Efficiency of repetitive transcranial magnetic stimulation on rehabilitation of motor function in patients with stroke: A systematic review

Background: Studies have different views on the effect of repetitive transcranial magnetic stimulation applied in stroke patients for improving motor function. Objective: To evaluate the effect of repetitive transcranial magnetic stimulation on rehabilitation of motor function in patients with stroke. Methods: We searched Cochrane Central Register of Controlled Trials, PubMed, ISI Web of science, Medline, EMBASE, China Biology Medicine disc, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodical, Wanfang Data (from database building to July 2013) for randomized controlled trials concerning repetitive transcranial magnetic stimulation on improving motor function in patients with stroke. The included studies were evaluated according to the method recommended by the Cochrane Collaboration. Meta analysis was performed in qualified literatures. The extracted data were analyzed by RevMan 5.1 software and GRADEprofiler 3.6 software. Results and Conclusion: A total of 23 trials were included (intervention group n=400, control group n=301). Quantitative analysis was conducted in seven studies, and descriptive study was performed in the remaining studies. Meta-analyses analyzed Fugl Meyer Motor Scale and Barthel index. Results showed that Fugl Meyer Motor Scale [SMD =0.48, 95%CI(0.10, 0.86)] and Barthel index [SMD=1.38, 95%CI (0.68, 2.09)] were significantly higher in the intervention group than that in the control group. In accordance with The Grading of Recommendations Assessment, Development and Evaluation, outcome indexes were evaluated, and the two indexes were graded low quality. The current evidence shows that repetitive transcranial magnetic stimulation appears to enhance motor function and activities of daily living of the patients with stroke. Considering the limitations of the included studies, more multi-central randomized controlled trials with large sample sizes and high qualities are required in future to verify the therapeutic efficacy of repetitive transcranial magnetic stimulation on motor function of stroke patients.