PDF(Pubmed)
Abstract：
UNASSIGNED: Repetitive transcranial magnetic stimulation (rTMS), as an emerging non-invasive neuromodulation technique, is now widely employed in rehabilitation therapy. The purpose of this paper is to comprehensively summarize existing evidence regarding rTMS intervention for lower limb motor function in patients at different stages of stroke.
UNASSIGNED: A systematic search was conducted to identify randomized controlled trials (RCTs) assessing the efficacy of rTMS for treating lower limb motor dysfunction after stroke. Multiple databases, including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP Database, PubMed, Embase, Web of Science, and Cochrane Library, were searched. The search period extended from the inception of the libraries to June 2024. Literature information was extracted, and methodological quality was evaluated using the risk of bias assessment tool in the Cochrane Handbook. Meta-analysis was performed using Stata 17.0 software.
UNASSIGNED: Overall, 49 appropriate studies (including 3,558 stroke subjects) were found. Meta-analysis results demonstrated that rTMS effectively improved lower limb motor function across all stages of stroke. The intervention was particularly more effective in patients in the subacute stage than in the acute or chronic stages. Subgroup analysis revealed that, for acute-stage patients, low-frequency stimulation targeting the M1 or DLPFC brain regions on the unaffected side with 20-40 sessions significantly improved FMA-LE scores. In subacute-phase patients, low-frequency stimulation targeting the M1 brain regions on the unaffected side with 18 sessions significantly improved FMA-LE scores. The results demonstrated that HF-rTMS was more effective than LF-rTMS in improving walking speed, with the greatest efficacy observed at 20 sessions. While for enhancing gait balance in stroke patients, LF-rTMS with the best therapeutic effect was observed at a frequency of 20-40 treatments.
UNASSIGNED: This study demonstrates the efficacy of rTMS in improving lower limb motor function, balance, and walking speed in stroke patients at various stages. The findings provide a valuable reference for the development of optimized rTMS treatment plans in clinical practice.Systematic review registration: PROSPERO: CRD42023466094.
UNASSIGNED: A systematic search was conducted to identify randomized controlled trials (RCTs) assessing the efficacy of rTMS for treating lower limb motor dysfunction after stroke. Multiple databases, including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP Database, PubMed, Embase, Web of Science, and Cochrane Library, were searched. The search period extended from the inception of the libraries to June 2024. Literature information was extracted, and methodological quality was evaluated using the risk of bias assessment tool in the Cochrane Handbook. Meta-analysis was performed using Stata 17.0 software.
UNASSIGNED: Overall, 49 appropriate studies (including 3,558 stroke subjects) were found. Meta-analysis results demonstrated that rTMS effectively improved lower limb motor function across all stages of stroke. The intervention was particularly more effective in patients in the subacute stage than in the acute or chronic stages. Subgroup analysis revealed that, for acute-stage patients, low-frequency stimulation targeting the M1 or DLPFC brain regions on the unaffected side with 20-40 sessions significantly improved FMA-LE scores. In subacute-phase patients, low-frequency stimulation targeting the M1 brain regions on the unaffected side with 18 sessions significantly improved FMA-LE scores. The results demonstrated that HF-rTMS was more effective than LF-rTMS in improving walking speed, with the greatest efficacy observed at 20 sessions. While for enhancing gait balance in stroke patients, LF-rTMS with the best therapeutic effect was observed at a frequency of 20-40 treatments.
UNASSIGNED: This study demonstrates the efficacy of rTMS in improving lower limb motor function, balance, and walking speed in stroke patients at various stages. The findings provide a valuable reference for the development of optimized rTMS treatment plans in clinical practice.Systematic review registration: PROSPERO: CRD42023466094.
摘要：
■重复经颅磁刺激(rTMS),作为一种新兴的非侵入性神经调节技术，现在广泛用于康复治疗。本文旨在全面总结rTMS干预不同阶段脑卒中患者下肢运动功能的现有证据。
■进行了系统搜索，以确定评估rTMS治疗中风后下肢运动功能障碍的疗效的随机对照试验（RCT）。多个数据库,包括中国国家知识基础设施(CNKI)，万方数据知识服务平台,VIP数据库,PubMed,Embase,WebofScience,和Cochrane图书馆,被搜查了。搜索期从图书馆开始延伸至2024年6月。提取文献信息,使用Cochrane手册中的偏倚风险评估工具评估方法学质量。采用Stata17.0软件进行Meta分析。
■总的来说，发现了49项适当的研究（包括3,558名中风受试者）。Meta分析结果表明，rTMS可有效改善脑卒中各个阶段的下肢运动功能。在亚急性阶段的患者中，干预尤其比在急性或慢性阶段更有效。亚组分析显示，对于急性期患者，针对未受影响侧M1或DLPFC脑区的低频刺激20-40次疗程可显著改善FMA-LE评分.在亚急性期患者中，针对未受影响侧M1脑区的低频刺激18次,显著提高了FMA-LE评分.结果表明，HF-rTMS在提高步行速度方面比LF-rTMS更有效。在20个疗程中观察到最大的疗效。在提高脑卒中患者步态平衡的同时,在20-40次治疗的频率下观察到具有最佳治疗效果的LF-rTMS。
■这项研究证明了rTMS在改善下肢运动功能方面的功效，balance,中风患者在不同阶段的步行速度。研究结果为临床上制定优化的rTMS治疗方案提供了有价值的参考。系统审查注册：PROSPERO：CRD42023466094。
■进行了系统搜索，以确定评估rTMS治疗中风后下肢运动功能障碍的疗效的随机对照试验（RCT）。多个数据库,包括中国国家知识基础设施(CNKI)，万方数据知识服务平台,VIP数据库,PubMed,Embase,WebofScience,和Cochrane图书馆,被搜查了。搜索期从图书馆开始延伸至2024年6月。提取文献信息,使用Cochrane手册中的偏倚风险评估工具评估方法学质量。采用Stata17.0软件进行Meta分析。
■总的来说，发现了49项适当的研究（包括3,558名中风受试者）。Meta分析结果表明，rTMS可有效改善脑卒中各个阶段的下肢运动功能。在亚急性阶段的患者中，干预尤其比在急性或慢性阶段更有效。亚组分析显示，对于急性期患者，针对未受影响侧M1或DLPFC脑区的低频刺激20-40次疗程可显著改善FMA-LE评分.在亚急性期患者中，针对未受影响侧M1脑区的低频刺激18次,显著提高了FMA-LE评分.结果表明，HF-rTMS在提高步行速度方面比LF-rTMS更有效。在20个疗程中观察到最大的疗效。在提高脑卒中患者步态平衡的同时,在20-40次治疗的频率下观察到具有最佳治疗效果的LF-rTMS。
■这项研究证明了rTMS在改善下肢运动功能方面的功效，balance,中风患者在不同阶段的步行速度。研究结果为临床上制定优化的rTMS治疗方案提供了有价值的参考。系统审查注册：PROSPERO：CRD42023466094。
