Effects of non-invasive brain stimulation on motor function after spinal cord injury: a systematic review and meta-analysis.
Jian-Min Chen, Xiao-Lu Li, Qin-He Pan and 3 others
PMID 36635693WHAT IT FOUND
Non-invasive brain stimulation improved lower-limb strength and balance in people with spinal cord injury, but did not improve walking speed, endurance, or upper-limb function.
Most participants received concurrent rehabilitation, so the specific contribution of the brain stimulation remains unclear.
Key findings
01Brain stimulation groups showed greater improvements in lower-limb strength and balance compared with sham groups.
02There was no significant difference in mobility outcomes, including walking distance and speed, between brain stimulation and sham groups.
03Ten of the fourteen included studies combined brain stimulation with other rehabilitation therapies, meaning the effect of any single component cannot be isolated.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
High heterogeneity in the included studies, particularly regarding the type and duration of concurrent rehabilitation therapies, makes it difficult to attribute outcomes solely to brain stimulation. The number of studies for each specific outcome measure was small (often fewer than 10), limiting the power of subgroup analyses and publication bias assessment. Most participants had incomplete spinal cord injuries (ASIA B, C, or D), so results may not apply to those with complete injuries. The review only covers short-term effects, as long-term follow-up data were not consistently reported. One study reported a seizure during rTMS, indicating a potential serious adverse event despite overall safety.
Declared interests
The study was funded by the National Natural Science Foundation of China, the Natural Science Foundation of Guangxi Province, and the Guangxi Key Research and Development Program. No specific commercial conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the significant improvements in lower-limb strength and balance as proof that brain stimulation alone causes these changes. Ten of the fourteen studies combined stimulation with other active rehabilitation therapies, so the benefit may stem from the intensity of the concurrent treatment rather than the stimulation itself.