Evidence map›Paper›PMID 40409966›Full record

Trial reportBMJ open2025

Repetitive transcranial magnetic stimulation as an adjunct to quadriceps strengthening exercise in knee osteoarthritis: a pilot randomised controlled trial.

Wei-Ju Chang, Alan Chiang, Nahian Chowdhury, Sam Adie, Justine M Naylor, Harrison Finn, Rodrigo R N Rizzo, Edward Gorgon, Edel O'Hagan, Siobhan M Schabrun

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Wei-Ju ChangSchool of Health Sciences, University of New South Wales Medicine & Health, Sydney, New South Wales, Australia wei-ju.chang@unsw.edu.au.ORCID http://orcid.org/0000-0003-0524-4883
Alan ChiangCentre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia.ORCID http://orcid.org/0000-0002-9156-0534
Nahian ChowdhuryCentre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia.
Sam AdieSchool of Clinical Medicine, University of New South Wales Medicine & Health, Sydney, New South Wales, Australia.
Justine M NaylorSchool of Clinical Medicine, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia.
Harrison FinnNeuroscience Research Australia, Randwick, New South Wales, Australia.
Rodrigo R N RizzoSchool of Health Sciences, University of New South Wales Medicine & Health, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0002-9624-6210
Edward GorgonFaculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0003-1565-4587
Edel O'HaganCentre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia.ORCID http://orcid.org/0000-0002-1914-5918
Siobhan M SchabrunSchool of Physical Therapy, University of Western Ontario, London, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo examine the feasibility, safety and perceived patient response of a combined repetitive transcranial magnetic stimulation (rTMS) and quadriceps strengthening exercise intervention for knee osteoarthritis.

methodsA two-arm, participant-blinded, therapist-blinded and assessor-blinded, randomised controlled trial with additional follow-up of pain and function at 3 months. Participants were randomised to receive active rTMS+exercise (AR+EX) or sham rTMS+exercise (SR+EX) twice weekly for 6 weeks while completing home exercises twice a week. Primary outcomes included recruitment rate, treatment attendance, dropouts, willingness to undergo therapy (11-point Numeric Rating Scale, 'not at all willing'=0 and 'very willing'=10), success of participant, therapist and outcome assessor blinding, adverse events and Global Perceived Effect Scale. Secondary outcomes were pain, function and measures of physiological mechanisms.

results86 people were screened, 31 (36%) were randomised, 28 (90%) completed the treatments and 3 (10%) dropouts at 3-month follow-up. Both groups had high treatment attendance (98.4% and 100%). All participants scored at least 7 on the willingness to undergo therapy scale. Blinding was successful. No adverse events were reported. At the postintervention assessment, 80% in the AR+EX group and 75% in the SR+EX group reported an improvement on the Global Perceived Effect Scale. Both groups demonstrated within-group improvements in pain at the postintervention assessment but not at the 3-month follow-up. Function improved only in the AR+EX group at the postintervention assessment.

conclusionsCombined rTMS and quadriceps strengthening exercise intervention for knee osteoarthritis is feasible, safe and well-received. A full-scale trial is justified to assess the clinical benefits of this novel treatment. TRIAL REGISTRATION NUMBER: ACTRN12621001712897.

Indexed as

Exercise TherapyOsteoarthritis, KneeQuadriceps MuscleResistance TrainingTranscranial Magnetic StimulationAgedCombined Modality TherapyFeasibility StudiesFemaleHumansMaleMiddle AgedPain MeasurementPilot ProjectsTreatment OutcomeChronic PainClinical TrialExerciseFeasibility StudiesPain management

Identifiers

PMID40409966
PMCPMC12104922

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.