SynthesisFrontiers in neurology2025
Comparison of the effects of different physical stimulation therapies on reducing upper limb spastic paralysis and motor dysfunction in stroke survivors after stroke: a network meta-analysis of randomized controlled trials.
Synthesis in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparison of the effects of different traditional Chinese exercises on improving the motor function of stroke survivors: a network meta-analysis and systematic review.Frontiers in neurologyPooled it
- Clinical evidence on integrated Chinese-Western medicine for stroke rehabilitation.Integrative medicine research · 2026Article
- Enhancing Cardiopulmonary Function Through Spasticity Reduction-Effects of Botulinum Toxin A After Stroke: A Prospective Before-After Study.Medicina (Kaunas, Lithuania) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Upper limb spasticity is a common and disabling sequela of stroke, which significantly impairing motor function and the capacity to perform activities of daily living (ADL). The relative efficacy of different physical therapies and their combinations compared to monotherapies remains unclear. Methods: A comprehensive database search was conducted to identify randomized controlled trials (RCTs) published from database inception to 2024 that evaluated physical therapies for post-stroke upper limb spasticity. Data were analyzed using RevMan and STATA/R software with a Bayesian framework for network meta-analysis. Evidence consistency was assessed via node-splitting approaches, and intervention efficacy was ranked using the surface under the cumulative ranking curve (SUCRA). Effect sizes were expressed as mean differences (MD) with 95% confidence intervals (CI), and study quality was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. Results: Forty-nine RCTs involving 3,219 patients were included. The combination of physical rehabilitation (PR) with repetitive transcranial magnetic stimulation (rTMS) and electro-acupuncture (EA) demonstrated the highest improvement in Fugl-Meyer Assessment for Upper Extremity (FMA-UE) scores (91.1%), outperforming PR alone (13.2%) or EA monotherapy (30.3%). PR combined with rTMS and body acupuncture (BA) shows the most significant improvement in the Modified Barthel Index (MBI) (83.1%), superior to PR (20.8%) or BA (23.8%) alone. Adverse events (e.g., minor bruising from EA) were infrequent and self-resolving. Conclusion: Current evidence indicates that synergistic application of PR with rTMS and acupuncture (EA/BA) significantly enhances upper limb motor function and ADL capacity. However, GRADE evaluations rated most evidence as moderate quality, limited by implementation bias, insufficient subgroup analyses, and lack of long-term follow-up data. Future studies should adopt standardized protocols and investigate efficacy variations across stroke subtypes. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42025633289, identifier [CRD42025633289].
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