Effect of Repetitive Transcranial Magnetic Stimulation in Decreasing Muscle Tone of Spastic Cerebral Palsy Kids to Improve Motor Activity – A Systemic Review and Meta-Analysis

Authors

  • Poonguzhalai Subramanian Assistant Professor, Department of Physiology, Sri Manakula Vinayagar Medical College, Pudhucherry, India
  • Deivanayagame Balasubramanian Associate Professor, Department of Physiology, Sri Manakula Vinayagar Medical College, Pudhucherry, India
  • Reena Mohan Assistant Professor, Department of Community Medicine, Sri Manakula Vinayagar Medical College, Pudhucherry, India
  • Jennifer Florence Assistant Professor, Department of Community Medicine, Mahatma Gnadhi Medical College and Research Institute, Pudhucherry, India
  • Preethi Tamilarasan Associate Professor, Department of Paediatrics, Sri Manakula Vinayagar Medical College, Pudhucherry, India
  • Suja Xaviar Assistant Professor, Department of Pharmacology, Sri Manakula Vinayagar Medical College, Pudhucherry, India

Abstract

Background: Cerebral palsy (CP) is a neurodevelopmental disorder that predominantly affects the kids' motor activity. The mainstay of treatment for the motor deficit in CP is conventional physical therapy. Due to the advancement in medical technology, a non-invasive stimulation of brain parenchyma like repetitive transcranial magnetic stimulation (rTMS) is found to be an effective therapy for motor deficits in spastic CP kids

Objective: To assess the efficacy of repetitive transcranial magnetic stimulation in spastic CP kids.

Methodology: Data sources: PubMed and Google Scholar were systematically searched until June 2024. Study selection: The meta-analysis included all published Randomized controlled trials that investigated the efficacy of rTMS over conventional physical therapy in children up to 18 years of age. Data extraction was guided by a predetermined checklist.

Results: Data extraction was guided by a predetermined checklist using Revman 5 software. Mean and standard deviation were evaluated and analysed. A total of 8 articles were selected, of which 5 articles were assessed quantitatively and the remaining 3 articles were taken for qualitative assessment. The primary outcome (Modified Ashworth scale) favours the usage of rTMS in Spastic Cerebral palsy kids (Mean standard deviation = - 0.37, 95% CI -0.64, -0.09 P < 0.00001). The secondary outcome (Gross motor function measure) included 156 patients (Mean standard deviation = - 0.62, 95% CI -0.96, -0. 27 P < 0.00001). Both primary and secondary outcomes are in favour of rTMS or its combination with conventional therapy.

Conclusion: This systematic review and meta-analysis demonstrated that rTMS has a beneficial effect in reducing spasticity in CP kids compared to the control group under conventional therapy.

Keywords: Cerebral palsy, Spasticity, Conventional therapy, repetitive transcranial magnetic stimulation, Developmental delay.

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Published

2025-06-23

How to Cite

1.
Subramanian P, Balasubramanian D, Mohan R, Florence J, Tamilarasan P, Xaviar S. Effect of Repetitive Transcranial Magnetic Stimulation in Decreasing Muscle Tone of Spastic Cerebral Palsy Kids to Improve Motor Activity – A Systemic Review and Meta-Analysis. J Riphah Coll. Rehabili. sci. [Internet]. 2025Jun.23 [cited 2025Jul.17];13(2). Available from: https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2315

Issue

Vol. 13 No. 2 (2025): JRCRS Volume 13 Issue 2

Section

Systematic Review

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