Efficacy of Acupuncture Combined With Robotic Therapy in the Treatment of Limb Dysfunction After Stroke: A Systematic Review and Meta-Analysis.

Objective: To conduct a meta-analysis investigating the effect of acupuncture combined with robotic therapy on limb dysfunction after a stroke. Data Sources: Electronic searches of 8 databases were conducted from database establishment to September 20, 2024. Study Selection: Randomized controlled trials comparing acupuncture combined with robot therapy versus monotherapy for poststroke limb dysfunction. Data Extraction: Data extraction was independently performed by 2 authors, with any discrepancies resolved through discussion with a third investigator. The extracted dataset included the first author's name, publication year, characteristics of the study population, sample size, intervention protocols, motor function scores, and other relevant outcome measures. Data Synthesis: A total of 19 randomized controlled studies were included, encompassing 1353 patients, with a maximum sample size of 120 patients and a minimum sample size of 40 patients. Our findings revealed that the combined therapy group exhibited significantly higher scores on the Fugl-Meyer Assessment (FMA) for limb motor function and the Modified Barthel Index (MBI) for activities of daily living compared with the robot group: (standard mean difference [MD], 4.89; 95% CI, 2.66-7.12; P<.001) and (MD, 7.17; 95% CI, 4.20-10.14; P<.001), respectively. Similarly, the results indicated that the combined therapy group achieved significantly higher scores on both the FMA and MBI compared with the acupuncture-only group: (MD, 4.68, 95% CI, 3.32-6.04, P<.001) and (MD, 11.66; 95% CI, 7.92-15.39; P<.001), respectively. Furthermore, the FMA score was higher in the combined therapy group than in the conventional treatment group (MD, 5.98; 95% CI, 3.11-8.84; P<.001). Conclusions: Acupuncture combined with robotic therapy appears to enhance limb motor function and improve quality of life, with the clinical efficacy of this combined intervention exceeding that of either therapy administered individually. However, considering the moderate to low quality of the included studies and their frequent absence of blinding, future clinical research should focus on high-quality randomized double-blind controlled trials for validation.