Comparative effects of different magnetic stimulation modalities on upper limb motor function and activities of daily living in patients with stroke: a systematic review and network meta-analysis
5 affiliations
- 1Hunan Institute of Engineering
- 2Shanghai Normal University Tianhua College
- 3Shenyang Normal University
- 4Shanghai University of Sport
- 5Shanghai Lixin University of Accounting and Finance
Abstract
Objective: To systematically evaluate the effects of different magnetic stimulation (MS) modalities on upper limb motor function and activities of daily living (ADL) in patients with stroke through a network meta-analysis.
Methods: Embase, Web of Science, PubMed, Wanfang, VIP, and CNKI were searched from inception to January 2026 for randomized controlled trials evaluating MS interventions for upper limb motor function and activities of daily living (ADL) in patients with stroke. A frequentist network meta-analysis was performed using standardized mean difference (SMD) with 95% confidence interval (CI). The surface under the cumulative ranking curve (SUCRA) was used to estimate the relative ranking probabilities of interventions. Risk of bias was assessed using RoB 2, and the certainty of evidence was evaluated using GRADE.
Results: A total of 48 randomized controlled trials were included. For upper limb motor function, rPMS (SMD = 0.65, 95% CI: 0.19 to 1.12), rTMS (SMD = 0.96, 95% CI: 0.68 to 1.24), and combined MS (SMD = 1.01, 95% CI: 0.47 to 1.55) were all superior to conventional rehabilitation. SUCRA rankings suggested that combined MS ranked highest, followed by rTMS. However, pairwise comparisons among active magnetic stimulation interventions did not reach statistical significance. For ADL, rPMS (SMD = 0.60, 95% CI: 0.26 to 0.95), rTMS (SMD = 0.76, 95% CI: 0.56 to 0.97), and combined MS (SMD = 1.27, 95% CI: 0.94 to 1.59) significantly improved ADL compared with conventional rehabilitation. Combined MS was also superior to rPMS and rTMS alone. Sensitivity analysis excluding studies that reported only the Barthel Index showed broadly consistent results. No clear evidence of publication bias or small-study effects was detected. The certainty of evidence was rated as low.
Conclusion: MS interventions may improve upper limb motor function and ADL in patients with stroke. Combined MS and rTMS showed relatively high ranking probabilities for upper limb motor recovery, whereas combined MS showed the highest ranking probability for ADL improvement. Given the heterogeneity among included studies, non-significant differences in some direct comparisons, and low certainty of evidence, these findings should be interpreted cautiously and confirmed by high-quality head-to-head trials.
Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261302905 , Identifier: CRD420261302905.
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BibTeX
@article{yang2026comparative,
title = {{Comparative effects of different magnetic stimulation modalities on upper limb motor function and activities of daily living in patients with stroke: a systematic review and network meta-analysis}},
author = {Shuijin Yang and Yan Rao and Chen Wei and Shuqi Jia and Qiang Liu},
journal = {Frontiers in Neurology},
year = {2026},
month = oct,
doi = {10.3389/fneur.2026.1842774},
url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1842774/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Comparative effects of different magnetic stimulation modalities on upper limb motor function and activities of daily living in patients with stroke: a systematic review and network meta-analysis
AU - Shuijin Yang
AU - Yan Rao
AU - Chen Wei
AU - Shuqi Jia
AU - Qiang Liu
PY - 2026
DA - 2026/10/27
JO - Frontiers in Neurology
DO - 10.3389/fneur.2026.1842774
UR - https://www.frontiersin.org/articles/10.3389/fneur.2026.1842774/full
AB - Objective: To systematically evaluate the effects of different magnetic stimulation (MS) modalities on upper limb motor function and activities of daily living (ADL) in patients with stroke through a network meta-analysis. Methods: Embase, Web of Science, PubMed, Wanfang, VIP, and CNKI were searched from inception to January 2026 for randomized controlled trials evaluating MS interventions for upper limb motor function and activities of daily living (ADL) in patients with stroke. A frequentist network meta-analysis was performed using standardized mean difference (SMD) with 95% confidence interval (CI). The surface under the cumulative ranking curve (SUCRA) was used to estimate the relative ranking probabilities of interventions. Risk of bias was assessed using RoB 2, and the certainty of evidence was evaluated using GRADE. Results: A total of 48 randomized controlled trials were included. For upper limb motor function, rPMS (SMD = 0.65, 95% CI: 0.19 to 1.12), rTMS (SMD = 0.96, 95% CI: 0.68 to 1.24), and combined MS (SMD = 1.01, 95% CI: 0.47 to 1.55) were all superior to conventional rehabilitation. SUCRA rankings suggested that combined MS ranked highest, followed by rTMS. However, pairwise comparisons among active magnetic stimulation interventions did not reach statistical significance. For ADL, rPMS (SMD = 0.60, 95% CI: 0.26 to 0.95), rTMS (SMD = 0.76, 95% CI: 0.56 to 0.97), and combined MS (SMD = 1.27, 95% CI: 0.94 to 1.59) significantly improved ADL compared with conventional rehabilitation. Combined MS was also superior to rPMS and rTMS alone. Sensitivity analysis excluding studies that reported only the Barthel Index showed broadly consistent results. No clear evidence of publication bias or small-study effects was detected. The certainty of evidence was rated as low. Conclusion: MS interventions may improve upper limb motor function and ADL in patients with stroke. Combined MS and rTMS showed relatively high ranking probabilities for upper limb motor recovery, whereas combined MS showed the highest ranking probability for ADL improvement. Given the heterogeneity among included studies, non-significant differences in some direct comparisons, and low certainty of evidence, these findings should be interpreted cautiously and confirmed by high-quality head-to-head trials. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261302905 , Identifier: CRD420261302905.
SN - 1664-2295
ER -