Observation on the Efficacy of Acupuncture in Treating Upper Limb Motor Dysfunction in Patients with Acute Ischemic Stroke During the Recovery Period

Abstract

Objective

To evaluate the efficacy of acupuncture for upper limb motor dysfunction in patients with acute ischemic stroke (AIS) during the convalescent stage.

Methods

Methods between May 2021 and May 2024, 260 patients with AIS in the convalescent stage were enrolled from the Department of Neurology, 908 Hospital of Joint Logistic Support Force of PLA, and randomly allocated to a control group or an observation group. The treatment period lasted 4 weeks. Outcomes assessed included overall efficacy, upper limb motor function, cognitive performance, neurological deficit severity, ability in daily living activities, serum neurotrophic markers, and safety.

Results

The observation group showed a significantly higher overall response rate compared with the control group (χ²=12.783, P<0.001). After treatment, Fugl-Meyer Assessment (FMA), Mini-Mental State Examination (MMSE), and Modified Barthel Index (MBI) scores as well as serum brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) concentrations increased significantly in both groups (P<0.05). The extent of improvement was greater in the observation group (P<0.05). At the same time, National Institutes of Health Stroke Scale (NIHSS) and Neurological Deficit Function (NDF) scores decreased notably in both cohorts (P<0.05), with the observation group achieving a more pronounced reduction (P<0.05). Throughout the study, no treatment-related safety concerns were detected in either group.

Conclusion

In patients with AIS during the recovery stage, adjunctive acupuncture produced better outcomes than low-frequency repetitive transcranial magnetic stimulation alone. It promoted upper limb functional recovery, improved cognition, reduced neurological impairment, and enhanced quality of life, while also showing good safety and overall effectiveness.

Keywords

acute ischemic stroke recovery period low-frequency repetitive transcranial magnetic stimulation acupuncture impaired upper limb motor function efficacy

Get full access to this article

View all access options for this article.

References

Barthels

Das

(2020). Current advances in ischemic stroke research and therapies[J]. Biochim Biophys Acta Mol Basis Dis, 1866(4), 165260. https://doi.org/10.1016/j.bbadis.2018.09.012

Chen

H. S.

Cui

Zhou

Z. H.

, et al. (2023). Dual antiplatelet therapy vs alteplase for patients with Minor nondisabling acute ischemic stroke: The ARAMIS randomized clinical trial[J]. JAMA, 329(24), 2135–2144. https://doi.org/10.1001/jama.2023.7827

Chen

Jin

, et al. (2019). Meta-analysis of the efficacy of low-frequency repetitive transcranial magnetic stimulation in treating post-stroke depression (in Chinese). Chin J Med Phys, 36(6), 736–744. https://doi.org/10.3969/j.issn.1005-202X.2019.06.023

Chen

Cai

Pan

, et al. (2022a). Progress in repetitive transcranial magnetic stimulation for upper limb motor dysfunction after acute stroke (in Chinese). Chin J Rehabil Med, 37(10), 1415–1420. https://doi.org/10.3969/j.issn.1001-1242.2022.10.023

Chen

Y. C.

N. X.

Pei

Z. F.

, et al. (2020). A NeuroD1 AAV-based gene therapy for functional brain repair after ischemic injury through in vivo astrocyte-to-neuron conversion[J]. Mol Ther, 28(1), 217–234. https://doi.org/10.1016/j.ymthe.2019.09.003

Chen

Wang

Dong

, et al. (2022b). Changes in neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and short-term prognosis in patients with acute ischemic stroke complicated by obstructive sleep apnea–hypopnea syndrome (in Chinese). J Neurosci Ment Health, 22(12), 878–882. https://doi.org/10.3969/j.issn.1009-6574.2022.12.007

Cheng

Tang

Zhang

, et al. (2022). Effects of low-frequency repetitive transcranial magnetic stimulation on spastic motor dysfunction after ischemic stroke (in Chinese). J Beihua Univ Nat Sci, 23(1), 79–83. https://doi.org/10.11713/j.issn.1009-4822.2022.01.015

Edwards

D. J.

Liu

C. Y.

Dunning

, et al. (2023). Electric field navigated 1-Hz rTMS for poststroke motor recovery: The E-FIT randomized controlled trial[J]. Stroke, 54(9), 2254–2264. https://doi.org/10.1161/STROKEAHA.123.043164

Expert Consensus Writing Group on Integrated Chinese and Western Medicine Rehabilitation for Stroke (2025). Expert consensus on rehabilitation strategies and clinical application of spastic paralysis after stroke (in Chinese). Chin J Gen Pract., 23(2), 179–185. https://doi.org/10.16766/j.cnki.issn.1674-4152.003862

10.

