Our findings may help clinicians align treatment selection with specific clinical objectives (e.g., symptom relief vs. functional recovery)

The gap

Evidence profile

Sourced from the future work and limitations of the source papers, classified as general, drawn from work published between 2025 and 2026, spanning 4 journals. Those papers have been cited 1 times in total.

Supporting evidence — 4 representative gaps

• Comparative effectiveness of acupuncture and Tuina for cervical vertigo: a systematic review and network meta-analysis of randomized controlled trials (2026) · Frontiers in Neurology · doi

  Our findings may help clinicians align treatment selection with specific clinical objectives (e.g., symptom relief vs. functional recovery), while recognizing uncertainty in the underlying evidence. A major gap remains the lack of well-designed, head- to-head trials directly comparing clearly defined acupuncture and manual-therapy protocols. Future RCTs should standardize diagnostic criteria, intervention dose (frequency/duration), and outcome reporting, and should include adequate follow-up and

  generalfuture work
  Keywords: head ndings help clinicians align treatment selection speci clinical objectives symptom relief functional recovery recognizing
• Efficacy evaluation of acupuncture combined with manipulation for lateral epicondylitis: a meta-analysis (2026) · Frontiers in Medicine · doi

  should use more rigorous trial designs, standardized intervention protocols, and longer follow-up periods to verify the comparative efficacy of different combinations of acupuncture and manipulation for LE and to identify the conditions under which these interventions achieve optimal effects. Multicenter RCTs and regions are needed to address the current evidence gaps. These trials should follow rigorous methodological standards, use appropriate randomization and allocation concealment, implement blinding whenever feasible, establish long-term follow-up and across different countries

  generalfuture work
  Keywords: follow rigorous erent trial designs standardized intervention protocols longer periods verify comparative cacy combinations acupuncture
• Effect of various acupuncture courses for upper limb motor dysfunction after ischemic stroke: a Bayesian network meta-analysis (2025) · Frontiers in Aging Neuroscience · cited 1× · doi

  Acupuncture therapy exhibits cumulative effects, with therapeutic effects accumulating as the duration and frequency of acupuncture increase. However, upon reaching a certain level, the therapeutic effects reach a plateau or even decline (Cheng et al., 2022). Evidence for a precise efficacy plateau in acupuncture for PIS-ULMD is currently lacking. However, a related study on post-stroke wrist-hand functional reconstruction showed that electroacupuncture benefits change dynamically over time, featuring distinct phases of improvement, plateau, and decline (Wang et al., 2019). In line with the findings of this study, although the 12-week course involved a higher total intervention dose, its efficacy on the primary outcome measure was not significantly superior to that of the 8-week course. This observation aligns with the previously mentioned possibility of “acupuncture tolerance” in the introduction. We  believe that the results of this study provide preliminary clinical evidence supporting the hypothesis that “acupuncture efficacy reaches a plateau.” However, due to the limited number of studies involving longer treatment durations included in this meta-analysis, the current evidence remains insufficient. Therefore, more high-quality randomized controlled trials are needed in the future to validate this hypothesis. Our results mark initial progress in exploring the optimal treatment duration of acupuncture for patients with PIS-ULMD, addressing a previous evidence gap. Despite the low quality of the current evidence, the findings may serve as a preliminary reference for selecting treatment cycles in clinical practice. Furthermore, this study revealed that the optimal treatment courses differ for motor function and overall neurological deficits, suggesting that future research should consider comprehensive selection of treatment courses based on patients’ motor abilities and neurological impairments. 4.5 Strengths and limitations technical variations This study possesses several notable strengths. In contrast to previous research, it is the first to specifically investigate the effects of different acupuncture intervention courses on patients with PIS-ULMD, conducting subgroup analyses that address a critical gap in the literature regarding optimal acupuncture treatment duration for PIS-ULMD. Furthermore, the application of network meta-analysis (NMA) has significantly strengthened the robustness of the evidence by synthesizing both direct and indirect comparative data. However, this study has several limitations that should be acknowledged. Firstly, since our research primarily focused on acupuncture treatment duration, and sensitivity analysis revealed that specific acupuncture protocols had minimal impact on the overall study findings. This approach is also consistent with existing research on acupuncture dosage, which has similarly not emphasized al., 2024). We consequently pooled these interventions for analysis. However, we acknowledge that variations in specific techniques remain a key limitation and potential source of heterogeneity. Secondly, Studies on acupuncture treatment durations beyond the 4-week and 8-week courses remain relatively limited. This evidence gap may affect the reliability of treatment ranking results, particularly for less-studied treatment courses. Thirdly, since all included studies were conducted in China, the generalizability of our conclusions is limited. Caution should be  exercised when extrapolating these findings to other populations or clinical settings. Fourthly, safety analysis indicated that most studies did not record acupuncture- related adverse events. Especially since safety data for the 12-week treatment group were nearly absent (only one study reported such information). As a result, this meta-analysis cannot reliably assess whether extending treatment beyond 8 weeks increases the risk of adverse effects. Furthermore, factors such as lack of allocation concealment and unclear blinding methods in some studies may reduce the reliability of the conclusions in this review. (Wang et

