Effect of Sequential Electroacupuncture Combined With Augmented Reality Gait Training on Walking Function and Neuromuscular Control in Subacute Stroke: A Randomized Controlled Trial.

OBJECTIVE: To investigate the effects of sequential electroacupuncture (EA) combined with augmented reality (AR) gait training on walking function and neuromuscular control in patients with subacute stroke (onset 1-6 mo). DESIGN: A single-blind, randomized controlled trial allocating 40 patients with subacute stroke to an experimental (EA+AR, n=20) or control group (AR alone, n=20) for 4 weeks. The primary outcome was gait speed. RESULTS: Generalized estimating equations (GEE) analyses revealed that the experimental group demonstrated significantly greater improvement in gait speed (Wald χ²=6.509, P=0.011) compared with controls. Significant improvements were also observed in stride length, gait symmetry, FMA-LE, BBS, and CCI (all P <0.05). No significant between-group differences were found for step width, cadence, or joint kinematics (all P >0.05). No adverse events occurred. CONCLUSION: The sequential EA-AR protocol significantly improved gait speed-the primary outcome-as well as stride length, gait symmetry, motor function, balance, and neuromuscular control. These findings suggest that temporally structured EA prior to AR training may facilitate motor relearning, potentially through transient neuromodulatory states induced by EA, though this mechanistic interpretation requires further confirmation.