Guo

Yang

(2024). Feasibility of Xingnao kaiqiao acupuncture as an adjunct therapy in patients with ischemic stroke during the recovery period (in Chinese). Liaoning J Tradit Chin Med, 51(5), 172–176. https://doi.org/10.13192/j.issn.1000-1719.2024.05.046

11.

Guo

Yue

Zou

, et al. (2020). Correlation between serum osteopontin, oxidative stress markers, neurological damage, and prognosis in patients with acute cerebral infarction (in Chinese). Clin Exp Med, 19(12), 1307–1310. https://doi.org/10.3969/j.issn.1671-4695.2020.12.021

12.

Khaw

Subramaniam

Abd Aziz

N. A.

, et al. (2021). Current update on the clinical utility of MMSE and MoCA for stroke patients in Asia: A systematic review[J]. Int J Environ Res Public Health, 18(17), 8962. https://doi.org/10.3390/ijerph18178962

13.

Liu

Zhou

, et al. (2022). Clinical observation of modified Buyang Huanwu decoction combined with acupuncture in the treatment of motor dysfunction after ischemic stroke (in Chinese). J Anhui Univ Tradit Chin Med, 41(2), 39–43. https://doi.org/10.3969/j.issn.2095-7246.2022.02.010

14.

Liu

Jia

Liu

, et al. (2023). Comparative analysis of intramuscular heat needling and traditional acupuncture for upper limb motor dysfunction after stroke (in Chinese). Clin Acupunct Moxibustion, 39(3), 46–50. https://doi.org/10.19917/j.cnki.1005-0779.023051

15.

Minami

Fukumoto

Kobayashi

, et al. (2021). Effect of home-based rehabilitation of purposeful activity-based electrical stimulation therapy for chronic stroke survivors: A crossover randomized controlled trial[J]. Restor Neurol Neurosci, 39(3), 173–180. https://doi.org/10.3233/RNN-211157

16.

Peng

Liu

Cui

(2018). Keeping up with the times: Interpretation of the “guidelines for the diagnosis and treatment of acute ischemic stroke in China, 2018” (in Chinese). Chin J Neurol, 51(9), 657–659. https://doi.org/10.3760/cma.j.issn.1006-7876.2018.09.001

17.

Peng

(2018). Guidelines for the diagnosis and treatment of acute ischemic stroke in China, 2018 (in Chinese). Chin J Neurol, 51(9), 666–682. https://doi.org/10.3760/cma.j.issn.1006-7876.2018.09.004

18.

Qin

Yang

Chu

Y. H.

, et al. (2022). Signaling pathways involved in ischemic stroke: Molecular mechanisms and therapeutic interventions. Signal Transduct Target Ther, 7(1), 215. https://doi.org/10.1038/s41392-022-01064-1

19.

Ren

Shan

(2020). Research progress on the effects and mechanisms of Repetitive Transcranial Magnetic stimulation in Post-Stroke Depression (in Chinese). Chin J Phys Med Rehabil, 42(4), 367–371. https://doi.org/10.3760/cma.j.issn.0254-1424.2020.04.019

20.

Sun

Qian

, et al. (2024). Acupuncture treatment of post-stroke spastic hemiplegia from the perspective of “relaxing tendons by strong stimulation” (in Chinese). Chin J Med, 39(10), 5293–5297.

21.

Xiaojia

Hao

Xufei

,et al. (2025). Clinical Practice Guideline for the Prevention and Treatment of Stroke with Integrated Traditional Chinese and Western Medicine (2023 Edition). Chinese General Practice, 28(05), 521–533. https://doi.org/10.12114/j.issn.1007-9572.2024.0485

22.

Xie

Zhao

, et al. (2024). Research progress on acupuncture mechanisms in post-stroke cognitive impairment intervention (in Chinese). China J Tradit Chin Med Pharm, 39(7), 3571–3574.

23.

Yin

Liu

Zhang

, et al. (2020). Effects of rTMS treatment on cognitive impairment and resting-state brain activity in stroke patients: A randomized clinical trial[J]. Front Neural Circuits, 14, 563777. https://doi.org/10.3389/fncir.2020.563777

24.

Zhao

Zhang

Chen

, et al. (2022). Neuronal injuries in cerebral infarction and ischemic stroke: From mechanisms to treatment (review)[J]. Int J Mol Med, 49(2), 15. https://doi.org/10.3892/ijmm.2021.5070

25.

Zhou

Liu

Sun

, et al. (2023). Research progress on acupuncture regulating microRNA in ischemic stroke intervention (in Chinese). Med Recapitulate, 29(6), 1087–1092.