Wang Xiaoyu ¹ Lianjun Yin ^2* Yikun Wang ^1* Haining Zhang ^1* Shiying Zhang ^1* Jiantong Wu ^1* Shun Fan ^1* Zhengfei Li ^1* Huanan Li ¹ Jingui Wang ^1*

• ¹ First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Nankai District, China
• ² Recovery Unit, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China

Background: Transcutaneous electrical acupoint stimulation (TEAS) is an innovative noninvasive therapy that facilitates the contraction of paralysed muscles in the upper limbs, enhancing their functional recovery. Several studies have demonstrated the efficacy of TEAS in restoring upper limb function. This study aims to evaluate the impact of TEAS on upper limb motor recovery after stroke.Objectives: This article aims to evaluate the influence of TEAS on upper limb motor recovery after stroke and improve the quality of life.Methods: Eight databases were systematically searched from their inception to October 1, 2024. Two independent reviewers conducted the screening and data extraction of the study. The primary outcome measure was the Fugl Meyer Assessment of the upper extremity (FMA-UE), which evaluates upper extremity motor function in stroke patients. Secondary outcomes included the Modified Ashworth Scale (MAS) for assessing spasticity and the Modified Barthel Index (MBI) to evaluate patients' ability to perform activities of daily living. Data synthesis was performed using RevMan 5.4 and Stata 14.0. The GRADE method was employed to assess the quality of evidence.Results: 16 trials involving 1218 stroke patients were included in this meta analysis. Meta analysis showed that the TEAS can improve the function of upper limbs (SMD = 1.70, 95CI% = 1.09 to 2.31, p < 0.00001, I 2 = 93%; low certainty of evidence), spasticity (SMD = -1.18, 95CI% = -1.79 to -0.58, p < 0.00001, I 2 = 90%; very low certainty of evidence) and ability to daily life activities (SMD = 1.53, 95CI% = 0.85 to 2.20, p < 0.00001, I 2 = 95%; low certainty of evidence). Conclusion: Our results indicated that TEAS improved motor function and functional activities, and reduced muscle tone of upper limbs after stroke. However, these results should be interpreted with caution due to the limited strength of the evidence. High quality studies with larger sample sizes and multi center designs are essential to validate these preliminary findings further.This study was registered on PROSPERO with registration number CRD42024592509.