Effect of transcranial magnetic stimulation on the limb function of stroke patients: a systematic review and meta-analysis.

OBJECTIVE

This study aims to evaluate the effects of transcranial magnetic stimulation (TMS) on Fugl-Meyer Assessment for Upper Limb (FMA-UL), Fugl-Meyer Assessment for Lower Limb (FMA-LL), Modified Ashworth Scale (MAS), Box and Block Test (BBT), Action Research Arm Test (ARAT), and Wolf Motor Function Test (WMFT) in stroke patients.

DATA SOURCES: A systematic search of PubMed, Web of Science, Embase, and Ovid databases was conducted to identify relevant studies.

METHODS

Only randomized controlled trials (RCTs) investigating TMS interventions in stroke patients were included. Data analysis was performed using Stata 18.0, incorporating subgroup analysis, sensitivity analysis, and bias assessments.

RESULTS

A total of 21 documents were included. The meta-analysis revealed that TMS significantly improved ARAT (MD = 8.01, 95% CI: 0.53-15.50, P = 0.04) and BBT (MD = 5.36, 95% CI: 0.16-10.56, P = 0.04). However, no significant effects were observed for FMA-UL, FMA-LL, MAS, and WMFT (P > 0.88). The subgroup analysis shows that there is a significant difference in the effects of different intervention cycles on FMA-UL in stroke patients. The intervention cycle has no effect on FMA (P > 0.05), but weeks> 2 improves FMA (MD = 4.44, 95% CI: 0.83-8.06, P = 0.016).

CONCLUSION

TMS has a positive effect on the limb function of stroke patients, especially the flexibility and motion function of the upper limbs. However, due to the limited sample size in this study, further large-scale RCTs are necessary to confirm these findings.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/myprospero, identifier: CRD42024618509.