Repetitive peripheral magnetic stimulation alone or in combination with repetitive transcranial magnetic stimulation in poststroke rehabilitation: a systematic review and meta-analysis.
Yong Wang, Kenneth N K Fong, Youxin Sui and 2 others
PMID 39407278WHAT IT FOUND
Repetitive peripheral magnetic stimulation improved upper limb movement and daily activities in stroke patients compared to sham or no stimulation.
Adding transcranial magnetic stimulation did not provide extra benefit over transcranial magnetic stimulation alone. Higher stimulation doses were linked to better activity outcomes.
Key findings
01Both repetitive peripheral magnetic stimulation alone and combined with transcranial magnetic stimulation significantly improved upper limb motor function compared to control groups.
02Combining repetitive peripheral magnetic stimulation with transcranial magnetic stimulation was not more effective for motor function or daily activities than using transcranial magnetic stimulation alone.
03Higher total number of pulses and more pulses per session were associated with greater improvements in activities of daily living.
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
There was substantial heterogeneity in the rPMS protocols used across studies, including differences in intensity, frequency, and targets, making it difficult to recommend a single optimal protocol. The rPMS-alone subgroup showed significant publication bias, suggesting the reported effects might be overstated. The finding that higher doses improve daily activities was driven largely by one study (Fawaz et al.), reducing confidence in this dose-response relationship. The review could not determine specific clinical cutoff values for effective stimulation doses or the optimal number of treatment sessions.
Declared interests
The authors declared no competing interests. The study was supported by non-U.S. government funding.
The easy way to misread this
Do not assume that combining rPMS with rTMS is superior to using either method alone. The data showed no significant difference in motor or daily living outcomes when the combination was compared to rTMS alone, suggesting the added complexity and cost of dual stimulation may not yield better results.