Repetitive Transcranial Magnetic Stimulation for the Treatment of Lower Limb Dysfunction in Patients Poststroke: A Systematic Review with Meta-Analysis.


Author: Ghayour-Najafabadi M1, Memari AH2, Hosseini L2, Shariat A2, Cleland JA3

Affiliation: <sup>1</sup>Department of Motor Behavior, Faculty of Physical Education and Sport Science, University of Tehran, Tehran, Iran. Electronic address: m.ghayournaj@ut.ac.ir.

<sup>2</sup>Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

<sup>3</sup>Franklin Pierce University, Manchester, New Hampshire.
Conference/Journal: J Stroke Cerebrovasc Dis.
Date published: 2019 Dec
Other:
 Volume ID: 28   ,  Issue ID: 12   ,  Pages: 104412   ,  Special Notes: doi: 10.1016/j.jstrokecerebrovasdis.2019.104412. Epub  2019 Oct 2.   ,  Word Count: 171  
    PURPOSE: To investigate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in recovery of lower limb dysfunction in patients poststroke.



PARTICIPANTS AND METHODS: Cochrane Central Register of Controlled Trials, Medline, ISI web of knowledge, EBSCO, Embase, Cumulative Index to Nursing and Allied Health Literature and Scopus.



RESULTS: Fifteen trials with 385 patients were included. Results showed that rTMS had a significant effect on balance (standard mean difference [SMD] = .38; 95% confidence interval [CI], .07: .69; I2 = 51%) and mobility (SMD: -.67; 95% CI, -1.08: -.26; I2 = 72%). However, rTMS had no significant immediate effects on the lower limb subscale of the Fugl-Meyer Assessment (FMA-L) (SMD = .01; 95% CI, -.29: .31; I2 = 0%). Continued effects of rTMS was also found to be significant during the follow-up period (SMD = .46; 95% CI, .09: .84; I2 = 14%).



CONCLUSION: rTMS was found to result in positive effects on mobility, balance and long-term prognosis of FMA-L. However data indicated that there is insufficient evidence for the effectiveness of rTMS in improving lower limb function.



Copyright © 2019. Published by Elsevier Inc.



KEYWORDS: Patients poststroke; balance; disability, lower extremity motor function; rTMS



PMID: 31585773  DOI: 10.1016/j.jstrokecerebrovasdis.2019.104412