OBJECTIVE: Hand dysfunction is one of the main causes of disability in stroke. This systematic review and meta-analysis aimed to evaluate the efficacy of different types of acupuncture therapy in improving hand dysfunction among post-stroke patients. METHODS: A comprehensive search was conducted across eight databases (PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Chongqing VIP Chinese Scientific Journals Database (VIP), China Biology Medicine (CBM), and Wan Fang) to identify randomized controlled trials (RCTs). Forty-two RCTs involving 2,766 participants were included. Primary outcomes were the Brunnstrom Recovery Stage (BRS), Fugl-Meyer Assessment (FMA), and Lindmark scores; secondary outcomes included the Modified Ashworth Scale (MAS), Range of Motion (ROM), Manual Muscle Testing (MMT), and Modified Barthel Index (MBI). RESULTS: Meta-analyses demonstrated significant improvements in hand function across multiple outcomes: BRS (mean difference (MD) 0.56, 95% confidence interval (CI) 0.43 to 0.69), FMA (MD 1.24, 95% CI 0.96 to 1.53), MAS (MD -0.48, 95% CI -0.59 to -0.38), ROM (MD 0.95, 95% CI 0.64 to 1.26), and MBI (MD 6.70, 95% CI 4.85 to 8.55). Subgroup analyses revealed that electroacupuncture (EA) outperformed traditional acupuncture (TA) in improving BRS (p = 0.008). Heterogeneity was partially attributed to acupuncture modalities, with EA exhibiting lower variability compared to traditional methods. CONCLUSION: This meta-analysis supports the use of acupuncture, particularly EA, for enhancing hand function in post-stroke patients. EA demonstrates superior efficacy and consistency, suggesting its prioritization in clinical practice.

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