Therapeutic efficacy of repetitive transcranial magnetic stimulation on gait and limb balance function in patients with lower limb dysfunction post-cerebral infarction: a systematic review and meta-analysis

Abstract Background This investigation is designed to evaluate the effects of rTMS and its varying stimulation parameters and target sites on the therapeutic outcomes for post-stroke lower limb motor impairment and balance, with the objective of pinpointing stimulation locations and parameters that...

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Main Authors: De-mei Jia, Xuan Li, Bin-cang Zhang, Bing-ran Zhang, Qiu-juan Zhang, Ming-wei Liu, Lin-ming Zhang
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Neurology
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Online Access:https://doi.org/10.1186/s12883-025-04112-9
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Summary:Abstract Background This investigation is designed to evaluate the effects of rTMS and its varying stimulation parameters and target sites on the therapeutic outcomes for post-stroke lower limb motor impairment and balance, with the objective of pinpointing stimulation locations and parameters that are both reasonable and applicable in clinical practice. Materials and methods An exhaustive search was carried out across the PubMed, MEDLINE, Embase, CENTRAL, and Web of Science databases to identify RCTs that assessed the effectiveness of rTMS in the treatment of lower limb motor impairment following a stroke. Meta-analysis was performed usingR statistical environment (V.4.2.2, www.r-project.org ). The review period encompassed the interval from the databases' origination through to February 18, 2024. Results Research reveals that applying rTMS to the unaffected motor cortex markedly enhances gait speed in stroke patients,exhibiting a significant effect (SMD: 1.117, 95% CI:0.40, 1.82, I2 = 0.0%). rTMS sessions comprising 1000–1500 pulses (SMD: 0.92, 95% CrI:0.63, 1.21, I2 = 42%, six studies), with a total session count ≥ 10 (SMD: 0.85, 95% CrI:0.53, 1.18, I2 = 54.1%, six studies), and high-frequency rTMS (SMD: 0.83, 95% CrI:0.34, 1.09, I2 = 46.3%, three studies) exhibit significant efficacyin improving lower limb balance and gait post-stroke. Conclusions The research indicates that rTMS has been instrumental in enhancing the post-stroke prognosis for gait and limb balance. Nevertheless, the therapeutic efficacy of rTMS is subject to the diversity in stimulation locations and parameter settings.
ISSN:1471-2377