PDF(Pubmed)
Abstract：
(1) Background: Restoring arm and hand function is one of the priorities of people with cervical spinal cord injury (cSCI). Noninvasive electromagnetic neuromodulation is a current approach that aims to improve upper-limb function in individuals with SCI. The aim of this study is to review updated information on the different applications of noninvasive electromagnetic neuromodulation techniques that focus on restoring upper-limb functionality and motor function in people with cSCI. (2) Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used to structure the search protocol. A systematic review of the literature was performed in three databases: the Cochrane Library, PubMed, and Physiotherapy Evidence Database (PEDro). (3) Results: Twenty-five studies were included: four were on transcranial magnetic stimulation (TMS), four on transcranial direct current stimulation (tDCS), two on transcutaneous spinal cord stimulation (tSCS), ten on functional electrical stimulation (FES), four on transcutaneous electrical nerve stimulation (TENS), and one on neuromuscular stimulation (NMS). The meta-analysis could not be completed due to a lack of common motor or functional evaluations. Finally, we realized a narrative review of the results, which reported that noninvasive electromagnetic neuromodulation combined with rehabilitation at the cerebral or spinal cord level significantly improved upper-limb functionality and motor function in cSCI subjects. Results were significant compared with the control group when tSCS, FES, TENS, and NMS was applied. (4) Conclusions: To perform a meta-analysis and contribute to more evidence, randomized controlled trials with standardized outcome measures for the upper extremities in cSCI are needed, even though significant improvement was reported in each non-invasive electromagnetic neuromodulation study.
摘要：
（1）背景：恢复手臂和手功能是颈脊髓损伤（cSCI）患者的优先事项之一。无创电磁神经调节是目前的一种方法，旨在改善SCI患者的上肢功能。这项研究的目的是回顾有关非侵入性电磁神经调节技术的不同应用的最新信息，这些技术专注于恢复cSCI患者的上肢功能和运动功能。(2)方法:采用系统评价和Meta分析(PRISMA)指南的首选报告项目构建检索方案。在三个数据库中对文献进行了系统的回顾：Cochrane图书馆，PubMed,和物理治疗证据数据库（PEDro）。（3）结果：共纳入25项研究，其中4项是经颅磁刺激（TMS），四对经颅直流电刺激（TDCS），两个经皮脊髓刺激（tSCS），功能电刺激（FES）四个经皮神经电刺激（TENS），和一个神经肌肉刺激（NMS）。由于缺乏共同的运动或功能评估，无法完成荟萃分析。最后,我们实现了对结果的叙述性回顾，该研究报告,在cSCI受试者中,非侵入性电磁神经调节联合脑或脊髓水平的康复治疗显著改善了上肢功能和运动功能.结果与对照组相比，tSCS时，FES,TENS,并应用了NMS。(4)结论：为了进行荟萃分析并提供更多证据，需要对cSCI上肢进行标准化结局测量的随机对照试验，尽管在每项非侵入性电磁神经调节研究中都有显著改善.
