A narrative review of clinical studies on thread embedding acupuncture treatment for spasticity after stroke

Objectives: This study aimed to review clinical studies on thread embedding acupuncture (TEA) for the treatment of patients with post-stroke spasticity (PSS)Methods: Clinical studies related to TEA treatment for PSS were searched for in several electronic databases, including PubMed, Cochrane Library, MEDLINE, OASIS, and CNKI. After the selection/exclusion process, information on study design, disease, experimental/control group, intervention, outcome measurement, between-group differences, and adverse events was extracted.Results: A total of 13 randomized controlled trials were included in this review. The usual frequency of TEA treatment was once every 1-2 weeks, and the treatment most commonly included 4 sessions. In the dorsal area, EX-B2 and the acupoints in governing vessel meridian were commonly used. Acupoints in the meridian of the large intestine were most frequently used in the treatment of upper limb spasticity. Except for HT1, PC6, and PC8, all TEA points for treating PSS of the upper limb were on the Yang meridians. For the lower limb spasticity, the most frequently used acupoints were ST36, GB34, GB30, BL60, and BL57 on Yang meridians, and LR3, SP6, SP9, and SP10 on Yin meridians. TEA treatment showed better effects than conventional treatment for PSS in terms of spasticity, motor dysfunction, and activities of daily livings. Nevertheless, the absence of the follow-up observation, lack of sham TEA treatment, and low quality of the included studies necessitated caution in interpreting the results.Conclusions: The results of this review are expected to provide basic data on the modalities of TEA treatment for PSS and provide insights to facilitate well-designed studies in the future.