The Effectiveness of Acupuncture in the Treatment of Post‑Stroke Spasticity in Adults: An Integrative Review

Introduction: Stroke is a leading cause of disability worldwide. Spasticity affects 20% to 40% of survivors, resulting in functional dependence and biopsychosocial impacts. Effective management is challenging, and acupuncture is emerging as an expanding therapeutic alternative. Objective: To evaluate the efficacy of acupuncture in treating post-stroke spasticity in adults. Methods: This integrative review involved a wide search of main databases (PubMed, Cochrane Library, Scopus and Web of Science), retrieving 1.003 articles, of which 13 were included. The review focused on adults with post-stroke spasticity receiving manual acupuncture, scalp acupuncture, and electroacupuncture; excluding studies involving pediatric patients, spasticity resulting from conditions other than stroke, or interventions unrelated to acupuncture. Article screening was conducted in Rayyan by two blinded researchers, who independently assessed titles and abstracts according to the inclusion and exclusion criteria. After unblinding, discrepancies were resolved by consensus. Data was then systematically extracted using a standardized protocol. Finally, all information was compiled to this present study. Results: Most meta-analyses evaluating the efficacy of acupuncture using the Modified Ashworth Scale (MAS) demonstrated significant positive effects in reducing muscle tone. Similarly, assessments using the Fugl-Meyer Assessment (FMA) and the Barthel Index (BI/MBI) yielded significant results favoring the use of acupuncture. Furthermore, according to a 2026 network meta-analysis, the combination of scalp acupuncture and body acupuncture had the highest probability of being the best intervention for reducing MAS (SUCRA = 81.53%) and associated pain (VAS SUCRA = 69.24%). Conclusion: Acupuncture appears to be effective in reducing spasticity, especially when combined with rehabilitation. Larger, multicenter randomized clinical trials following STRICTA and CONSORT guidelines are recommended for greater statistical precision. Keywords: “Acupuncture Therapy”; “Adult”; "Muscle Spasticity"引言：脑卒中（Stroke）是全球范围内致残的首要病因。20%至40%的脑卒中幸存者会出现痉挛（Spasticity），进而导致功能依赖及社会心理层面的不良影响。目前临床对其实施有效治疗颇具挑战，而针灸正逐渐成为一种日益受到关注的治疗选择。 目的：评估针灸治疗成人脑卒中后痉挛的临床疗效。 方法：本次整合性综述检索了主流数据库（PubMed、Cochrane Library、Scopus及Web of Science），共检索得到1003篇文献，最终纳入13篇。本综述的研究对象为脑卒中后痉挛的成人患者，干预方式涵盖毫针针刺、头皮针及电针；排除纳入儿科患者、非脑卒中相关病因所致痉挛、或非针灸类干预措施的研究。两名盲法研究者通过Rayyan平台开展文献筛选工作，依据纳入与排除标准独立评估文献标题及摘要。揭盲后，研究者通过协商一致解决评估分歧。随后采用标准化方案系统性提取研究数据，最终整合所有信息形成本综述。 结果：多数采用改良Ashworth量表（Modified Ashworth Scale, MAS）评估针灸疗效的荟萃分析均显示，针灸可显著降低肌肉张力。同理，采用Fugl-Meyer运动功能评分（Fugl-Meyer Assessment, FMA）及巴氏指数（Barthel Index, BI/MBI）开展的评估也均得出了支持针灸应用的显著阳性结果。此外，2026年的一项网络荟萃分析显示，头皮针联合体针疗法在降低MAS评分（SUCRA=81.53%）及相关疼痛（VAS SUCRA=69.24%）方面，具有最高的最优干预概率。 结论：针灸在缓解痉挛方面展现出良好疗效，尤其与康复训练联合应用时效果更为显著。建议后续开展遵循STRICTA与CONSORT指南的大样本多中心随机对照试验，以提升统计精准度。 关键词："针灸疗法"; "成人"; "肌肉痉挛"