{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:58:46Z","timestamp":1790657926043,"version":"4.1.0"},"reference-count":114,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hemiplegia, as a common sequela of stroke, can severely affect patients\u2019 quality of life. Although rehabilitation therapy can improve neurological function and motor abilities, a single therapy often has limited effectiveness in meeting the comprehensive rehabilitation needs. Clinical observations have demonstrated that the integration of acupuncture with rehabilitation therapy yields significant synergistic benefits. However, given the paucity of direct comparative studies between distinct combination therapies, the optimal treatment regimen remains to be definitively established. This study aims to evaluate the efficacy of rehabilitation combined with different acupuncture techniques in treating patients with post-stroke hemiplegia using a network meta-analysis (NMA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched eight databases for randomized controlled trials (RCTs) related to acupuncture combined with rehabilitation (ACU\u202f+\u202fRT) for post-stroke hemiplegia, with the searched period from database inception to March 5, 2026. The included literature was analyzed using Bayesian NMA with R software version 4.5.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study included 71 RCTs, involving 6,121 patients and nine interventions. The NMA results indicated that for Fugl-Meyer Assessment (FMA) efficacy, the top three interventions were floating acupuncture combined with rehabilitation (FACU\u202f+\u202fRT), warm needle moxibustion combined with rehabilitation (WNM\u202f+\u202fRT), and moxibustion combined with rehabilitation (MOX\u202f+\u202fRT). However, according to the SUCRA ranking, WNM\u202f+\u202fRT emerged as the most likely optimal intervention (SUCRA\u202f=\u202f76.06%; MD\u202f=\u202f16.1, 95%CI: 9.25 to 23.1). Regarding Barthel Index (BI) scores, scalp acupuncture combined with rehabilitation (SA\u202f+\u202fRT) ranked first (MD\u202f=\u202f17.4, 95%CI: 7.47 to 27.1; SUCRA\u202f=\u202f86.20%), followed by ACU\u202f+\u202fRT and MOX\u202f+\u202fRT. In terms of Modified Barthel Index (MBI) scores, FACU\u202f+\u202fRT demonstrated the highest efficacy (MD\u202f=\u202f16.4, 95%CI: 2.88 to 29.9; SUCRA\u202f=\u202f87.87%), followed by MOX\u202f+\u202fRT and electroacupuncture combined with rehabilitation (EA\u202f+\u202fRT). Finally, for Modified Ashworth Scale (MAS) scores, SA\u202f+\u202fRT was ranked first (MD\u202f=\u202f\u22121.10, 95%CI: \u22122.05 to \u22120.15; SUCRA\u202f=\u202f78.38%), with MOX\u202f+\u202fRT ranking second.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current evidence indicates that combining different acupuncture methods yields varying therapeutic effects. Regarding the improvement of FMA scores, WNM\u202f+\u202fRT may be considered the preferred clinical regimen due to the limited evidence supporting FACU\u202f+\u202fRT (based on a single study). Furthermore, SA\u202f+\u202fRT proves most effective for improving BI scores and reducing MAS, while FACU\u202f+\u202fRT exhibits potential benefits for MBI scores. However, as the number of studies reporting MAS data is relatively small (5 cases), the robustness of this result still needs to be further confirmed in future research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      CRD420261334951,\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261334951<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1878287","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:40:30Z","timestamp":1790656830000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative effectiveness of acupuncture combined with rehabilitation for post-stroke hemiplegia: a systematic review and network meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Hongliang","family":"Wang","sequence":"first","affiliation":[{"name":"School of Acupuncture and Tuina, Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Tang","sequence":"additional","affiliation":[{"name":"School of Integrated Traditional Chinese and Western Medicine, Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peizhe","family":"Li","sequence":"additional","affiliation":[{"name":"School of Acupuncture and Tuina, Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihao","family":"Dong","sequence":"additional","affiliation":[{"name":"School of Acupuncture and Tuina, Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Shang","sequence":"additional","affiliation":[{"name":"School of Basic Medical Sciences, Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Acupuncture and Tuina, Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1654","DOI":"10.1097\/CCM.0000000000004597","article-title":"Management of Acute Ischemic Stroke","volume":"48","author":"Herpich","year":"2020","journal-title":"Crit Care 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