Efficacy of elongated needles for motor and balance function after a stroke: a systematic review and Meta-analysis

书嫣 张¹海纯 周^2*

• ¹Heilongjiang University of Chinese Medicine, Harbin, China
• ²Fourth Affiliated Hospital of Heilongjiang University of traditional Chinese Medicine, Harbin, Heilongjiang Province, China

Introduction: The aim of this study was to systematically evaluate the efficacy and safety of elongated needles in enhancing motor and balance functions post-stroke. This assessment intends to support the wider adoption and application of elongated needles in post-stroke rehabilitation.Methods and Analysis: We systematically reviewed RCTs from multiple databases (inception-May 2024) evaluating elongated needles for post-stroke limb movement and balance dysfunction. Primary outcome measures included balance and motor ability assessment. Secondary outcomes encompassed Assessment of Functioning in Activities of Daily Living (ADL) and the incidence of adverse events. Meta-analysis was performed using RevMan 5.4 and Stata 16.0 software. In cases of significant heterogeneity, subgroup analyses, meta-regression analyses, and sensitivity analyses will be conducted to explore the sources of heterogeneity. The risk of bias will be appraised by two independent reviewers utilizing the Cochrane Handbook's tool for assessing risk in systematic reviews of interventions. The GRADE assessment was used to evaluate the quality of the study outcomes.Results: This meta-analysis included 18 randomized controlled trials (RCTs), encompassing a total of 1,230 subjects. The results indicated that elongated needles, utilized either as a solo intervention or in conjunction with other modalities, markedly enhanced balance capabilities in stroke patients when compared to conventional acupuncture, rehabilitation training, oral Chinese medicine, and alternative therapies including electroacupuncture and acupoint sticking (MD=6.34, P<0.001, I2=85%, 95% CI=4.80-7.89). Furthermore, elongated needles, whether applied alone or in combination with other therapies, significantly improved the motor function of limbs in patients (SMD=1.21, p<0.00001, I2=92%, 95% CI=0.63-1.79). Additionally, elongated needles, when used alone or in conjunction with other treatments, demonstrated greater efficacy in enhancing patients' activities of daily living compared to conventional acupuncture alone, rehabilitation training, or their combined regimen (SMD=1.13, P<0.00001, I2=83%, 95% CI=0.70-1.55). However, further clinical research is warranted to substantiate the advantages of elongated needles over other therapies, including electroacupuncture and acupoint sticking. In terms of safety, the overwhelming majority of the studies included in the analysis reported the absence of adverse reactions.Conclusion: Evidence from current studies indicates that elongated needle may improve post-stroke patients' balance and motor function, and enhance their daily living skills.