{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:11:49Z","timestamp":1790698309800,"version":"4.1.0"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Repetitive peripheral magnetic stimulation (rPMS), a representative non-invasive neuromodulation technique, is widely utilized for the recovery of motor dysfunction following stroke. Although its clinical efficacy has been confirmed, discrepancies among studies and the optimal rPMS stimulation parameters remain unclear. This study aims to systematically analyze and quantitatively evaluate the optimal stimulation parameters using rPMS parameter subgroups extracted from existing studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Conducted in accordance with PRISMA guidelines, this study searched for research related to rPMS and the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) in stroke patients. A systematic review and meta-analysis of the aggregated studies were then performed. Furthermore, a robust error meta-regression (REMR) model was employed to explore the non-linear dose-response relationship between rPMS stimulation parameters (frequency, intensity, duration, and treatment days) and FMA-UE scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 14 trials (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f580) were included. The results indicated that rPMS yielded a significant therapeutic effect on FMA-UE score improvement (SMD\u202f=\u202f0.91, 95% CI 0.31\u20131.51;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.003) and spasticity reduction (SMD\u202f=\u202f\u22121.15, 95% CI\u202f\u2212\u202f1.80 to \u22120.49;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0006). Dose-response analysis revealed an inverted U-shaped curve for both frequency and duration: the greatest clinical benefits were achieved with optimal stimulation at 10\u202fHz (peak gain: 13.82 points, 95% CI 9.65\u201318.00), 10\u201320\u202fmin per session, a plateau effect at 20\u201355% maximum stimulator output (MSO), and a treatment course of \u226521\u202fdays. During the subacute stroke window (14\u202fdays to 6\u202fmonths), neural-targeted stimulation (e.g., brachial plexus, radial nerve) demonstrated superiority over muscle-targeted approaches (SMD\u202f=\u202f0.81 vs. 0.47;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Under optimal parameter windows, the therapeutic mechanism of rPMS may be associated with triggering homeostatic plasticity and beta-band corticomuscular coherence. The greatest benefits are obtained particularly with neural-targeted protocols during the subacute phase of stroke, utilizing low frequency (\u226420\u202fHz), moderate-to-low intensity (20\u201355% MSO), and an extended treatment course (\u226521\u202fdays). In conclusion, current evidence provides a novel scientific basis and clinical reference for the application of rPMS in stroke rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1824669","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:23:18Z","timestamp":1777522998000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of repetitive peripheral magnetic stimulation on upper extremity motor function recovery after stroke: a meta-analysis and dose-response study"],"prefix":"10.3389","volume":"17","author":[{"given":"Liu","family":"Hui","sequence":"first","affiliation":[{"name":"Department of Neurology, Yingshan County People's Hospital","place":["Nanchong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhang","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yingshan County People's Hospital","place":["Nanchong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xie","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yingshan County People's Hospital","place":["Nanchong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Tianhua","sequence":"additional","affiliation":[{"name":"Department of Neurology, West China Hospital of Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"190","DOI":"10.3390\/healthcare10020190","article-title":"Rehabilitation of upper limb motor impairment in stroke: a narrative review on the prevalence, risk factors, and economic statistics of stroke and state of the art therapies","volume":"10","author":"Anwer","year":"2022","journal-title":"Healthcare (Basel, Switzerland)"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1016\/S0140-6736(18)31269-8","article-title":"Prevention of stroke: a global perspective","volume":"392","author":"Pandian","year":"2018","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1016\/j.tins.2022.05.002","article-title":"Poststroke arm and hand paresis: should we target the cervical spinal cord?","volume":"45","author":"Pirondini","year":"2022","journal-title":"Trends Neurosci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1080\/10749357.2022.2051829","article-title":"Longitudinal changes of motor cortex function during motor recovery after stroke","volume":"30","author":"Chunyong","year":"2023","journal-title":"Top Stroke Rehabil"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/j.rehab.2018.07.006","article-title":"Association of spasticity and motor dysfunction in chronic stroke","volume":"62","author":"Pundik","year":"2019","journal-title":"Ann Phys