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Peer-reviewedCC BY-NC-NDZhongguo kangfu lilun yu shijian

Effects of different electromagnetic stimulation protocols on hand function and activities of daily living for stroke patients: a network meta-analysis

  • Liu Shan1
  • Xu Kunyao1
  • Zhou Zhimeng1
  • Zhou Lingyun2
  • Zeng Mao3
  • He Sha4
  • Dai Luoyang4
  • Qin Ting4
  • Hu Qinglin4
  • Yang Jiahai1
  • Li Rui4
4 affiliations
  1. 1The Second Clinical Medical College of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou 550002, China
  2. 2Department of Geriatrics, Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou 550002, China
  3. 3College of Chinese Orthopedics and Traumatology of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou 550002, China
  4. 4Department of Rehabilitation, Guizhou Hospital, Beijing Jishuitan Hospital, Guiyang, Guizhou 550014, China
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Abstract

Objective To 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. Methods NMA 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. Results A 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. Conclusion Electromagnetic 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.

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Cite

BibTeXRIS
BibTeX
@article{shan2026effects,
  title = {{Effects of different electromagnetic stimulation protocols on hand function and activities of daily living for stroke patients: a network meta-analysis}},
  author = {Liu Shan and Xu Kunyao and Zhou Zhimeng and Zhou Lingyun and Zeng Mao and He Sha and Dai Luoyang and Qin Ting and Hu Qinglin and Yang Jiahai and Li Rui},
  journal = {Zhongguo kangfu lilun yu shijian},
  year = {2026},
  month = aug,
  doi = {10.3969/j.issn.1006-9771.2026.08.005},
  url = {https://doi.org/10.3969/j.issn.1006-9771.2026.08.005},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Effects of different electromagnetic stimulation protocols on hand function and activities of daily living for stroke patients: a network meta-analysis
AU  - Liu Shan
AU  - Xu Kunyao
AU  - Zhou Zhimeng
AU  - Zhou Lingyun
AU  - Zeng Mao
AU  - He Sha
AU  - Dai Luoyang
AU  - Qin Ting
AU  - Hu Qinglin
AU  - Yang Jiahai
AU  - Li Rui
PY  - 2026
DA  - 2026/08/01
JO  - Zhongguo kangfu lilun yu shijian
DO  - 10.3969/j.issn.1006-9771.2026.08.005
UR  - https://doi.org/10.3969/j.issn.1006-9771.2026.08.005
AB  - Objective To 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. Methods NMA 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. Results A 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. Conclusion Electromagnetic 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.
SN  - 1006-9771
ER  -