Impact of Non-Invasive Brain Stimulation on Physical Outcomes in Individuals with Spinal Cord Injury: A Systematic Review and Meta-Analysis

Article type
Authors
Hisham H1, Zanudin A1, Mohd Nordin N1, Mat S2, Husin B3, Abd Manaf H4, Alghwiri A5
1Physiotherapy Program, Center for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
2Physiotherapy Program, Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
3Malaysian Spinal Cord Injury Advocacy Association (MASAA), Presint 9,, Putrajaya, Malaysia
4Centre of Physiotherapy, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, 42300, Selangor, Malaysia
5Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, 11942, Jordan
Abstract
Background:
Spinal cord injury (SCI) often results in significant motor impairments. Hence, Non-invasive brain stimulation (NIBS) is being utilized to potentially improve physical outcomes in individuals with SCI by influencing neural plasticity.
Objectives:
This systematic review and meta-analysis aim to consolidate current studies on the impact of NIBS on physical outcomes in individuals with SCI, offering insights into its effectiveness and possible mechanisms.
Methods:
A thorough literature search was performed on major databases, including PubMed, MEDLINE, CENTRAL, and Web of Science, to find relevant research published until 2024. Studies investigating the impact of NIBS on physical outcomes, such as motor function, muscle strength, and spasticity, among individuals with SCI were included. The research included a few studies on NIBS techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), along with study designs. The included studies will be evaluated for methodological quality and risk of bias. The data extraction will be extracted from the included studies. Two separate researchers will perform scientific quality assessments and risk of bias utilizing standardized forms. Any conflicts will be resolved through consensus discussion with the most senior researcher in the team. A meta-analysis will be performed if feasible to investigate the impact of NIBS on physical outcomes, with a significance level of p < 0.05. Subgroup analyses will be performed to investigate the parameters and population characteristics of the included studies.
Results:
More than 300 publications were reviewed for eligibility; the conclusive data and outcomes will be disclosed in September during the Global Evidence Summit in Prague, Czech Republic. This investigation will bridge the gap in understanding the impact of NIBS on physical outcomes from the eligible study.
Conclusions:
This review will provide health and rehabilitation practitioners with information on the effects of NIBS on physical outcomes in patients with SCI. This study will highlight the use of NIBS as an adjunct intervention to conventional rehabilitation, with the potential to improve motor recovery and functional outcomes. The integration of NIBS into SCI rehabilitation protocols could open new avenues for personalized and effective neurorehabilitation strategies.