Rehabil Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1097\/PHM.0000000000001968","article-title":"Effects of stroke lesions and timing of rehabilitation on the compensatory movement patterns during stroke recovery","volume":"101","author":"Lee","year":"2022","journal-title":"Am J Phys Med Rehabil"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1161\/STROKEAHA.122.040073","article-title":"Projected global trends in ischemic stroke incidence, deaths and disability-adjusted life years from 2020 to 2030","volume":"54","author":"Pu","year":"2023","journal-title":"Stroke"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1258","DOI":"10.1016\/j.apmr.2025.01.466","article-title":"Peripheral electrical stimulation on motor function and activities of daily living after stroke: a systematic review and network Meta-analysis","volume":"106","author":"Zhou","year":"2025","journal-title":"Arch Phys Med Rehabil"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2145","DOI":"10.2147\/NDT.S532443","article-title":"The effects of repetitive transcranial magnetic stimulation on post-traumatic stress disorder and parameter discussion: a meta-analysis based on randomized controlled trials","volume":"21","author":"Wang","year":"2025","journal-title":"Neuropsychiatr Dis Treat"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1515\/revneuro-2019-0047","article-title":"Motor stroke recovery after tDCS: a systematic review","volume":"31","author":"Orr\u00f9","year":"2020","journal-title":"Rev Neurosci"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"5257","DOI":"10.1080\/09638288.2021.1925979","article-title":"Repetitive peripheral magnetic stimulation for the assessment of wrist spasticity: reliability, validation and correlation with clinical measures","volume":"44","author":"Fernandez-Lobera","year":"2022","journal-title":"Disabil Rehabil"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1612490","DOI":"10.3389\/fneur.2025.1612490","article-title":"Efficacy of repetitive peripheral magnetic stimulation on upper limb motor function after stroke: a systematic review and meta-analysis of randomized controlled trials","volume":"16","author":"Liu","year":"2025","journal-title":"Front Neurol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"949575","DOI":"10.3389\/fnins.2022.949575","article-title":"Brain-machine interface-based training for improving upper extremity function after stroke: a meta-analysis of randomized controlled trials","volume":"16","author":"Xie","year":"2022","journal-title":"Front Neurosci"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ (Clin Res)"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"85","DOI":"10.6224\/JN.202104_68(2).11","article-title":"Application of the risk of bias 2 tool","volume":"68","author":"Lee","year":"2021","journal-title":"Hu Li Za Zhi"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1016\/S1474-4422(19)30415-6","article-title":"Advances and challenges in stroke rehabilitation","volume":"19","author":"Stinear","year":"2020","journal-title":"Lancet Neurol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1177\/09622802231172043","article-title":"Detecting the skewness of data from the five-number summary and its application in meta-analysis","volume":"32","author":"Shi","year":"2023","journal-title":"Stat Methods Med Res"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1186\/1471-2288-14-135","article-title":"Estimating the sample mean and standard deviation from the sample size, median, range and\/or interquartile range","volume":"14","author":"Wan","year":"2014","journal-title":"BMC Med Res Methodol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1097\/XEB.0000000000000132","article-title":"The robust error meta-regression method for dose-response meta-analysis","volume":"16","author":"Xu","year":"2018","journal-title":"Int J Evid Based Healthc"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1016\/j.apmr.2014.02.003","article-title":"Effects of repetitive peripheral magnetic stimulation on upper-limb spasticity and impairment in patients with spastic hemiparesis: a randomized, double-blind, sham-controlled study","volume":"95","author":"Krewer","year":"2014","journal-title":"Arch Phys Med Rehabil"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"4","DOI":"10.4172\/2329-9096.1000352","article-title":"Repetitive peripheral magnetic stimulation (rpms) in combination with muscle stretch decreased the wrist and finger flexor muscle spasticity in chronic patients after CNS lesion","volume":"4","author":"Werner","year":"2016","journal-title":"Int. J. Phys. Med. Rehabil."