Repetitive peripheral magnetic stimulation alone or in combination with repetitive transcranial magnetic stimulation in poststroke rehabilitation: a systematic review and meta-analysis

Abstract Objective This study aimed to comprehensively review the effects of repetitive peripheral magnetic stimulation (rPMS) alone or in combination with repetitive transcranial magnetic stimulation (rTMS) on improving upper limb motor functions and activities of daily living (ADL) in patients wit...

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Main Authors: Yong Wang, Kenneth N. K. Fong, Youxin Sui, Zhongfei Bai, Jack Jiaqi Zhang
Format: Article
Language:English
Published: BMC 2024-10-01
Series:Journal of NeuroEngineering and Rehabilitation
Subjects:
Online Access:https://doi.org/10.1186/s12984-024-01486-8
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author Yong Wang
Kenneth N. K. Fong
Youxin Sui
Zhongfei Bai
Jack Jiaqi Zhang
author_facet Yong Wang
Kenneth N. K. Fong
Youxin Sui
Zhongfei Bai
Jack Jiaqi Zhang
author_sort Yong Wang
collection DOAJ
description Abstract Objective This study aimed to comprehensively review the effects of repetitive peripheral magnetic stimulation (rPMS) alone or in combination with repetitive transcranial magnetic stimulation (rTMS) on improving upper limb motor functions and activities of daily living (ADL) in patients with stroke, and to explore possible efficacy-related modulators. Methods A literature search from 1st January 2004 to 1st June 2024 was performed to identified studies that investigated the effects of rPMS on upper limb motor functions and ADL in poststroke patients. Results Seventeen studies were included. Compared with the control, both rPMS alone or rPMS in combination with rTMS significantly improved upper limb motor function (rPMS: Hedge’s g = 0.703, p = 0.015; rPMS + rTMS: Hedge’s g = 0.892, p < 0.001) and ADL (rPMS: Hedge’s g = 0.923, p = 0.013; rPMS + rTMS: Hedge’s g = 0.923, p < 0.001). However, rPMS combined with rTMS was not superior to rTMS alone on improving poststroke upper limb motor function and ADL (Hedge’s g = 0.273, p = 0.123). Meta-regression revealed that the total pulses (p = 0.003) and the number of pulses per session of rPMS (p < 0.001) correlated with the effect sizes of ADL. Conclusions Using rPMS alone or in combination with rTMS appears to effectively improve upper extremity functional recovery and activity independence in patients after stroke. However, a simple combination of these two interventions may not produce additive benefits than the use of rTMS alone. Optimization of rPMS protocols, such as applying appropriate dosage, may lead to a more favourable recovery outcome in poststroke rehabilitation.
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spelling doaj-art-d3b36df541cc4dc7addadeb39c33fc0e2025-08-20T02:17:34ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032024-10-0121111610.1186/s12984-024-01486-8Repetitive peripheral magnetic stimulation alone or in combination with repetitive transcranial magnetic stimulation in poststroke rehabilitation: a systematic review and meta-analysisYong Wang0Kenneth N. K. Fong1Youxin Sui2Zhongfei Bai3Jack Jiaqi Zhang4Department of Rehabilitation Sciences, The Hong Kong Polytechnic UniversityDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic UniversityDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic UniversityDepartment of Neurology and Neurorehabilitation, Shanghai YangZhi Rehabilitation Hospital, School of Medicine, Tongji UniversityDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic UniversityAbstract Objective This study aimed to comprehensively review the effects of repetitive peripheral magnetic stimulation (rPMS) alone or in combination with repetitive transcranial magnetic stimulation (rTMS) on improving upper limb motor functions and activities of daily living (ADL) in patients with stroke, and to explore possible efficacy-related modulators. Methods A literature search from 1st January 2004 to 1st June 2024 was performed to identified studies that investigated the effects of rPMS on upper limb motor functions and ADL in poststroke patients. Results Seventeen studies were included. Compared with the control, both rPMS alone or rPMS in combination with rTMS significantly improved upper limb motor function (rPMS: Hedge’s g = 0.703, p = 0.015; rPMS + rTMS: Hedge’s g = 0.892, p < 0.001) and ADL (rPMS: Hedge’s g = 0.923, p = 0.013; rPMS + rTMS: Hedge’s g = 0.923, p < 0.001). However, rPMS combined with rTMS was not superior to rTMS alone on improving poststroke upper limb motor function and ADL (Hedge’s g = 0.273, p = 0.123). Meta-regression revealed that the total pulses (p = 0.003) and the number of pulses per session of rPMS (p < 0.001) correlated with the effect sizes of ADL. Conclusions Using rPMS alone or in combination with rTMS appears to effectively improve upper extremity functional recovery and activity independence in patients after stroke. However, a simple combination of these two interventions may not produce additive benefits than the use of rTMS alone. Optimization of rPMS protocols, such as applying appropriate dosage, may lead to a more favourable recovery outcome in poststroke rehabilitation.https://doi.org/10.1186/s12984-024-01486-8StrokeUpper extremityPeripheral magnetic stimulationTranscranial magnetic stimulationCortical excitability
spellingShingle Yong Wang
Kenneth N. K. Fong
Youxin Sui
Zhongfei Bai
Jack Jiaqi Zhang
Repetitive peripheral magnetic stimulation alone or in combination with repetitive transcranial magnetic stimulation in poststroke rehabilitation: a systematic review and meta-analysis
Journal of NeuroEngineering and Rehabilitation
Stroke
Upper extremity
Peripheral magnetic stimulation
Transcranial magnetic stimulation
Cortical excitability
title Repetitive peripheral magnetic stimulation alone or in combination with repetitive transcranial magnetic stimulation in poststroke rehabilitation: a systematic review and meta-analysis
title_full Repetitive peripheral magnetic stimulation alone or in combination with repetitive transcranial magnetic stimulation in poststroke rehabilitation: a systematic review and meta-analysis
title_fullStr Repetitive peripheral magnetic stimulation alone or in combination with repetitive transcranial magnetic stimulation in poststroke rehabilitation: a systematic review and meta-analysis
title_full_unstemmed Repetitive peripheral magnetic stimulation alone or in combination with repetitive transcranial magnetic stimulation in poststroke rehabilitation: a systematic review and meta-analysis
title_short Repetitive peripheral magnetic stimulation alone or in combination with repetitive transcranial magnetic stimulation in poststroke rehabilitation: a systematic review and meta-analysis
title_sort repetitive peripheral magnetic stimulation alone or in combination with repetitive transcranial magnetic stimulation in poststroke rehabilitation a systematic review and meta analysis
topic Stroke
Upper extremity
Peripheral magnetic stimulation
Transcranial magnetic stimulation
Cortical excitability
url https://doi.org/10.1186/s12984-024-01486-8
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