Abstract
Objective
The purpose of this review was to systematically assess the effectiveness of repetitive
transcranial magnetic stimulation (rTMS) intervention on gait in individuals with
Parkinson disease (PD).
Data Sources
We searched online electronic databases up to March 28, 2019, including MEDLINE, Embase,
the Cochrane Library, and so on.
Study Selection
The inclusion criteria for this review were randomized controlled trials (RCTs), exploring
the effect of rTMS in patients diagnosed with idiopathic PD.
Data Extraction
Data extraction was performed independently by 2 reviewers based on predefined criteria
and the methodologic quality of included studies was quantified by the Physiotherapy
Evidence Database scale. The outcome measure was walking performance, including walking
time (short term and long term), Timed Up and Go (TUG) test, and so on.
Data Synthesis
Among 14 eligible studies, including 298 participants (mean age ± SD [y], 63.24±9.71;
191 [64%] men) were analyzed in this meta-analysis. Walking time was improved with
rTMS compared with sham rTMS (standardized mean difference [SMD] -0.30; 95% confidence
interval [CI], -0.57 to -0.03; P=.03). The score for the freezing of gait questionnaire did not differ significantly
between rTMS and no intervention. Four studies compared TUG between the 2 treatment
groups and no significant differences were found between the rTMS and control group
(SMD -0.45; 95% CI, -1.32 to 0.41; P=.30). During the off-state, there were no significant differences in estimated effect
sizes (SMD=-0.29; 95% CI, -0.79 to 0.21; P=.25), which is significantly different in on-state (SMD -0.98; 95% CI, -1.78 to -0.18;
P=.02) evaluation.
Conclusions
The results of the meta-analysis propose the favorable effect of rTMS on walking performance
in the short term but not over the long term in individuals with PD.
Keywords
List of abbreviations:
CI (confidence interval), FOG (freezing of gait), FOG-Q (freezing of gait questionnaire), M1 (primary motor cortex), PD (Parkinson disease), PEDro (Physiotherapy Evidence Database scale), RCT (randomized controlled trial), rTMS (repetitive transcranial magnetic stimulation), SMD (standardized mean difference), TUG (timed Up and Go)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 26, 2019
Footnotes
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
