SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Experimental Therapeutics
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1575879
Is acupuncture combined with repeated transcranial magnetic stimulation more effective in improving upper limb motor dysfunction after stroke? A systematic review and Meta-analysis of randomized controlled trials
Provisionally accepted
- 1Changchun Traditional Chinese Medicine Hospital, Changchun, China
- 2Department of Psychology, Changchun Sixth Hospital, Changchun, Hebei Province, China
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Background: Upper limb motor dysfunction is a common sequela of stroke, which adversely affects patients' quality of life and ability of daily living. Although acupuncture and repeated transcranial magnetic stimulation (rTMS) can improve this symptom, it is uncertain whether the combined application of the two treatments can enhance the therapeutic effect.Objective: Through systematic review and meta-analysis, this study discusses the improvement effect of acupuncture combined with rTMS on upper limb motor dysfunction after stroke.Methods: We searched PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), Wanfang Database, and Chinese Biomedical Literature Service (CBM) for randomized controlled trials of acupuncture combined with rTMS for the treatment of upper limb motor dysfunction after stroke, and performed a screening process according to the inclusion and exclusion criteria. The data were screened, extracted, and analyzed using RevMan 5.4 software for Meta-analysis.Results: A total of 18 papers involving 1360 patients were included. The results of the Meta-analysis showed that the combination therapy was superior to acupuncture alone and rTMS alone in improving FMA-UE (acupuncture: MD= 7.55, 95%CI: 4.18~10.92, I2 = 97%, P<0.00001; rTMS: MD= 9.74, 95%CI: 6.41~13.07, I2 = 98%, P<0.00001); combination therapy was superior to acupuncture alone and rTMS alone in improving MBI (acupuncture: MD= 6.43, 95%CI: 4.07~8.78, I2 = 61%, p=0.01; rTMS: MD= 9.49, 95%CI: 7.52~11.47, I2 = 39%, P = 0.12); combination therapy was more effective in improving MAS compared to acupuncture (MD= -0.55, 95% CI: -0.69 to -0.41, I2=0%, P=0.61); combination therapy was more effective in improving NIHSS compared to rTMS (MD= -3. 14, 95%CI: -4.79 to -1.5, I2 = 74%, P = 0.02).Conclusion: Acupuncture combined with rTMS is more effective than acupuncture or rTMS intervention alone in improving upper extremity motor function and daily living ability and improving neurological damage after stroke.
Keywords: Acupuncture, repeated transcranial magnetic stimulation, Stroke, Upper limb motor dysfunction, Meta-analysis
Received: 20 Feb 2025; Accepted: 19 May 2025.
Copyright: © 2025 Yan, Luo, Hou, Wang and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qiguang Yang, Changchun Traditional Chinese Medicine Hospital, Changchun, China
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