Citation

Li Y, Fan J, Yang J, He C, Li S. Am. J. Phys. Med. Rehabil. 2018; 97(11): 773-781.

Affiliation

Athinoula A. Martions Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, USA.

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/PHM.0000000000000948

PMID

29734235

Abstract

OBJECTIVE: To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on walking and balance function in patients with stroke.

DESIGN: MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, CENTRAL, and the Physiotherapy Evidence Database were comprehensively searched for randomized controlled trials published through March 2017 that investigated the effects of rTMS on lower limb function. Main outcomes included walking speed, balance function, motor function, and cortical excitability.

RESULTS: Nine studies were included. The meta-analysis revealed a significant effect of rTMS on walking speed (SMD 0.64, 95% CI: 0.32 to 0.95), particularly ipsilesional stimulation (SMD 0.80, 95% CI: 0.36 to 1.24). No significant effects were found for balance function (SMD 0.10, 95% CI: -0.26 to 0.45), motor function (MD 0.50, 95% CI: -0.68 to 1.68) or cortical excitability (motor-evoked potentials (MEPs) of the affected hemisphere: MD 0.21 mV, 95% CI: -0.11 to 0.54; MEPs of the unaffected hemisphere: MD 0.09 mV, 95% CI: -0.16 to -0.02).

CONCLUSION: These results suggest that rTMS, particularly ipsilesional stimulation, significantly improves walking speed. Future studies with larger sample sizes and an adequate follow-up period are required to further understand the effects of rTMS on lower limb function and its relationship with changes in cortical excitability with the help of functional neuroimaging techniques.

Language: en