Impact of repetitive transcranial magnetic stimulation combined with traditional Chinese Tuina for stroke: a systematic review and meta-analysis

Stroke has emerged as one of the leading causes of long-term disability worldwide. Although the therapeutic effects of traditional Chinese Tuina and rTMS as monotherapies have been partially established, research on their combined application in stroke rehabilitation remains limited. This meta-analysis aims to investigate the effects of traditional Chinese Tuina combined with rTMS for stroke. Nine databases, including EMBASE, PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Alternative HealthWatch, VIP, Wanfang, CNKI and the Chinese Biomedical Literature Database, were searched from inception to August 5, 2025. Two authors independently performed literature screening, data extraction, and risk-of-bias assessment. Meta-analysis was conducted using STATA software. Eleven studies involving 1,134 patients were included in this meta-analysis. The meta-analysis indicated that, compared to the control group, the intervention group demonstrated significantly higher motor function scores [p p p p p 0.001]; session count and stimulation frequency independently had a marginally significant impact on motor function [p = 0.09 p = 0.06 p p p The combination of rTMS and Tuina significantly improves motor function, enhances quality of life, alleviates depressive symptoms, and improves sleep quality for stroke. 24 rTMS sessions may yield the most favourable improvement in motor function. Moreover, low-frequency and 8-coil demonstrate optimal efficacy in enhancing patients’ quality of life.