We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
A Systematic Review and Meta-Analysis on the Use of Repetitive Transcranial Magnetic Stimulation for Spasticity Poststroke.
- Authors
McIntyre, Amanda; Mirkowski, Magdalena; Thompson, Spencer; Burhan, Amer M.; Miller, Tom; Teasell, Robert
- Abstract
<bold>Background: </bold>Spasticity is a common and potentially debilitating complication that develops after stroke, arising in approximately 30% of patients.<bold>Objective: </bold>To evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in improving spasticity after stroke.<bold>Design: </bold>Meta-analysis and systematic review.<bold>Setting: </bold>Not applicable.<bold>Patients: </bold>A total of 273 poststroke (hemorrhagic = 123, ischemic = 150) participants were included with sample sizes ranging from 5 to 80. The majority of participants were male (66.0%) with a mean age ranging from 55.0 to 64.6 years. Mean stroke duration ranged from 6 months to 10 years.<bold>Methods: </bold>A literature search of multiple databases was conducted for articles published in English from January 1980 to April 2015 using select keywords. Studies were included if (1) the population included was >50% stroke patients; (2) the sample size included ≥4 subjects; (3) the intervention applied was rTMS; and (4) upper extremity spasticity was assessed pre- and postintervention. Randomized controlled trials (RCTs) were assessed for methodologic quality with the Physiotherapy Evidence Database tool. All research designs were given a level of evidence according to a modified Sackett Scale.<bold>Main Outcome Measurements: </bold>Modified Ashworth Scale (MAS).<bold>Results: </bold>Ten studies met the inclusion criteria: 2 RCTs (Physiotherapy Evidence Database scores 8-9) and 8 pre-post studies. Meta-analyses of primarily uncontrolled pre-post studies found significant improvements in MAS for elbow (P < .001), wrist (P < .001), and finger flexors (P < .001). However, a meta-analysis of the 2 available RCTs failed to find a significant rTMS treatment effect on MAS for the wrist (standardized difference = .34, P = .30).<bold>Conclusions: </bold>There is limited available evidence to support the use of rTMS in improving spasticity poststroke. Despite the positive findings reported, better powered and appropriately controlled trials are necessary.<bold>Level Of Evidence: </bold>II.
- Publication
PM & R: Journal of Injury, Function & Rehabilitation, 2018, Vol 10, Issue 3, p293
- ISSN
1934-1482
- Publication type
journal article
- DOI
10.1016/j.pmrj.2017.10.001