Effect of Acupuncture in the Management of Competitive Anxiety: A Systematic Review and Meta-Analysis

Objective: The aim of this review is to evaluate the effect of acupuncture on competition-induced anxiety in elite athletes to provide an assessment of the overall efficacy of the use of acupuncture in the management of competitive anxiety. Method: A systematic literature search was performed by two reviewers (SB and TE) on electronic databases from their inception to 2022. The risk of bias was assessed using the Cochrane grading system in the RevMan 5.4 software by SB and TE. Acupuncture intervention was assessed using the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). A total of 36 studies were retrieved and, following further assessment, 5 studies consisting of 219 participants were included in this review. Results: Somatic anxiety was statistically lower in the acupuncture group compared with the control and sham groups with a large effect size (1.92, p = 0.05, 2.47, p = 0.01 respectively). The acupuncture group presented with a lower level of cognitive anxiety compared with the control and sham groups with a large effect size (2.99, p = 0.003, 3.26, p = 0.001 respectively). The overall difference between each group was insignificant in the management of self-confidence. Conclusion: Acupuncture has a good effect in the management of competitive somatic and cognitive anxiety; however, more studies are required with a large sample size to determine the effect of acupuncture in the management of competitive self-confidence.