2.2. Eligibility criteria

RCTs with parallel-group or crossover designs were included. All non-RCT studies were excluded.

Participants in eligible studies were adults who suffered dysarthria following stroke, regardless of sex, age, or duration of the disease. Individuals diagnosed with dysarthria resulting from other conditions (e.g., Parkinson's disease or brain tumors), or from aphasia, were excluded.

The intervention group received ACWSRT, regardless of frequency, intensity, or duration of the interventions. We included patients receiving either manual acupuncture or electroacupuncture, using conventional acupoints. We also included acupuncture therapies that focused on specific parts of the body, such as nape, scalp, or tongue acupuncture. RCTs that combined ACWSRT with herbal medicine, moxibustion, tuina, auricular therapy, or other alternative complementary treatments, were excluded.

The comparator was speech rehabilitation training alone (SRTA), i.e., conventional speech and language therapies including articulation, voice, prosody, and respiratory training.

The primary outcome measure was the clinical response rate measured with the Frenchay Dysarthria Assessment (FDA) tool. Clinical response was defined as sufficient improvement of speech and language function, and the clinical response rate was calculated as the portion of the patients exhibiting a clinical response among the analyzed populations. Clinical response was evaluated using the following scale: (1) cured, (2) markedly effective, (3) effective, and (4) ineffective.

The secondary outcomes were speech intelligibility and quality of life (measured using a validated questionnaire). Adverse events and serious adverse events were also summarized.