Table 3_The effectiveness of transcranial magnetic stimulation in ameliorating limb motor function disorders after stroke: an umbrella review.docx

ObjectiveThis study aimed to reassess systematic reviews and meta-analyses investigating the effects of transcranial magnetic stimulation (TMS) on limb motor impairment in stroke patients.
MethodsThe PRISMA 2020 checklist and AMSTAR 2 tool were used to evaluate the completeness of reporting and methodological quality of the included literature. The GRADE system was used to assess the quality of evidence for the outcome measures reported in the included systematic reviews and meta-analyses.
ResultsA total of 34 articles were included. PRISMA 2020 scores ranged from 17.5 to 26, with a mean score of 22.44. Based on the AMSTAR 2 methodological quality assessment, two studies were rated as high quality, one as moderate, six as low, and 25 as very low. According to the GRADE system, the evidence consisted of four high-quality, 29 moderate-quality, 42 low-quality, and 46 very low-quality evidence bodies.
ConclusionThe findings suggest that TMS has a positive impact on the recovery of limb motor function in stroke patients, with notable improvements observed in upper limb function (e.g., ARAT and FMA-UE scores), walking ability, and activities of daily living. However, the overall strength of these conclusions is constrained by the generally low methodological quality of the included literature.

研究目的 本研究旨在对探讨经颅磁刺激（transcranial magnetic stimulation, TMS）对脑卒中患者肢体运动功能障碍影响的系统评价及Meta分析进行重新评估。
研究方法 本研究采用PRISMA 2020清单与AMSTAR 2工具，对纳入文献的报告完整性及方法学质量进行评价；同时运用GRADE系统，对纳入的系统评价与Meta分析中所报道的结局指标的证据质量展开评估。
研究结果 最终共纳入34篇文献。PRISMA 2020评分区间为17.5至26，平均得分为22.44。经AMSTAR 2方法学质量评级，2项研究被评定为高质量，1项为中等质量，6项为低质量，25项为极低质量。依据GRADE系统，本次评估的证据体包含4项高质量、29项中等质量、42项低质量及46项极低质量证据。
研究结论 本研究结果表明，经颅磁刺激对脑卒中患者的肢体运动功能恢复具有积极作用，在上肢功能（如动作研究与治疗活动测试（Action Research Arm Test, ARAT）评分、上肢Fugl-Meyer评估量表（Fugl-Meyer Assessment for Upper Extremity, FMA-UE）评分）、步行能力及日常生活活动能力方面均观察到显著改善。但由于纳入文献的整体方法学质量普遍偏低，上述结论的证据强度受到一定限制。