Efficacy of repeated peripheral magnetic stimulation on upper limb moter function after stroke: a systematic review and meta-analysis of randomized controlled trials

Junxia Liu¹Meirong Zhu¹Xiaoyan Liu¹Weiju Tang¹Yunan Xiang¹Yulei Xie^2*Yinxu Wang^2*

• ¹First People's Hospital of Longquanyi District, Chengdu, Sichuan Province, China
• ²Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Anhui Province, China

Background: About 50%-70% of survivors are left with varying degrees of limb paralysis, severely affecting the ability to daily living and rehabilitation. Conventional rehabilitation interventions such as task-oriented training and transcranial magnetic stimulation have been widely utilized, the efficacy has been constrained by individualized and neuroplastic activation. Repeated peripheral magnetic stimulation (rPMS), a novel non-invasive neuromodulation technique, directly targets peripheral nerves and muscles to potentially facilitate motor pathway remodeling. There is a lack of evaluation of the effectiveness of rPMS for upper limb motor function and pasticity in stroke. Methods: Randomized controlled trials of rPMS until 20 February 2025 in post-stroke patients were searched in PubMed, Embase, Cochrane Library, and Web of Science. Methodological quality was evaluated via the Cochrane Collaboration tool. Meta-analyses were performed using RevMan (version 5.4). The GRADE method was used to assess the quality of the evidence. Results: A total of 12 studies involving 492 patients were included. Meta-analysis results indicated that, compared with the control group, subgroup analyses based on disease stage, stimulation frequency, coil type, stimulation duration, and stimulation intensity all showed significant improvements, supported by high-quality evidence. The pooled standardized mean differences (SMD) were as follows: disease stage SMD = 0.69 (P = 0.006); stimulation frequency SMD = 0.58 (P = 0.004); coil type SMD = 0.82 (P = 0.001); stimulation duration SMD = 0.62 (P = 0.004); and stimulation intensity SMD = 0.79 (P = 0.002). Additionally, rPMS significantly improved patients' ability to live independently (SMD = 0.66, P < 0.0001), with moderate-quality evidence. However, rPMS did not demonstrate a significant effect on reducing spasticity (mean difference [MD] = 0.25, P = 0.20), supported by low-quality evidence. Conclusion: rPMS improved upper limb motor function and activities of daily living, as well as self-care abilities in patients after stroke, with good acceptability and mild adverse reactions. Its effect on spasticity was not significant.