{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:37:13Z","timestamp":1790087833936,"version":"4.0.1"},"reference-count":74,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:00:00Z","timestamp":1676505600000},"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. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This review was conducted to assess the quality of the evidence of effectiveness of repetitive transcranial magnetic stimulation (rTMS) in treating motor and language ability of cerebral palsy (CP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Medline, Cochrane library, Web of Science, Embase, PubMed, and CNKI databases were searched up to July 2021 by two independent reviewers. Randomized controlled trials (RCTs) that were published in English and Chinese and met the following criteria were included. The population comprised patients who met the diagnostic criteria for CP. Intervention included the following: comparison about rTMS and sham rTMS or comparison about rTMS combine with other physical therapy and other physical therapy. Outcomes included motor function, as follows: gross motor function measure (GMFM), Gesell Development Diagnosis Scale, fine motor function measure (FMFM), Peabody developmental motor scale, and Modified Ashworth scale. For language ability, sign-significant relation (S-S) was included. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Finally, 29 studies were included in the meta-analysis. Results of evaluation using the Cochrane Collaborative Network Bias Risk Assessment Scale showed that 19 studies specifically explained randomization, among which two studies described allocation concealment, four studies blinded participants and persons and had low risk of bias, and six studies explained that the assessment of outcome measures was blinded. Significant improvements in motor function were observed. The GMFM of total score was determined by using the random-effect model [\n                      <jats:italic>I<\/jats:italic>\n                      2\n                      <jats:sup>\u2009<\/jats:sup>\n                      =\u200988%; MD\u2009=\u2009\u22121.03; 95% CI (\u22121.35, \u22120.71);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.0001] and FMFM was determined by using the fixed-effect model [\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.40 and\n                      <jats:italic>I<\/jats:italic>\n                      2\u2009=\u20093%; SMDs\u2009=\u2009\u22120.48, 95% CI (\u22120.65, \u22120.30);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01]. For language ability, the language improvement rate was determined using a fixed-effect model [\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.88 and\n                      <jats:italic>I<\/jats:italic>\n                      2\u2009=\u20090%; MD\u2009=\u20090.37, 95% CI (0.23, 0.57);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01]. According to the PEDro scale, 10 studies had low-quality, four studies had excellent quality, and the other studies had good quality. Using the GRADEpro GDT online tool, we included a total of 31 outcome indicators, as follows: 22 for low quality, seven for moderate quality, and two for very low quality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The rTMS could improve the motor function and language ability of patients with CP. However, rTMS prescriptions varied, and the studies had low sample sizes. Studies using rigorous and standard research designs about prescriptions and large samples are needed to collect sufficient evidence about the effectiveness of using rTMS to treat patients with CP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2023.835472","type":"journal-article","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T07:43:02Z","timestamp":1676533382000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Effects of repetitive transcranial magnetic stimulation on motor function and language ability in cerebral palsy: A systematic review and meta-analysis"],"prefix":"10.3389","volume":"11","author":[{"given":"Ying-Ying","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-lin","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-jie","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu-qiang","family":"Qiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1080\/03091902.2018.1510555","article-title":"Neuromodulatory effect of repetitive transcranial magnetic stimulation pulses on functional motor performances of spastic cerebral palsy children","volume":"42","author":"Gupta","year":"2018","journal-title":"J Med Eng Technol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"747","DOI":"10.3969\/j.issn.1001-1242.2015.07.028","article-title":"Chinese Rehabilitation guidelines for cerebral palsy (2015): part one","volume":"30","author":"Tang","year":"2015","journal-title":"Chin J Rehab Med"},{"key":"B3","first-page":"213","article-title":"Antenatal and intrapartum risk factors for cerebral palsy in term and near-term newborns","volume":"16","author":"Soleimani","year":"2013","journal-title":"Arch Iran Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1016\/S0140-6736(13)61835-8","article-title":"Cerebral palsy","volume":"383","author":"Colver","year":"2014","journal-title":"Lancet"},{"key":"B5","first-page":"192","article-title":"Cerebral palsy in childhood","volume":"40","author":"Reddihough","year":"2011","journal-title":"Aust Fam Physician"},{"key":"B6","doi-asserted-by":"publisher","first-page":"309","DOI":"10.3760\/j:issn:0254-1424.2007.05.026","article-title":"Definition, classification and diagnostic conditions of cerebral palsy in children","volume":"29","author":"Chen","year":"2007","journal-title":"Chin J Phys Med Rehab"},{"key":"B7","doi-asserted-by":"publisher","first-page":"368","DOI":"10.12968\/bjon.2010.19.6.47249","article-title":"Cerebral palsy: classification, diagnosis and challenges of care","volume":"19","author":"Hayes","year":"2010","journal-title":"Br J Nurs"},{"key":"B8","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1111\/j.1365-3016.2010.01157.x","article-title":"Uncovering the complex relationship between pre-eclampsia, preterm birth and cerebral palsy","volume":"25","author":"Mann","year":"2011","journal-title":"Paediatr Perinat Epidemiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1001\/jamapediatrics.2014.3036","article-title":"Risk for cerebral palsy in infants with total serum bilirubin levels at or above the exchange transfusion threshold: a population-based study","volume":"169","author":"Wu","year":"2015","journal-title":"JAMA Pediatr"},{"key":"B10","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1016\/j.pmr.2007.07.005","article-title":"Cerebral palsy","volume":"18","author":"Green","year":"2007","journal-title":"Phys Med Rehabil Clin N Am"},{"key":"B11","doi-asserted-by":"publisher","first-page":"317047","DOI":"10.1155\/2015\/317047","article-title":"Spasticity and its contribution to hypertonia in cerebral palsy","volume":"2015","author":"Bar-On","year":"2015","journal-title":"Biomed Res Int"},{"key":"B12","doi-asserted-by":"publisher","first-page":"030802261989788","DOI":"10.1177\/0308022619897885","article-title":"Transcranial direct current stimulation for improving gross motor function in children with cerebral palsy: a systematic review","volume":"83","author":"Diego","year":"2020","journal-title":"Br J Occup Ther"},{"key":"B13","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1017\/s0012162200001511","article-title":"Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. 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