Association of Electroacupuncture Combined With Task-Oriented Rehabilitation Training With Longitudinal Improvement in Upper-Limb Function After Ischemic Stroke: A Propensity Score-Matched Retrospective Cohort Study

Objective This study aimed to determine whether adding electroacupuncture to task-oriented rehabilitation training was associated with improved upper-limb recovery after ischemic stroke. Methods This propensity score-matched retrospective cohort study included 122 patients with post-stroke upper-limb motor impairment treated from January 2018 to April 2019. After 1:1 matching, 61 patients receiving task-oriented training alone were compared with 61 receiving adjunctive electroacupuncture. Motor function, hand performance, activities of daily living, Brunnstrom stage, and wrist range of motion were assessed at baseline, week 4, and 12 weeks after treatment completion (week 16). Surface electromyography, cerebral arterial mean flow velocity, serum biomarkers, and adverse events were also evaluated. Results The primary outcome, Fugl-Meyer Assessment of the Upper Extremity score, and secondary outcomes including Action Research Arm Test, Modified Barthel Index, and Jebsen–Taylor Hand Function Test showed significant time, group, and time-by-group interaction effects ( P < 0.05). All functional outcomes improved over time in both matched groups during follow-up. Improvements in upper-limb function, hand performance, daily living ability, Brunnstrom stage, and wrist motion were consistently greater with adjunctive electroacupuncture. At week 4, the combined-treatment group showed larger increases in root mean square and integrated electromyography values and higher mean flow velocities in the anterior cerebral artery, middle cerebral artery, posterior cerebral artery, affected-side vertebral artery, and basilar artery. Brain-derived neurotrophic factor increased more, whereas neuron-specific enolase, visinin-like protein 1, and C-reactive protein decreased more markedly. Adverse event rates did not differ significantly between groups (14.75% vs. 18.03%). Conclusion Electroacupuncture combined with task-oriented rehabilitation was associated with greater, sustained improvements in upper-limb motor function and independence after ischemic stroke. Prospective studies are needed to confirm efficacy and safety, as this observational study cannot establish causality and was underpowered for definitive safety comparisons.