Eight RCTs (n=534 patients) were included in the review; sample sizes ranged from 13 to 120 patients. Three trials adequately described randomisation, but it was not clear if allocation was concealed in any of the trials. Two trials reported blinding of outcome assessors but patients across all the trials were either not blinded to treatment or blinding was unclear. One study did not clearly report how many patients were included in the analyses.
There were significant beneficial effects found with contralateral acupuncture in response rate compared with ipsilateral acupuncture (RR 1.12, 95% CI 1.04 to 1.22; I2 =0%; six RCTs; n=361 patients). Subgroup analyses showed similar superior effects of contralateral acupuncture on response rate in patients with cerebral infarction (RR 1.15, 95% CI 1.04 to 1.27, I2=0%; four RCTs; n=261 patients).
Analyses of patients with cerebral infarction and intra-cranial haemorrhage did not show any difference in response rate between contralateral acupuncture and ipsilateral acupuncture, although there was some heterogeneity (I2=44%; two RCTs).
There were no significant differences between contralateral acupuncture and ipsilateral acupuncture observed across the trials in the performance of activities of daily living (three RCTs; I2=36%), neurological deficit scores (two RCTs; I2=60%), or on motor function (three RCTs; I2=86%); there was some heterogeneity found across the results for these outcomes.