Analysis on principles of acupoint selection and characteristics of stimulation parameters based on randomized controlled trials of electroacupuncture for dysfunction after ischemic stroke

To analyze the characteristics of acupoint selection and stimulation parameters in randomized controlled trials (RCTs) of electroacupuncture for motor dysfunction after ischemic stroke.

The search was conducted in Chinese and English Databases, including China National Knowledge Infrastructure (CNKI), Wanfang, VIP, China Biomedical Literature Database, PubMed, Cochrane Library, Web of Science, and Embase, from the inceptions of these databases to December 31, 2025. RCTs of electroacupuncture for motor dysfunction after ischemic stroke in patients were included. Data on participant characteristics, the location or type of motor dysfunction, acupoint selection, and electroacupuncture stimulation parameters were extracted. Descriptive statistics and frequency analysis were used to summarize the distribution and characteristics of acupoints and stimulation parameters. Methodological quality assessment was performed to evaluate the included studies, and association rule analysis, hierarchical clustering, and network visualization were applied to identify structural patterns of high-frequency acupoint combinations.

A total of 208 RCTs were included, involving 192 acupoints with a total use frequency of 1948. The main high-frequency acupoints were Quchi (LI11), Zusanli (ST36), Hegu (LI4), Waiguan (TE5), Jianyu (LI15), Yanglingquan (GB34), Shousanli (LI10) and Sanyinjiao (SP6). Acupoint selection varied to some extent in accordance with the location or type of motor dysfunction. For motor dysfunction in the upper limbs, Quchi (LI11), Hegu (LI4), Waiguan (TE5), Shousanli (LI10) and Jianyu (LI15) were commonly used, whereas for that in the lower limbs and feet, Zusanli (ST36), Yanglingquan (GB34), Sanyinjiao (SP6), Taichong (LR3) and Jiexi (ST41) were frequently selected. Association rule and cluster analysis suggested that the core acupoint group was primarily composed of Quchi (LI11), Hegu (LI4), Waiguan (TE5), LI10, and LI15 for the motor impairment of upper limbs; that for the motor impairment of lower limbs included ST36, GB34, SP6, ST41 and Xuanzhong (GB39). Regarding stimulation parameters of electroacupuncture, the low frequency and its variants were predominated, while dense-disperse and continuous waves were the common waveform types; current intensity and pulse width were mostly depended on “patient’s tolerance” or “mild local muscle twitching ”. The duration of each treatment session was 30 minutes, treatment schedules were reported as once daily, 5 or 6 times per week, and the treatment course was ranged from 2 to 4 weeks.

Among the included RCTs of electroacupuncture for motor dysfunction after ischemic stroke, acupoint selection is characterized as a certain of centrality, stability and diversity. The stimulation parameters of electroacupuncture exhibit significant heterogeneity and are not reported in accordance with the relevant guidelines. In the future, based on the clarification of different functional subtypes, it needs to enhance the quantification and standardized reporting of the intervention parameters of electroacupuncture, so as to improve inter-study comparability and protocol reproducibility.