Effects of different electromagnetic stimulation protocols on hand function and activities of daily living for stroke patients: a network meta-analysis
10.3969/j.issn.1006-9771.2026.08.005
- VernacularTitle:不同电磁刺激方案对脑卒中患者手功能及日常生活活动能力效果的网状Meta分析
- Author:
Shan LIU
1
;
Kunyao XU
1
;
Zhimeng ZHOU
1
;
Lingyun ZHOU
2
;
Mao ZENG
3
;
Sha HE
4
;
Luoyang DAI
4
;
Ting QIN
4
;
Qinglin HU
4
;
Jiahai YANG
1
;
Rui LI
4
Author Information
1. The Second Clinical Medical College of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou 550002, China
2. Department of Geriatrics, Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou 550002, China
3. College of Chinese Orthopedics and Traumatology of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou 550002, China
4. Department of Rehabilitation, Guizhou Hospital, Beijing Jishuitan Hospital, Guiyang, Guizhou 550014, China
- Publication Type:Journal Article
- Keywords:
stroke;
electromagnetic stimulation;
hand function;
activities of daily living;
network meta-analysis
- From:
Chinese Journal of Rehabilitation Theory and Practice
2026;32(8):916-926
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo systematically compare the effects of diverse electromagnetic stimulation protocols on hand function and activities of daily living (ADL) in stroke patients using network meta-analysis (NMA), and screen the optimal stimulation strategy for post-stroke hand dysfunction rehabilitation. MethodsNMA was performed in accordance with the PRISMA-NMA statement. Databases of CNKI, Wanfang data, VIP, CBM, PubMed, Web of Science and Embase were searched from database inception to April, 2026 for eligible randomized controlled trials (RCTs) comparing different electromagnetic stimulation protocols for post-stroke hand impairment. The Cochrane Risk of Bias tool and PEDro scale were used to assess methodological quality of included studies, while the GRADE system was adopted to grade evidence quality of primary outcomes of Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI). After literature screening, data extraction and bias evaluation, RevMan 5.4 and Stata 17.0 were used for meta-analysis and NMA. ResultsA total of 22 RCT involving 17 electromagnetic stimulation protocols were finally included. The PEDro scores ranged from six to ten. The top five protocols for improving FMA-UE score were repetitive peripheral magnetic stimulation (rPMS) + repetitive transcranial magnetic stimulation (rTMS), intermittent theta-burst stimulation (iTBS) + rPMS, iTBS + transcranial direct current stimulation (tDCS), transcutaneous electrical acupoint stimulation (TEAS) and contralaterally controlled functional electrical stimulation (CCFES). tDCS was the most effective on MBI, followed by TEAS and iTBS+rPMS. Evidence quality for FMA-UE and MBI was moderate. Funnel plots suggested low risk of publication bias, and consistency tests verified good coherence between direct and indirect comparisons in network models. ConclusionElectromagnetic stimulation significantly facilitates upper limb and hand functional recovery, and improves ADL in stroke patients. The combined central-peripheral magnetic stimulation protocol may be the most effective on motor rehabilitation, whereas tDCS on ADL.
