Repetitive Transcranial Magnetic Stimulation for Upper Limb Motor Function and Activities of Daily Living in Patients with Stroke: a Protocol of a Systematic Review and Bayesian Network Meta-Analysis

IntroductionPatients with stroke usually suffer from varying degrees of movement dysfunction, which seriously affects their quality of life, especially for the upper limb dysfunction. Therefore, this study aims to compare the effects of different repetitive transcranial magnetic stimulation (rTMS) modalities on upper limb motor function and daily activities in patients with stroke.Methods and analysisRelevant research will be collected systematically from PubMed, Web of Science, Embase, Cochrane Library, ProQuest, Wanfang Database, China National Knowledge Infrastructure and Chinese Scientific and Journal Database (VIP) about randomised controlled trials of rTMS in the stroke treatment range from the establishment to November 2020. Primary outcomes will be obtained from scales measuring the upper limb motor function like Upper Extremity Fugl-Meyer Assessment Scale, Wolf Motor Function Test, Jebsen-Taylor Hand Function Test, Action Research Arm Test and Box and Block Test. The secondary outcomes include modified Barthel Index and adverse events (such as vertigo, headache and epilepsy), with the goal of assessing patients’ activities of daily living and the safety of treatment. In order to avoid personal bias in the included studies, two reviewers will conduct the data extraction and quality evaluation independently, and all data analyses will be performed by Generate Mixed Treatment comparison software V.0.14.3 and Stata V.16.0.Ethics and disseminationThe network meta-analysis (NMA) in this study does not require ethical approval because the data analysis will be used only to evaluate the rTMS treatment efficacy without patients’ private information. In addition, the results will be disseminated in international conference reports and peer-reviewed manuscripts.PROSPERO registration numberCRD42020212253.