Systematic Review: JRCRS. 2025; 13(2):69-76.
2- 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
Poonguzhalai Subramanian1, Deivanayagame Balasubramanian2, Reena Mohan3, Jennifer Florence4, Preethi Tamilarasan5, Suja Xaviar6
1 Assistant Professor, Department of Physiology, Sri Manakula Vinayagar Medical College, Pudhucherry, India
2 Associate Professor, Department of Physiology, Sri Manakula Vinayagar Medical College, Pudhucherry, India
3 Assistant Professor, Department of Community Medicine, Sri Manakula Vinayagar Medical College, Pudhucherry, India
4 Assistant Professor, Department of Community Medicine, Mahatma Gnadhi Medical College and Research Institute, Pudhucherry, India
5 Associate Professor, Department of Paediatrics, Sri Manakula Vinayagar Medical College, Pudhucherry, India
6 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 noninvasive 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.