Association of Adjunctive Hyperbaric Oxygen Therapy With Short-Term Functional Recovery in Patients With Recovery-Phase Ischemic Stroke Receiving Acupuncture and Rehabilitation: A Propensity-Score-Matched Retrospective Cohort Study

Objective To examine the association between adjunctive hyperbaric oxygen therapy (HBOT) and short-term functional recovery in patients receiving acupuncture and motor rehabilitation after ischemic stroke in the recovery phase. Methods A retrospective cohort study analyzed 102 patients (onset 1–3 months prior, October 2022–December 2025) categorized into Control (acupuncture + motor therapy, n = 51) and Observation (acupuncture + motor therapy + HBOT, n = 51) groups. Baseline characteristics (age, sex, time from onset, National Institutes of Health Stroke Scale, Brunnstrom stage, Barthel Index) were balanced using 1:1 propensity score matching. Primary outcomes (changes in Brunnstrom stage and Barthel Index) were compared between groups using multivariable linear regression with cluster-robust standard errors accounting for matched pairs and adjustment for residual postmatching imbalance; paired Wilcoxon signed-rank tests were performed as sensitivity analyses. The secondary composite response outcome was analyzed using McNemar's test. Results After matching, baseline characteristics were generally balanced, although four covariates retained modest residual imbalance (standardized mean difference 0.10–0.16) and were further adjusted for. The Observation group showed greater improvement in Brunnstrom stage (adjusted mean difference, 0.65; 95% CI, 0.52–0.78; p < 0.001) and Barthel Index (adjusted mean difference, 5.62; 95% CI, 3.93–7.32; p < 0.001) than the Control group. Matched-pair Wilcoxon sensitivity analyses yielded consistent results (both p < 0.001). The composite response rate was higher in the Observation group (88.2% vs. 64.7%), with matched-pair analysis also supporting a between-group difference (McNemar p = 0.0015). Conclusion The addition of HBOT to acupuncture plus motor rehabilitation was associated with greater short-term improvements in motor recovery and daily living independence; given the retrospective design, these findings are hypothesis-generating and require confirmation in prospective randomized trials.