Comparative Efficacy of Body Acupuncture, Electroacupuncture, and Auricular Acupuncture in Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: To compare the efficacy of body acupuncture, electroacupuncture, and auricular acupuncture on motor, functional, and neurological recovery after stroke. DESIGN: Systematic review and meta-analysis of randomized controlled trials. Eligible studies enrolled adult stroke survivors receiving one of three acupuncture modalities versus control treatments. Primary outcome was motor function (Fugl-Meyer Assessment). Secondary outcomes included activities of daily living, neurological function, and safety. Pairwise and Bayesian network meta-analyses were conducted. RESULTS: A total of 21 trials were included. Acupuncture significantly improved motor function compared with controls (SMD=6.48; 95% CI=4.72-8.24; P<0.001). Electroacupuncture showed the greatest benefit (SMD=7.92; 95% CI=5.60-10.24), followed by body acupuncture (SMD=5.41; 95% CI=3.25-7.57) and auricular acupuncture (SMD=3.28; 95% CI=1.12-5.44). Significant improvements were also observed in activities of daily living and neurological impairment. Network meta-analysis indicated that electroacupuncture had the highest probability of being among the most effective modalities (SUCRA=96.4%). CONCLUSION: Electroacupuncture demonstrated the most favorable overall therapeutic profile among the three acupuncture modalities, followed by body acupuncture and auricular acupuncture. These findings support modality-specific acupuncture selection for stroke rehabilitation while highlighting the need for additional head-to-head randomized trials.