Therapeutic effect of scalp-based acupuncture and moxibustion as an adjunctive treatment on children with cerebral palsy comparing to conventional rehabilitation therapy: a systematic review and meta-analysis of randomized controlled trials

Cerebral palsy in children represents one of the most significant challenges in pediatric neurology, characterized as a predominantly congenital condition that affects the development of the central nervous system. This complex condition manifests through a variety of debilitating symptoms, including intellectual deficits, motor dysfunction, behavioral changes, and impairment of essential abilities such as language, vision, and hearing. The causes of this condition are multifactorial, potentially related to prenatal factors such as maternal alcoholism, substance use, diseases such as diabetes and hypertension during pregnancy, complications during delivery such as cerebral hypoxia-ischemia, or postnatal problems such as infections and malnutrition. Conventional treatment traditionally includes neurotrophic medications, muscle relaxants, and physical rehabilitation therapies; however, the complex nature of the condition has motivated the search for more effective complementary therapeutic approaches.

This study conducted a systematic review and meta-analysis to scientifically evaluate the efficacy of scalp acupuncture as a complementary treatment for children with cerebral palsy, comparing its results with conventional rehabilitation therapy. Researchers conducted a comprehensive search of four major medical databases between January 2000 and December 2021, specifically looking for randomized controlled trials investigating the use of scalp acupuncture in children with cerebral palsy. After rigorous methodological selection, 11 high-quality studies were included, totaling 731 child participants — 369 in the experimental group and 362 in the control group. The methodology employed rigorous evaluation criteria, using internationally recognized standardized scales to measure different aspects of child development, including the Mental Development Index, the Psychological Development Index, and the Gross Motor Function Measure.

Study quality was assessed using specific tools to minimize the risk of bias and ensure the reliability of results.

The results consistently and statistically significantly demonstrated that scalp acupuncture provided superior benefits compared with conventional rehabilitation alone. The pooled analysis revealed a notable improvement in the overall treatment efficacy rate, with children who received scalp acupuncture being 3.73 times more likely to experience significant symptomatic improvement. With respect to mental development, children treated with scalp acupuncture demonstrated mean gains 15.58 points higher than those of the control group, indicating substantial advances in cognitive abilities. Similarly impressive was the impact on psychological development, where a mean difference of 13.23 points was observed in favor of the scalp acupuncture group.

Gross motor function — fundamental for the independence and quality of life of these children — also showed significant improvements, with mean differences of 17.45 points on the assessment scale. Particularly relevant was the finding that the technique demonstrated an excellent safety profile, with only isolated reports of mild bleeding at the needling sites, events easily managed and without lasting consequences.

The clinical implications of these findings are deeply encouraging for families and professionals dealing with childhood cerebral palsy. The results suggest that incorporating scalp acupuncture into conventional rehabilitation protocols can significantly enhance therapeutic outcomes, offering children greater possibilities for neurological, cognitive, and motor development. For health care professionals, these data provide robust scientific evidence that can support informed clinical decisions about including this therapeutic modality in treatment plans. The scalp acupuncture technique is based on the stimulation of specific scalp points that correspond to functional brain areas, potentially promoting neuroplasticity, improving cerebral circulation, and stimulating neural repair processes.

For families, these results offer renewed hope and an additional therapeutic option that can be safely integrated into existing care, potentially accelerating their children's developmental progress.

It is important to acknowledge that this study has some limitations that should be considered when interpreting the results. The relatively small number of included studies and the variability in the specific acupuncture techniques employed represent factors that may influence the generalizability of the findings. Additionally, the diversity of symptoms in children with cerebral palsy resulted in distinct therapeutic foci across studies, with some concentrating on motor dysfunction while others prioritized language or cognitive development problems. The methodological quality of the included studies, although adequate, still has room for improvement, with the majority classified as having "some concerns" regarding risk of bias.

These limitations indicate the need for future research with even more rigorous methodological designs, including multicenter studies with larger samples and standardized scalp acupuncture protocols. Notwithstanding these considerations, the results obtained provide valuable scientific evidence supporting the use of scalp acupuncture as a promising and safe complementary therapeutic modality for children with cerebral palsy, representing a significant advance in the therapeutic arsenal available for the management of this complex neurological condition.