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/6085961","article-title":"Musculoskeletal ultrasonography assessment of functional magnetic stimulation on the effect of glenohumeral subluxation in acute poststroke hemiplegic patients","volume":"2018","author":"Yang","year":"2018","journal-title":"Biomed Res Int"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"546599","DOI":"10.3389\/fneur.2020.546599","article-title":"Electroencephalography mu rhythm changes and decreased spasticity after repetitive peripheral magnetic stimulation in patients following stroke","volume":"11","author":"Chen","year":"2020","journal-title":"Front Neurol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"569","DOI":"10.3233\/NRE-203085","article-title":"Repetitive peripheral magnetic stimulation improves severe upper limb paresis in early acute phase stroke survivors","volume":"46","author":"Obayashi","year":"2020","journal-title":"NeuroRehabilitation"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1177\/02692155211072189","article-title":"A randomized controlled trial of repetitive peripheral magnetic stimulation applied in early subacute stroke: effects on severe upper-limb impairment","volume":"36","author":"Jiang","year":"2022","journal-title":"Clin Rehabil"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"106446","DOI":"10.1016\/j.jstrokecerebrovasdis.2022.106446","article-title":"Effect of high-frequency repetitive peripheral magnetic stimulation on motor performance in intracerebral Haemorrhage: a clinical trial","volume":"31","author":"Ke","year":"2022","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s12984-022-00985-w","article-title":"Peripheral magnetic theta burst stimulation to muscles can effectively reduce spasticity: a randomized controlled trial","volume":"19","author":"El Nahas","year":"2022","journal-title":"J Neuroeng Rehabil"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1186\/s43166-023-00204-x","article-title":"Repetitive peripheral magnetic stimulation for improving upper limb function in post-stroke hemiparesis","volume":"51","author":"Fawaz","year":"2024","journal-title":"Egypt Rheumatol Rehabil"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1100464","DOI":"10.3389\/fnins.2023.1100464","article-title":"The effects of combined high-frequency repetitive transcranial magnetic stimulation and cervical nerve root magnetic stimulation on upper extremity motor recovery following stroke","volume":"17","author":"Wu","year":"2023","journal-title":"Front Neurosci"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.33425\/2996-4377.1005","article-title":"Impact of repetitive peripheral magnetic stimulation on post-stroke patients with upper limb spasticity\u2014a randomized controlled trial","volume":"1","author":"Aleksandrovich","year":"2023","journal-title":"Int J Res Phys Med Rehabil"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1186\/s12984-024-01341-w","article-title":"Synergistic efficacy of repetitive peripheral magnetic stimulation on central intermittent theta burst stimulation for upper limb function in patients with stroke: a double-blinded, randomized controlled trial","volume":"21","author":"Chang","year":"2024","journal-title":"J Neuroeng Rehabil"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"44","DOI":"10.26689\/jcnr.v8i2.6166","article-title":"Study on the effect of repetitive peripheral magnetic stimulation combined with conventional rehabilitation measures on shoulder dysfunction in early stroke","volume":"8","author":"Yan","year":"2024","journal-title":"J. Clin. Nurs. Res."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"216","DOI":"10.23736\/S1973-9087.24.08264-9","article-title":"Repetitive peripheral magnetic stimulation for preventing shoulder subluxation after stroke: a randomized controlled trial","volume":"60","author":"Fujimura","year":"2024","journal-title":"Eur J Phys Rehabil Med"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1589\/jpts.31.917","article-title":"Minimal clinically important difference for the Fugl-Meyer assessment of the upper extremity in convalescent stroke patients with moderate to severe hemiparesis","volume":"31","author":"Hiragami","year":"2019","journal-title":"J Phys Ther Sci"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1186\/s12871-022-01655-z","article-title":"Anesthesia inhibited corticospinal excitability and attenuated the modulation of repetitive transcranial magnetic stimulation","volume":"22","author":"Wang","year":"2022","journal-title":"BMC Anesthesiol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1472837","DOI":"10.3389\/fneur.2024.1472837","article-title":"Effects of repetitive transcranial magnetic stimulation combined with repetitive peripheral magnetic stimulation on upper limb motor function after stroke: a systematic review and meta-analysis","volume":"15","author":"Luo","year":"2024","journal-title":"Front Neurol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/1569186120901633","article-title":"Effects of peripheral nerve stimulation on paralysed upper limb functional recovery in chronic stroke patients undergoing low-frequency repetitive transcranial magnetic stimulation and occupational therapy: a pilot study","volume":"33","author":"Maeda","year":"2020","journal-title":"Hong Kong J. Occup. Ther."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1016\/j.jhsg.2024.03.005","article-title":"A systematic review to compare electrical, magnetic, and Optogenetic stimulation for peripheral nerve repair","volume":"6","author":"Kaluskar","year":"2024","journal-title":"J. Hand Surg. Glob."