BackgroundSpasticity is a common motor disorder resulting from upper motor neuron lesions. It has a serious influence on an individual's motor function and daily activity. Repetitive peripheral magnetic stimulation (rPMS) is a non-invasive and painless approach developed for therapeutic intervention in clinical rehabilitation. However, the effectiveness of this intervention on spasticity in patients with spastic paralysis remains uncertain.ObjectiveThis study aimed to investigate the effectiveness of rPMS on spasticity, motor function, and activities of daily living in individuals with spastic paralysis.MethodsPubMed, PEDro, Embase, Cochrane Library, and Web of Science were searched for eligible papers with date up to March 31, 2022. Two independent researchers conducted study screening, data extraction, and methodological quality assessment. RCTs that explored the effects of rPMS on spasticity, motor function, and activities of daily living in patients with spastic paralysis were included for review. The Cochrane collaboration tool was used to assess methodological quality. The cumulative effects of available data were processed for a meta-analysis using Reedman software.ResultsEight studies with 297 participants were included. Most of the studies presented low to moderate risk of bias. Compared with the control group, the results showed that rPMS had a significant effect on spasticity (all spasticity outcomes: standardized mean difference [SMD] = −0.55, 95% confidence interval [CI]: −0.94 to −0.16, I2 = 40%, and P = 0.006, Modified Ashworth Scale: mean difference [MD] = −0.48, 95% CI: −0.82 to −0.14, I2 = 0%, and P = 0.006), motor function (Fugl–Meyer Assessment: MD = 4.17, 95% CI: 0.89 to 7.46, I2 = 28%, and P = 0.01), and activities of daily living (Barthel Index: MD = 5.12, 95% CI: 2.58 to 7.67, I2 = 0%, and P < 0.0001). No side effect was reported.ConclusionThe meta-analysis demonstrated that the evidence supported rPMS in improving spasticity especially for passive muscle properties evaluated with Modified Ashworth Scale/Ashworth Scale, as well as motor function and daily activity of living in individuals with spastic paralysis.Study registrationThe reviewed protocol of this study is registered in the international prospective register of systematic reviews (PROSPERO) (CRD42022322395).Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42022322395.
Background. Repetitive transcranial magnetic stimulation (rTMS) has been widely used in the treatment of neuropathic orofacial pain (NOP). The consistency of its therapeutic efficacy with the optimal protocol is highly debatable. Objective. To assess the effectiveness of rTMS on pain intensity, psychological conditions, and quality of life (QOL) in individuals with NOP based on randomized controlled trials (RCTs). Methods. We carefully screened and browsed 5 medical databases from inception to January 1, 2022. The study will be included that use of rTMS as the intervention for patients with NOP. Two researchers independently completed record retrieval, data processing, and evaluation of methodological quality. Quality and evidence were assessed using the PEDro scores and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results. Six RCTs with 214 participants were included in this systematic review: 2 studies were considered level 1 evidence, and 4 were considered level 2 evidence. Six studies found that high-frequency rTMS had a pain-relieving effect, while 4 studies found no improvement in psychological conditions and QOL. Quality of evidence (GRADE system) ranged from moderate to high. No significant side effects were found. Conclusions. There is moderate-to-high evidence to prove that high-frequency rTMS is effective in reducing pain in individuals with NOP, but it has no significant positive effect on psychological conditions and QOL. High-frequency rTMS can be used as an alternative treatment for pain in individuals with NOP, but further studies will be conducted to unify treatment parameters, and the sample size will be expanded to explore its influence on psychological conditions and QOL.
Repetitive peripheral magnetic stimulation (rPMS) is a non-invasive and painless approach that can penetrate deeper structures to improve motor function in people with physical impairment due to stroke. A review of available literature was undertaken to discuss the potential mechanisms of rPMS-based neuromodulation and the application of rPMS in the recovery of motor function (e.g., muscle strength, spasticity, motor control and joint mobility, glenohumeral subluxation) after stroke. Issues of concern about parameters and safety of rPMS were also overviewed. Existing evidence has shown that suprathreshold rPMS can be a potential intervention for motor recovery in patients with stroke because of its neuromodulatory effects. However, the rPMS parameters employed by each research team are highly variable for specific lesions. Thus, more high-quality studies on the optimal rPMS protocols for different impairments are warranted in the future.
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