Transcranial stimulation combined with four rehabilitation therapies for gait and motor function in Parkinson's disease: a network meta-analysis of 23 RCTs
Abstract
Introduction: Parkinson's disease (PD) has become the fastest-growing neurological disease worldwide. This network meta-analysis evaluated the efficacy of transcranial stimulation combined with four rehabilitation approaches for improving gait and motor function in Parkinson's disease.
Methods: We systematically searched seven databases: PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang. Data from 23 randomized controlled trials (n = 669 patients) were analyzed using a frequentist network meta-analysis approach. Primary outcomes included gait parameters (velocity, cadence, stride length) and motor function (Timed Up and Go test, Unified Parkinson's Disease Rating Scale Part III). Statistical analyses incorporated the Surface Under the Cumulative Ranking curve rankings and sensitivity analyses.
Results: (1) For gait outcomes, Dual-Task Training showed optimal efficacy for improving stride length (SUCRA = 100%) and velocity (86.5%), while Exercise Rehabilitation best improved cadence (100%). (2) For motor function, Conventional Rehabilitation demonstrated superior improvement in the Timed Up and Go test (100%), and Dual-Task Training showed advantages in Unified Parkinson's Disease Rating Scale Part III scores (85.1%). All combined interventions significantly outperformed the control groups (p < 0.05), and sensitivity analyses confirmed the robustness of these findings.
Conclusion: The results support the use of personalized rehabilitation strategies:…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 669 participants or records.
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