Effectiveness of scalp acupuncture and comparison with traditional acupuncture for stroke: an overview of systematic reviews and updated evidence.

Background: Stroke recovery is a critical global-health priority; there is growing interest alternative therapies in scalp acupuncture (SA) to overcome the limitations of conventional treatments and improve outcomes. This study provides an overview of systematic reviews to evaluate the evidence on the effectiveness and safety of SA and to compare its therapeutic potential with traditional acupuncture (TA).

Methods: A systematic search of 12 databases was conducted to identify systematic reviews and meta-analyses, completed on September 30, 2023, was performed without language restrictions. Selection criteria included adult stroke patients treated with SA, focusing on comparisons of effectiveness and safety in neurological deficits, motor function, disability, and total efficacy rate. Two reviewers independently screened studies and assessed methodological quality using AMSTAR-2, ROBIS, PRISMA-A, and GRADE frameworks. Data were synthesized to compare SA and TA for stroke outcomes, using total searched SA studies and TA data from the Cochrane review, followed by an analysis of high-quality studies to enhance evidence reliability.

Results: After overviewing seven systematic reviews, the certainty of evidence supporting the standalone effectiveness and safety of SA remains low owing to methodological shortcomings. However, SA showed a greater effect size in the neurological deficits (-0.96 vs -0.53) in total studies and high-quality studies (-0.92 vs -0.48). Regarding motor function, SA had a higher effect size in total studies (0.94 vs 0.70), but TA outperformed it in high-quality studies (0.39 vs 0.82). Regarding disability outcomes, TA had a slightly larger effect size in total studies (1.27 vs 1.06), whereas SA surpassed it in high-quality studies (1.65 vs. 1.16).

Conclusions: This overview highlights the potential of SA as an effective alternative therapy for stroke recovery, with high-quality studies demonstrating its effectiveness in improving neurological deficits and disability outcomes. This work guides clinicians on integrating SA for stroke recovery and offers insights for improving public health rehabilitation strategies. Despite limitations in the overall evidence owing to methodological shortcomings, the positive results from high-quality studies support SA as a possible approach for stroke recovery, underscoring the need for further rigorous research to strengthen its clinical application.