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"196","DOI":"10.3390\/s23010196","article-title":"Reliable fast (20 Hz) acquisition rate by a TD fNIRS device: brain resting-state oscillation studies","volume":"23","author":"Re","year":"2022","journal-title":"Sensors (Basel, Switzerland)"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"6322","DOI":"10.1038\/s41598-021-85851-w","article-title":"Specific modulation of corticomuscular coherence during submaximal voluntary isometric, shortening and lengthening contractions","volume":"11","author":"Glories","year":"2021","journal-title":"Sci Rep"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"7737","DOI":"10.1021\/acs.chemrev.8b00630","article-title":"Atomistic simulations of membrane Ion Channel conduction, gating, and modulation","volume":"119","author":"Flood","year":"2019","journal-title":"Chem Rev"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"102403","DOI":"10.1016\/j.jelekin.2020.102403","article-title":"Impact of the EMG normalization method on muscle activation and the antagonist-agonist co-contraction index during active elbow extension: practical implications for post-stroke subjects","volume":"51","author":"Chalard","year":"2020","journal-title":"J Electr Kinesiol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.jphys.2022.01.001","article-title":"Critically appraised paper: intensive motor rehabilitation after stroke is more effective within the subacute than acute or chronic phase compared with standard rehabilitation","volume":"68","author":"Spittle","year":"2022","journal-title":"J Physiother"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"13","DOI":"10.4103\/2773-2398.340140","article-title":"Application of repetitive peripheral magnetic stimulation for recovery of motor function after stroke based on neuromodulation: a narrative review","volume":"1","author":"Liu","year":"2022","journal-title":"Brain Netw Modul"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"632716","DOI":"10.3389\/fnins.2021.632716","article-title":"Repetitive peripheral magnetic stimulation of wrist extensors enhances cortical excitability and motor performance in healthy individuals","volume":"15","author":"Nito","year":"2021","journal-title":"Front Neurosci"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"107827","DOI":"10.1016\/j.jstrokecerebrovasdis.2024.107827","article-title":"Changes in sedentary behavior in the chronic phase following stroke","volume":"33","author":"Svalbj","year":"2024","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"992424","DOI":"10.3389\/fnhum.2023.992424","article-title":"Effects of transcranial combined with peripheral repetitive magnetic stimulation on limb spasticity and resting-state brain activity in stroke patients","volume":"17","author":"Qin","year":"2023","journal-title":"Front Hum Neurosci"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1169087","DOI":"10.3389\/fresc.2023.1169087","article-title":"Emerging theory of sensitization in post-stroke muscle spasticity","volume":"4","author":"Suputtitada","year":"2023","journal-title":"Front Rehabil Sci"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1429929","DOI":"10.3389\/fneur.2024.1429929","article-title":"The association between dexterity and upper limb impairment during stroke recovery","volume":"15","author":"Valladares","year":"2024","journal-title":"Front Neurol"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"854219","DOI":"10.3389\/fnins.2022.854219","article-title":"Transcranial magnetic stimulation for improving dysphagia after stroke: a Meta-analysis of randomized controlled trials","volume":"16","author":"Xie","year":"2022","journal-title":"Front Neurosci"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1555990","DOI":"10.3389\/fneur.2025.1555990","article-title":"Advances in hemiplegia rehabilitation: modern therapeutic interventions to enhance activities of daily living","volume":"16","author":"Xiong","year":"2025","journal-title":"Front Neurol"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.28982\/josam.1014433","article-title":"Does muscle stiffness predict early-onset knee osteoarthritis?","volume":"5","author":"En","year":"2021","journal-title":"J Surg Med"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1007\/s10517-021-05232-1","article-title":"Application of fMRI and simultaneous fMRI-EEG neurofeedback in post-stroke motor rehabilitation","volume":"171","author":"Bezmaternykh","year":"2021","journal-title":"Bull Exp Biol Med"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1080\/10749357.2023.2202018","article-title":"Characterizing the impact of multiple chronic conditions on return to participation in chronic stroke survivors","volume":"31","author":"Thompson","year":"2024","journal-title":"Top Stroke Rehabil"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"1520","DOI":"10.1016\/S0140-6736(21)00667-X","article-title":"Vagus nerve stimulation: a potential new treatment for ischaemic stroke","volume":"397","author":"van der Meij","year":"2021","journal-title":"Lancet (London, England)"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1824669\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:23:30Z","timestamp":1777523010000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1824669\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":55,"alternative-id":["10.3389\/fneur.2026.1824669"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1824669","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]},"article-number":"1824669"}}