| Objective: To systematically evaluate the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on the upper limb motor function and daily activity ability in stroke patients through the network Meta analysis. Methods: The random controlled trials (RCTs) about the treatment of stroke patients with rTMS were searched from CNKI, Wanfang, VIP, ChinaBiomedicalDatabase (CBM), PubMed, Cochrane Library, Embase and Web of Science databases, and the retrieval time range was from the establishment of the database to December 2020. Two reviewers used physiotherapy evidence database (PEDro) to assess the risk quality of literature and Meta analysis using Stata16.0.k to evaluate the risk quality of the included literature. The statistical analysis was conducted by stata16.0 after data extraction. Results: The enrolled 29 studies contained 2095 subjects. The mesh Meta-analysis showed that the Fugl-Meyer Assessment Upper Extremity Scale (FMA-UE) scores and the modified Barthel index (MBI) scores were significantly increased by 5Hz rTMS (P<0.05). The cumulative probability ranking results showed that the 10Hz rTMS had the highest probability ranking in improving the FMA-UE and MBI scores. For patients with mild and severe dysfunction, the results of reticular Meta subgroup analysis showed that the FMA-UE and MBI scores were statistically significant (P<0.05). In addition, 10Hz rTMS was better than 3Hz rTMS in improving the FMA-UE score in mild patients. In improving the MBI score of severe patients, 10Hz rTMS was better than 5Hz rTMS, and the difference was statistically significant (P<0.05). There was no significant difference in the pairwise comparisons between the remaining groups. Conclusion: According to the current eviden-ce, 10Hz rTMS is preferred for clinically using rTMS to improve upper limb motor dysfunction and daily activities in stroke patients. These conclusions need to be verified by more high-quality studies. |
