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PREreview of Effects of joint mobilization combined with acupuncture on pain, physical function, and depression in stroke patients with chronic neuropathic pain: a randomized controlled trial

Published
DOI
10.5281/zenodo.19198826
License
CC BY 4.0

Short Summary of Main Findings In this randomized controlled trial (preprint Feb 2023; later published in PLOS ONE 2023), 69 post-stroke patients with chronic neuropathic pain were assigned to three groups: joint mobilization (JM) + acupuncture (AC) (n=23), JM alone (n=23), or control (n=23). The JM+AC group showed significantly greater improvements in pain and physical function compared to both the JM-only and control groups. Both JM+AC and JM groups improved physical function and depression more than the control group. Overall, adding acupuncture to joint mobilization provided superior benefits for pain relief while enhancing function and mood.

How This Work Has Moved the Field Forward It offers randomized evidence supporting the additive effect of combining manual joint mobilization with acupuncture for managing chronic neuropathic pain after stroke — an area with limited high-quality trials. The three-arm design helps isolate the contribution of acupuncture, providing clinicians with a practical multimodal non-pharmacological option to improve pain, function, and depression in stroke rehabilitation.

Major Issues

  • Relatively small sample size (n=69 total, ~23 per group) limits statistical power and generalizability.

  • Short-term intervention and follow-up; long-term effects and sustainability unknown.

  • Although now peer-reviewed in PLOS ONE, the original preprint lacked full scrutiny at posting.

  • Limited details on blinding (likely challenging for manual/acupuncture therapies) and potential performance bias.

Minor Issues

  • Control group intervention not clearly specified in summaries (standard care?).

  • Some outcome measures and exact effect sizes/p-values are only modestly detailed in abstracts.

  • No subgroup analysis (e.g., by stroke type, time since stroke, or pain severity).

Competing interests

The author declares that they have no competing interests.

Use of Artificial Intelligence (AI)

The author declares that they did not use generative AI to come up with new ideas for their review.

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