{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:52:23Z","timestamp":1787064743706,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFC3603800"],"award-info":[{"award-number":["2023YFC3603800"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFC3603804"],"award-info":[{"award-number":["2023YFC3603804"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82272605"],"award-info":[{"award-number":["82272605"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&R"],"published-print":{"date-parts":[[2025,11]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n In the chronic phase of stroke, repetitive transcranial magnetic stimulation (rTMS) exhibits limited effectiveness in improving motor recovery due to reduced brain plasticity. Patients with chronic stroke also typically present with lower limb motor dysfunction and disability. Recent studies suggest that repetitive peripheral magnetic stimulation (rPMS) can promote brain plasticity and potentially offer additional improvement in patients with chronic stroke.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate whether combining a designed rPMS program with rTMS could further improve lower limb motor function, mobility, and balance function in patients with chronic stroke.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Two\u2010arm randomized controlled trial.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Inpatient clinic.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n 20 patients with chronic stroke with lower limb hemiparesis were recruited.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n One group received ipsilateral rTMS, and the other received rTMS and rPMS designed based on the lower limb myofascial chain and neural pathways.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n The primary outcome measure was the lower extremity motor section of the Fugl\u2010Meyer Assessment (FMA\u2010LE), evaluating lower limb motor function. Secondary outcomes included the timed up and go test (TUG), the 10\u2010meter walking test (10MWT), the 6\u2010minute walking test (6MWT), Berg balance scale (BBS), and parameters measured by the balance training and evaluation system (Rx, mediolateral sway; Ry, anteroposterior sway; and RecArea, total sway area). All outcome assessments were conducted at baseline, 2\u2009weeks post intervention, and 4\u2009weeks post intervention. Two\u2010way repeated measures analysis of variance (ANOVA) was then performed to analyze any group differences over time.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Two\u2010way ANOVA revealed a significant interaction effect between time and group for FMA\u2010LE (\n p<\/jats:italic>\n \u2009=\u2009.001), 6MWT (\n p<\/jats:italic>\n \u2009<\u2009.001), TUG (\n p<\/jats:italic>\n \u2009=\u2009.015), BBS (\n p<\/jats:italic>\n \u2009=\u2009.046), Rx (\n p<\/jats:italic>\n \u2009=\u2009.008), Ry (\n p<\/jats:italic>\n \u2009=\u2009.009), and RecArea (\n p<\/jats:italic>\n \u2009<\u2009.001). Effect size (the value of partial \u0273\n 2<\/jats:sup>\n ) of FMA\u2010LE was 0.40.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study provides evidence that combining rTMS with rPMS may be a more practical approach for improving lower limb motor function, ambulation, and balance in patients with chronic stroke compared to rTMS alone.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pmrj.13391","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T06:30:36Z","timestamp":1748241036000},"page":"1298-1307","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The effects of\n repetitive peripheral magnetic stimulation<\/scp>\n combined with\n repetitive transcranial magnetic stimulation<\/scp>\n on lower limb motor function and balance in patients with chronic stroke: A pilot randomized controlled trial"],"prefix":"10.1002","volume":"17","author":[{"given":"Qing","family":"Cai","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010Sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010Sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guirong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010Sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanzhi","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Haikou Hospital of the Maternal and Child Health Haikou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010Sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyu","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010Sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7385-3037","authenticated-orcid":false,"given":"Haiqing","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010Sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(13)61953\u20104"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269215519835889"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2021.620573"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25679"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2022.998820"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011968.pub4"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2022.106446"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MRR.0000000000000416"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1747493017711816"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3758\/bf03193146"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13760\u2010016\u20100633\u20102"},{"key":"e_1_2_10_13_1","volume-title":"Fascial manipulation for musculoskeletal pain","author":"Luigi S","year":"2018"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.2340\/1650197771331"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445\u20105994.2008.01880.x"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2007.11.029"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.1991.tb01616.x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20070205"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/16501970410017215"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20070255"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2011.11.004"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.2006.00701.x"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182212229"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2018.12.023"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2019.09.003"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neucli.2017.02.003"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2014.02.003"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2007.03.033"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2022.147999"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467\u2010023\u201006064\u2010z"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40122\u2010024\u201000613\u20106"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2023.992424"},{"key":"e_1_2_10_33_1","volume-title":"Statistical Power Analysis for the Social Sciences","author":"Cohen J","year":"1988"}],"container-title":["PM&R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.13391","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T13:02:48Z","timestamp":1763643768000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pmrj.13391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,26]]},"references-count":32,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/pmrj.13391"],"URL":"https:\/\/doi.org\/10.1002\/pmrj.13391","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,26]]},"assertion":[{"value":"2024-02-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}