  generalfuture work
  Keywords: acupuncture treatment evidence effects week courses duration plateau ulmd efficacy clinical limited meta optimal patients
• Acupuncture Treatment for Post-Stroke Aphasia at Harvest City Therapy Center in Bogor (2026) · Jurnal Indonesia Sosial Sains · doi

  2. After Therapy: After six sessions of acupuncture therapy, the patient's communication skills showed improvement. She began to express simple words better, understand instructions better, and respond more quickly and consistently. Furthermore, her social interactions also improved, as evidenced by better eye contact and more active engagement in communication. In addition, improved communication skills after repeated therapy were also reported in a systematic study that acupuncture as an adjunct therapy had a positive effect on aphasia rehabilitation (Zhang et al., 2021). From a TCM perspective, therapeutic success indicates the smooth flow of Qi and Xue and the reduction of Tan obstruction. Meanwhile, from a modern neurological perspective, these effects are associated with increased neuroplasticity, reactivation of neural networks, and enhanced connectivity between language areas in the brain (Li et al., 2015; Zhang et al., 2021). Thus, acupuncture can be viewed as a complementary therapy that has a strong theoretical basis in both TCM and modern medicine. 2360 CONCLUSION The study on acupuncture care for elderly patients with post-stroke aphasia at Harvest City Therapy House, Bogor, found that after six therapy sessions there was noticeable improvement in communication abilities, including clearer pronunciation of simple words, better comprehension of instructions, faster and more consistent responses, and enhanced social interaction reflected in increased eye contact and active engagement. These outcomes suggest that acupuncture may serve as a promising complementary therapy to support recovery of communication function in post-stroke aphasia. Based on these findings, it is recommended that practitioners consider integrating the applied acupuncture protocol (REN-23, HT-5, DU- 20, and EX-HN1 with tonification and reduction techniques) into clinical practice while continuing individualized evaluation of patient responses; future research should involve larger sample sizes, control groups, and longer follow-up periods, including randomized controlled trials comparing acupuncture alone, speech therapy alone, and combined interventions to strengthen evidence of efficacy. It is also recommended that families support ongoing therapy alongside conventional rehabilitation and home-based communication practice, while policymakers consider the inclusion of acupuncture as a complementary therapy within national health coverage for post-stroke rehabilitation to improve patient outcomes and quality of life. REFERENCE Baldwin, J. N., Napier, S., Neville, S., & Wright-St Clair, V. A. (2018). Impacts of older people’s patient and public involvement in health and social care research: A systematic review. Age and Ageing, 47(6), 801–809. Chen, Z., Zhang, D., Liu, C., Wang, H., Jin, X., Yang, F., & Zhang, J. (2024). Traditional Chinese medicine diagnostic prediction model for holistic syndrome differentiation based on deep learning. Integrative Medicine Research, 13(1), 101019. De Coninck, L., Declercq, A., Bouckaert, L., Vermandere, M., Graff, M. J. L., & Aertgeerts, B. (2021). Perspectives of older adults with a chronic condition on functioning, social participation and health: A qualitative study. BMC Geriatrics, 21(1), 418. Fitri, F. I., Rambe, A. S., Effendy, E., Kadri, A., Prawiroharjo, P., Lubis, I. N. D., Surbakti, K. P., Amin, M. M., Rusda, M., & Gustianingsih. (2025). A narrative review of primary progressive aphasia and stroke aphasia: Clinical and linguistic perspectives in the Indonesian context. Current Behavioral Neuroscience Reports, 12(1), 20. Hebert, D., Lindsay, M. P., McIntyre, A., Kirton, A., Rumney, P. G., Bagg, S., Bayley, M., Dowlatshahi, D., Dukelow, S., & Garnhum, M. (2016). Canadian stroke best practice recommendations: Stroke rehabilitation practice guidelines, update 2015. International Journal of Stroke, 11(4), 459–484. Kementerian Kesehatan Republik Indonesia. (2023). Indonesian health survey (SKI 2023).

  generallimitationsevidence 5/5
  Keywords: therapy acupuncture stroke communication aphasia patient better social rehabilitation zhang practice health complementary medicine post

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