Clinical Efficacy of Electroacupuncture Antagonistic Muscles Combined with Rehabilitation Training in the Treatment of Spastic Hemiplegia after Stroke: Systematic Review and Meta-analysis of Randomized Controlled Trials

Jingyue Liu¹Xiang Meng²Yana He¹Hailun Jiang¹Jieying Zhang¹Jinyuan Shi¹Jingshu Zhang¹Menglong Zhang¹Fei Cai¹Shizhe Deng¹Jiangwei Shi^1*Zhihong Meng^1*

• ¹First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
• ²Shanghai University of Traditional Chinese Medicine, Shanghai, China

Objective: Antagonistic muscles rehabilitation training has been extensively utilized in the rehabilitation of patients with spastic hemiplegia. With the increasing acceptance and application of acupuncture, numerous scholars have discovered that incorporating electroacupuncture combined with antagonistic muscles rehabilitation training can enhance the treatment for spastic hemiplegia after stroke. The objective of this study is quantify the clinical efficacy of electroacupuncture in treating spastic hemiplegia after stroke on the basis of antagonistic muscles rehabilitation training, provide insights for future clinical treatments and scientific investigations related to spastic hemiplegia. Methods: We searched eight Chinese and English databases to identify clinical randomized controlled trials investigating the efficacy of electroacupuncture antagonistic muscles combined with rehabilitation training for the treatment of spastic hemiplegia after stroke. The search period extended from the inception of each database up to April 4, 2025. Two researchers independently reviewed the literatures, extracted relevant data, and assessed the risk of bias using the Cochrane Risk of Bias Tool. Results: A total of 8 literatures were selected from an initial pool of 1680 for the purpose of meta-analysis. The findings indicated that the combination of electroacupuncture antagonistic muscles with rehabilitation training significantly alleviates muscle spasms in hemiplegic limbs[MD=-0.52,95%CI(-0.91,-0.13), P=0.36,I² =0%,Z=2.6,P<0.05],enhances daily living capabilities[MD=6.31,95%CI(3.91,8.71), P=0.02,I² =59%,Z=5.15,P<0.05],improve motor function[MD=9.9,95%CI(8.25,11.55), P=0.2,I² =33%,Z=11.75,P<0.05].Furthermore, we discovered that when the wave type and frequency of electroacupuncture are low frequency intermittent waves, electroacupuncture antagonistic muscles combined with rehabilitation training can effectively improve the lower limb motor function of hemiplegic patients. [MD=10.52,95%CI (8.66,12.37), P=0.89, I 2 =0%, Z=11.11, P<0.05], and electroacupuncture combined with Bobath technique is better than combined with conventional rehabilitation training.The integration of electroacupuncture treatment with antagonist muscle rehabilitation training can effectively alleviate muscle spasms, reduce muscle tension, and enhance lower limb motor function as well as daily living abilities.