中国康复理论与实践2026，Vol.32Issue(8)：916-926,11.DOI:10.3969/j.issn.1006-9771.2026.08.005
不同电磁刺激方案对脑卒中患者手功能及日常生活活动能力效果的网状Meta分析
Effects of different electromagnetic stimulation protocols on hand function and activities of daily living for stroke patients:a network meta-analysis
摘要
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 eligi-ble 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 out-comes of Fugl-Meyer Assessment-Upper Extremities(FMA-UE)and modified Barthel Index(MBI).After litera-ture 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(iT-BS)+rPMS,iTBS+transcranial direct current stimulation(tDCS),transcutaneous electrical acupoint stimula-tion(TEAS)and contralaterally controlled functional electrical stimulation(CCFES).tDCS was the most effec-tive 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 in-direct 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.关键词
脑卒中/电磁刺激/手功能/日常生活活动能力/网状Meta分析Key words
stroke/electromagnetic stimulation/hand function/activities of daily living/network meta-analysis分类
医药卫生引用本文复制引用
刘姗,杨家海,李蕊,许坤尧,周芷萌,周凌云,曾茂,何莎,代洛阳,覃婷,胡庆林..不同电磁刺激方案对脑卒中患者手功能及日常生活活动能力效果的网状Meta分析[J].中国康复理论与实践,2026,32(8):916-926,11.基金项目
贵州省高层次创新型人才"千层次"人才培养项目(No.gzwjrs 2023-009) Supported by Guizhou High-level Innovative Talents Training Project(Thousand-level Talents)(No.gzwjrs 2023-009) （No.gzwjrs 2023-009）
