Acupuncture Plus Rehab Therapy Promising for Post-Stroke Urinary Incontinence: Meta-Analysis

Research revealed that the combination of acupuncture therapy and rehabilitation therapy proves more effective than either approach alone in enhancing clinical outcomes and bladder function in patients with post-stroke urinary incontinence.

Post-stroke urinary incontinence (PSUI) significantly impacts patients’ quality of life and recovery trajectory. With growing interest in non-pharmacological interventions, this study aimed to comprehensively evaluate whether combining acupuncture with standard rehabilitation offers a superior approach compared to either therapy alone.

Zifeng Dai, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China, and colleagues extensively searched eight electronic databases, identifying 36 randomized controlled trials that met the inclusion criteria. These studies, encompassing 2,796 participants, assessed the impact of integrating AT with RT in treating PSUI.

The analysis revealed the following findings:

• Patients receiving acupuncture therapy (AT) combined with rehabilitation therapy (RT) had significantly better outcomes compared to those treated with either RT or AT alone.
• The overall treatment success rate was higher in the combined therapy group, with a Risk Ratio of 1.23.
• Bladder function showed notable improvement in the combination group, including increased maximum bladder capacity and enhanced urinary flow rate.
• There was a significant rise in average urine output per void in patients receiving the combined therapy.
• Pelvic floor muscle strength improved across different muscle fiber types in the AT plus RT group.
• The therapy effectively reduced residual urine volume and maximal detrusor pressure.
• A notable decline was observed in the frequency of urination and urinary incontinence episodes over 24 hours.
• Patient-reported outcomes supported these findings, with lower symptom severity reflected in better ICIQ-SF scores.
• Quality-of-life improvements were seen, especially in I-QOL scores, though changes in the NIH Stroke Scale and Barthel Index scores did not reach statistical significance.

Despite these encouraging findings, the researchers caution that the current body of evidence has its limitations. Many of the included studies varied in methodological quality, and most were conducted within a single cultural context, which may affect generalizability. The authors emphasize the need for more high-quality, multicenter randomized trials to confirm the benefits of AT combined with RT and explore its effectiveness across diverse patient populations.

“The findings of the meta-analysis indicate that incorporating acupuncture into rehabilitation strategies may provide additional clinical benefits for patients with post-stroke urinary incontinence,” the researchers concluded. They further noted that this combined approach not only enhances bladder function and alleviates symptoms but also improves patient-reported quality of life, making it a promising adjunctive therapy in post-stroke recovery care.

Reference:

Dai, Z., Wang, Y., Du, Y., Hou, L., Li, Y., Ma, K., Yan, Q., Wen, J., Dong, X., Chen, X., & Zhang, L. (2025). Efficacy of acupuncture therapy plus related rehabilitation therapy for post-stroke urinary incontinence: A systematic review and meta-analysis. Frontiers in Neurology, 16, 1575970. https://doi.org/10.3389/fneur.2025.1575970