The research progress on the improvement effect of repeated peripheral magnetic stimulation on upper limb and lower limb spasm after stroke_Journal of Biomedical Engineering

Authors：

XU Lijuan ¹ , YE Liang ¹ , JIA Jie ² ,  CHEN Shugeng ²

1. Rehabilitation Department, Hangzhou Linping Hospital of Traditional Chinese and Western Medicine, Hangzhou 310000, P. R. China;
2. Rehabilitation Department, Huashan Hospital, Fudan University, Shanghai 200040, P. R. China;

Corresponding?author：

Keywords：

Repetitive peripheral magnetic stimulation; Stroke; Spasm

DOI：

10.7507/1001-5515.202411049

Video：

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Abstract Full text Figures/Tables Video References Cited by

Post-stroke spasticity, a common sequelae of upper motor neuron lesions, results in motor control deficits and pathological hypertonia that not only reduce patients’ activities of daily living but may also cause impairment of adaptive neuroplasticity. Repetitive peripheral magnetic stimulation (rPMS), as a novel non-invasive neuromodulation technique, demonstrates unique clinical potential through targeted modulation of electromagnetic coupling effects in the peripheral neuromuscular system. Although current international studies have validated the therapeutic potential of rPMS for spasticity, significant heterogeneity persists in elucidating its mechanisms of action, optimizing parameter protocols, and standardizing outcome assessment systems. This review innovatively synthesized recent randomized controlled trials (RCTs) and mechanistic evidence, systematically summarizing rPMS-mediated multidimensional intervention paradigms for upper- and lower-limb spasticity. It rigorously examined the correlations between stimulation frequency parameters (low-frequency vs. high-frequency), anatomical targeting (nerve trunk vs. motor point), and clinical outcomes including spasticity severity, motor function, and quality of life. Crucially, the analysis reveals that rPMS may ameliorate spasticity after stroke through dual mechanisms involving local neuroelectrophysiological modulation and central sensorimotor network reorganization, thereby providing a theoretical foundation for developing individualized rPMS clinical protocols and establishing precision treatment strategies.

Citation： XU Lijuan, YE Liang, JIA Jie, CHEN Shugeng. The research progress on the improvement effect of repeated peripheral magnetic stimulation on upper limb and lower limb spasm after stroke. Journal of Biomedical Engineering, 2025, 42(3): 628-634. doi: 10.7507/1001-5515.202411049 Copy

1.	Kuriakose D, Xiao Z. Pathophysiology and treatment of stroke: Present status and future perspectives. Int J Mol Sci, 2020, 21(20): 7609.
2.	王隴德, 彭斌, 張鴻祺, 等. 《中國腦卒中防治報告2020》概要. 中國腦血管病雜志, 2022, 19(2): 136-144.
3.	Vaduganathan M, Mensah G A, Turco J V, et al. The global burden of cardiovascular diseases and risk: A compass for future health. J Am Coll Cardiol, 2022, 80(25): 2361-2371.
4.	Lundstr?m E, Terént A, Borg J. Prevalence of disabling spasticity 1 year after first-ever stroke. Eur J Neurol, 2008, 15(6): 533-539.
5.	侯牧韶, 崔曉格, 劉子渤, 等. 肌骨超聲技術在腦卒中后痙攣評估中的應用研究進展. 中華物理醫學與康復雜志, 2024, 46(5): 460-463.
6.	Armstrong A W, Read C. Pathophysiology, clinical presentation, and treatment of psoriasis: A review. JAMA, 2020, 323(19): 1945-1960.
7.	Bates B, Choi J Y, Duncan P W, et al. Veterans affairs/department of defense clinical practice guideline for the management of adult stroke rehabilitation care: executive summary. Stroke, 2005, 36(9): 2049-2056.
8.	Gomez-Cuaresma L, Lucena-Anton D, Gonzalez-Medina G, et al. Effectiveness of stretching in post-stroke spasticity and range of motion: Systematic review and meta-analysis. J Pers Med, 2021, 11(11): 1074.
9.	程期琳, 胡昔權. 外周磁刺激治療腦卒中患者上肢運動功能障礙的研究進展. 中國康復醫學雜志, 2023, 38(6): 840-844.
10.	Wissel J, Verrier M, Simpson D M, et al. Post-stroke spasticity: predictors of early development and considerations for therapeutic intervention. PM R, 2015, 7(1): 60-67.
11.	Thibaut A, Chatelle C, Ziegler E, et al. Spasticity after stroke: physiology, assessment and treatment. Brain Inj, 2013, 27(10): 1093-1105.
12.	何偉, 韓伯軍, 王慶廣, 等. 體外沖擊波作用于肌腹或肌肉-肌腱接合處對腦卒中患者下肢痙攣及步行能力的影響. 中華物理醫學與康復雜志, 2023, 45(10): 904-908.
13.	Cabanas-Valdés R, Calvo-Sanz J, Urrùtia G, et al. The effectiveness of extracorporeal shock wave therapy to reduce lower limb spasticity in stroke patients: a systematic review and meta-analysis. Top Stroke Rehabil, 2020, 27(2): 137-157.
14.	Lin S, Sun Q, Wang H, et al. Influence of transcutaneous electrical nerve stimulation on spasticity, balance, and walking speed in stroke patients: A systematic review and meta-analysis. J Rehabil Med, 2018, 50(1): 3-7.
15.	Xu P, Huang Y, Wang J, et al. Repetitive transcranial magnetic stimulation as an alternative therapy for stroke with spasticity: a systematic review and meta-analysis. J Neurol, 2021, 268(11): 4013-4022.
16.	Salazar A P, Pinto C, Ruschel M J, et al. Effectiveness of static stretching positioning on post-stroke upper-limb spasticity and mobility: Systematic review with meta-analysis. Ann Phys Rehabil Med, 2019, 62(4): 274-282.
17.	Kinoshita S, Ikeda K, Hama M, et al. Repetitive peripheral magnetic stimulation combined with intensive physical therapy for gait disturbance after hemorrhagic stroke: an open-label case series. Int J Rehabil Res, 2020, 43(3): 235-239.
18.	Zschorlich V, Yamaguchi T, Schneider C. Editorial: The use of repetitive peripheral magnetic stimulation (rPMS) in neurological disorders and neurorehabilitation. Front Neurol, 2023, 14: 1324882.
19.	Aamir A, