New Perspectives on the Efficacy of Governor Vessel Moxibustion Combined With Rehabilitation Training for Poststroke Muscle Spasticity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Background: Muscle spasticity, a prevalent motor impairment after stroke, substantially diminishes patients' quality of life. Governor Vessel moxibustion (GVM), a significant complementary therapy, shows promise, yet the current evidence remains inadequate. This study aimed to evaluate the efficacy of GVM with routine rehabilitation training in alleviating poststroke spasticity (PSS). Methods: We searched PubMed, Cochrane Library, Embase, Web of Science, four Chinese databases, and clinical trials registry for randomized controlled trials (RCTs) of PSS patients who mainly received GVM treatment alongside conventional rehabilitation. Statistical evaluations were conducted using Review Manager 5.4 and R Studio. For assessing bias in the included studies, the Cochrane risk of bias tool (RoB 2.0) was used to evaluate RCTs. Results: Eleven studies involving 859 PSS patients were included. Meta-analysis demonstrated that when combined with routine rehabilitation training, GVM effectively alleviated muscle spasticity, as measured by the modified Ashworth scale (MD, −0.65 [95% CI, −0.84 to −0.47], p < 0.01) and the composite spasticity index (MD, −1.82 [95% CI, −2.25 to −1.39], p < 0.01). The treatment time and frequency could potentially be the main contributors to heterogeneity. Results suggested that a treatment regimen consisting of 60-min sessions conducted once-weekly and lasting for at least 8 weeks was the most effective, providing evidence for optimizing clinical application of GVM combined with rehabilitation training in PSS management. Conclusion: GVM serves as an effective complementary therapy to routine rehabilitation for PSS patients, with generally mild adverse events. However, before formulating evidence-based and definitive recommendations, more rigorously designed and in-depth research is warranted.