Meta-analysis of the efficacy of external application of Chinese medicine in the treatment of lower limb motor impairment in patients with post-stroke hemiplegia

Jingwen Zhang¹Xingyu Kang¹Jiajie Niu¹Jingwen Zhao¹Siyu Chen¹Shuai Shi^2*

• ¹Heilongjiang University of Chinese Medicine, Harbin, China
• ²The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China

Objective: To systematically evaluate the efficacy of external application of traditional Chinese medicine (TCM) — including TCM plaster application, TCM iontophoresis, hot compress, fumigation, fuming and washing, soaking, hot ironing, and cold compress— in the treatment of lower limb dysfunction in patients with post-stroke hemiplegia. Methods: We performed a comprehensive computer-based search of multiple databases (for domestic literature, CNKI, China Biomedical Literature Service System (CBM), VIP, and Wanfang Database were used; for foreign literature, PubMed, Embase, Web of Science, Cochrane Library, etc. were used). The retrieval time limit was from the establishment of each database to the present. All randomized controlled trials (RCTs) and clinical observations evaluating the effect of TCM external application on lower limb motor function in post-stroke hemiplegia patients were collected. The literatures meeting the inclusion criteria were screened out. Two reviewers independently evaluated the methodological quality of the included studies and extracted effective data. The Cochrane bias risk assessment tool was used to evaluate the literature quality, and RevMan 5.4 software was used for meta-analysis. Results: A total of 43 RCTs involving 4,186 patients were finally included. The results of meta-analysis showed that TCM external application was significantly more effective than simple rehabilitation or recovery training in improving lower limb dysfunction after stroke, with notable improvements in motor function (e.g., Fugl-Meyer Assessment) and activities of daily living scores. Conclusion: External application of traditional Chinese medicine has significant efficacy and safety in the treatment of lower limb dysfunction after stroke. Potential mechanisms of action are also discussed.