f5cf0df3b060e1775ba2e22c2ba7128e 311663.pdf 537c548e3a9a89b507a40838fc5119f463d57f5f 311663.pdf d07c4ca7b3e58d6b90da582cf70680debcfabd57ca4ab151a772b78f0ae4a31b 311663.pdf Title: Noninvasive Electromagnetic Neuromodulation of the Central and Peripheral Nervous System for Upper-Limb Motor Strength and Functionality in Individuals with Cervical Spinal Cord Injury: A Systematic Review and Meta-Analysis Subject: (1) Background: Restoring arm and hand function is one of the priorities of people with cervical spinal cord injury (cSCI). Noninvasive electromagnetic neuromodulation is a current approach that aims to improve upper-limb function in individuals with SCI. The aim of this study is to review updated information on the different applications of noninvasive electromagnetic neuromodulation techniques that focus on restoring upper-limb functionality and motor function in people with cSCI. (2) Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used to structure the search protocol. A systematic review of the literature was performed in three databases: the Cochrane Library, PubMed, and Physiotherapy Evidence Database (PEDro). (3) Results: Twenty-five studies were included: four were on transcranial magnetic stimulation (TMS), four on transcranial direct current stimulation (tDCS), two on transcutaneous spinal cord stimulation (tSCS), ten on functional electrical stimulation (FES), four on transcutaneous electrical nerve stimulation (TENS), and one on neuromuscular stimulation (NMS). The meta-analysis could not be completed due to a lack of common motor or functional evaluations. Finally, we realized a narrative review of the results, which reported that noninvasive electromagnetic neuromodulation combined with rehabilitation at the cerebral or spinal cord level significantly improved upper-limb functionality and motor function in cSCI subjects. Results were significant compared with the control group when tSCS, FES, TENS, and NMS was applied. (4) Conclusions: To perform a meta-analysis and contribute to more evidence, randomized controlled trials with standardized outcome measures for the upper extremities in cSCI are needed, even though significant improvement was reported in each non-invasive electromagnetic neuromodulation study. Keywords: electromagnetic stimulation; noninvasive neuromodulation; functionality; motor function; upper limb; cervical spinal cord injury Author: Loreto García-Alén, Aina Ros-Alsina, Laura Sistach-Bosch, Mark Wright and Hatice Kumru Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Mon Jul 22 11:10:36 2024 CEST ModDate: Mon Jul 22 11:29:32 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 21 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 460798 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- YSPQJI+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 ZWJJYM+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 SEUSUD+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 GKJPJG+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 BAMNYG+VnURWPalladioL Type 1 Custom yes yes yes 32 0 RVSEMT+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 48 0 EJIEFJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 74 0 EJIEFL+PalatinoLinotype TrueType WinAnsi yes yes no 77 0 EJIEFN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 80 0 EJIEML+PalatinoLinotype TrueType MacRoman yes yes no 83 0 XYPWHM+CMSY10 Type 1 Builtin yes yes yes 89 0 OVNEXW+EURM10 Type 1 Builtin yes yes yes 109 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-07-11 02:44:29 CEST RepresentationInformation: 311663.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-07-10 19:46:07 CEST Size: 460798 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 523 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Search Strategy Destination: subsection.2.1 Item: Title: Study Selection Procedure Destination: subsection.2.2 Item: Title: Assessment of Methodological Quality Destination: subsection.2.3 Item: Title: Data Extraction and Statistical Analysis Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Study Selection and Characteristics Destination: subsection.3.1 Item: Title: Effect of Interventions Destination: subsection.3.2 Item: Title: Transcranial Magnetic Stimulation (TMS) Destination: subsection.3.3 Item: Title: Transcraneal Direct Cortical Stimulation (tDCS) Destination: subsection.3.4 Item: Title: Transcutaneous Spinal Cord Stimulation (tSCS) Destination: subsection.3.5 Item: Title: Functional Electric Stimulation (FES) Destination: subsection.3.6 Item: Title: Transcutaneous Electrical Nerve Stimulation (TENS) Destination: subsection.3.7 Item: Title: Neuromuscular Stimulation (NMS) Destination: subsection.3.8 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Noninvasive Electromagnetic Neuromodulation of the Central and Peripheral Nervous System for Upper-Limb Motor Strength and Functionality in Individuals with Cervical Spinal Cord Injury: A Systematic Review and Meta-Analysis Author: Loreto García-Alén, Aina Ros-Alsina, Laura Sistach-Bosch, Mark Wright and Hatice Kumru Subject: (1) Background: Restoring arm and hand function is one of the priorities of people with cervical spinal cord injury (cSCI). Noninvasive electromagnetic neuromodulation is a current approach that aims to improve upper-limb function in individuals with SCI. The aim of this study is to review updated information on the different applications of noninvasive electromagnetic neuromodulation techniques that focus on restoring upper-limb functionality and motor function in people with cSCI. (2) Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used to structure the search protocol. A systematic review of the literature was performed in three databases: the Cochrane Library, PubMed, and Physiotherapy Evidence Database (PEDro). (3) Results: Twenty-five studies were included: four were on transcranial magnetic stimulation (TMS), four on transcranial direct current stimulation (tDCS), two on transcutaneous spinal cord stimulation (tSCS), ten on functional electrical stimulation (FES), four on transcutaneous electrical nerve stimulation (TENS), and one on neuromuscular stimulation (NMS). The meta-analysis could not be completed due to a lack of common motor or functional evaluations. Finally, we realized a narrative review of the results, which reported that noninvasive electromagnetic neuromodulation combined with rehabilitation at the cerebral or spinal cord level significantly improved upper-limb functionality and motor function in cSCI subjects. Results were significant compared with the control group when tSCS, FES, TENS, and NMS was applied. (4) Conclusions: To perform a meta-analysis and contribute to more evidence, randomized controlled trials with standardized outcome measures for the upper extremities in cSCI are needed, even though significant improvement was reported in each non-invasive electromagnetic neuromodulation study. 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