scholarly journals A Meta-Analysis: Whether Repetitive Transcranial Magnetic Stimulation Improves Dysfunction Caused by Stroke with Lower Limb Spasticity

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Yu Liu ◽  
Hong Li ◽  
Jun Zhang ◽  
Qing-qing Zhao ◽  
Hao-nan Mei ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Lower Extremity ◽  
Randomized Controlled Trials ◽  
Lower Limb ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Limb Spasticity ◽  
Lower Limb Spasticity

Objective. To evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in improving lower limb spasticity after stroke. Methods. The PubMed, Web of Science, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM) disc, China Science and Technology Journal Database (VIP), and Wanfang databases were searched online from their inception to May 2021 for randomized controlled trials (RCTs) involving repetitive transcranial magnetic stimulation for lower extremity spasticity after stroke. Valid data were extracted from the included literature, and the quality evaluation was conducted with the Cochrane Handbook for Systematic Reviews of Interventions along with the Physiotherapy Evidence Database scale (PE-Dro scale). The data that met the quality requirements were systematically analysed using Review Manager 5.4 software. Results. A total of 554 patients from seven articles (nine studies) were quantitatively analysed. Outcomes included the Modified Ashworth Scale (MAS), Fugl–Meyer Assessment of Lower Extremity (FMA-LE), Modified Barthel Index (MBI), and Timed Up and Go (TUG), measured as the effect of rTMS compared with controls conditions after treatment. The systematic review showed that rTMS reduced MAS and increased MBI scores, respectively (SMD = −0.24, 95% CI [−0.45, −0.03], P  = 0.02; MD = 6.14, 95% CI [−3.93,8.35], P  ＜ 0.00001), compared with control conditions. Low-frequency rTMS (LF-rTMS) significantly improved FMA-LE scores (SMD = 0.32, 95% CI [0.13, 0.51], P  = 0.001). However, there was no significant difference in FMA-LE scores when using high-frequency rTMS (HF-rTMS) ( P  > 0.1) and in TUG times ( P  > 0.1) between the treatment and control groups. Conclusions. rTMS was effective in improving spasticity and activities of daily living. LF-rTMS has positive clinical effects on enhancing motor function in patients who experience lower extremity spasticity after stroke. To better validate the above conclusions, more multicentre, high-quality, and double-blind randomized controlled trials are needed.

scholarly journals Efficacy of Repetitive Transcranial Magnetic Stimulation in Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 10 (20) ◽  
pp. 4669
Author(s):  
Yu-Chi Su ◽  
Yao-Hong Guo ◽  
Pei-Chun Hsieh ◽  
Yu-Ching Lin
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Older Patients ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled

This article aimed to investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in fibromyalgia. The PubMed, Medline, Cochrane Library, and Web of Science databases were searched for articles published through 14 August 2021. We enrolled only randomized controlled trials. The Cochrane Collaboration risk of bias tool was used for quality assessment. Outcomes were analyzed as standardized mean differences (SMDs) with 95% CIs. The beta coefficient and p value were adopted for meta-regression. We included 18 studies comprising 643 participants. A significant reduction in disease influence, as measured by the Fibromyalgia Impact Questionnaire, was observed (SMD, −0.700, 95% CI, −1.173 to −0.228), and the reduction was larger in older patients (β = −0.1327, p = 0.008). The effect persisted at least two weeks after the final treatment session (SMD, −0.784, 95% CI, −1.136 to −0.432). Reductions in pain, depression, and anxiety were discovered, which persisted for at least two weeks after the last intervention. The effects on pain and depression remained significant up to one and a half months after the final session. No serious adverse events were reported by the included articles. In conclusion, our systematic review and meta-analysis revealed that rTMS is safe and effective for managing multiple domains of fibromyalgia-related symptoms and older patients may have a stronger treatment effect. Larger randomized controlled trials with sufficient male populations are warranted to confirm our findings, detect rare adverse events, and determine the optimal stimulation parameters.

Effects of Repetitive Transcranial Magnetic Stimulation on Upper Extremity Spasticity Post-Stroke: A Systematic Review

2021 ◽  
Author(s):  
Anas R. Alashram ◽  
Elvira Padua ◽  
Cristian Romagnoli ◽  
Manikandan Raju ◽  
Giuseppe Annino
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Randomized Controlled Trials ◽  
Upper Extremity ◽  
Magnetic Stimulation ◽  
Randomized Clinical Trials ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Trials ◽  
Post Stroke ◽  
Randomized Controlled

AbstractUpper extremity spasticity is one of the most popular impairments following stroke. It can reduce patients' functional level. Recently, repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising tool in stroke rehabilitation. This review was conducted to investigate the immediate and long-term effects of rTMS on the upper extremity spasticity post-stroke and determine the optimal treatment protocols. PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, AMED, and Web of Science databases were searched for randomized controlled trials investigating the effect of rTMS on the upper extremity spasticity in patients with stroke. The methodological quality was assessed using the Cochrane Collaboration’s tool. Ten randomized clinical trials were met the inclusion criteria. A total of 225 patients were included in this analysis, 35.30% of whom were females. The mean age for all patients was 60.14 years. The findings showed heterogeneous evidence on the benefits of rTMS intervention in the upper extremity spasticity post-stroke. The evidence for the effect of rTMS on the upper extremity spasticity post-stroke is promising. Combining rTMS with other rehabilitation interventions may show a superior effect in reducing the upper extremity spasticity compared with rTMS intervention alone. Further randomized controlled trials with long-term follow-ups are warranted.

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