training may be more effective than conventional rehabilitation alone in improving LLMD, balance function, walking ability, and daily living activities after stroke. Despite limitations due to the low quality of the included studies and methodological constraints, acupuncture combined with rehabilitation training may serve as an effective approach for the treatment of LLMD poststroke.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The flowchart of search results for meta-analysis.
Fig 2
Fig 2. (A) Risk of bias graph.
(B) Risk of bias summary.
Fig 3
Fig 3. The forest plot of FMA-L.
(A) Meta-analysis results containing FMA-L for all studies. (B) Results of subgroup analyses of FMA-L.
Fig 4
Fig 4. Sensitivity analysis results for FMA-L.
Fig 5
Fig 5. FMA-L scale publication bias test.
(A) The funnel plot of FMA-L. (B) The Egger test result of FMA-L.
Fig 6
Fig 6. The forest plot of BBS.
(A) Meta-analysis results containing BBS for all studies. (B) Results of subgroup analyses of BBS.
Fig 7
Fig 7. Sensitivity analysis results for BBS.
Fig 8
Fig 8. BBS scale publication bias test.
(A) The funnel plot of BBS. (B) The Egger test result of BBS.
Fig 9
Fig 9. The forest plot of MBI.
(A) Meta-analysis results containing MBI for all studies. (B) Results of subgroup analyses of MBI.
Fig 10
Fig 10. Sensitivity analysis results for MBI.
Fig 11
Fig 11. MBI scale publication bias test.
(A) The funnel plot of MBI. (B) The Egger test result of MBI.
Fig 12
Fig 12. The forest plot of FAC.
(A) Meta-analysis results containing FAC for all studies. (B) Results of subgroup analyses of FAC.
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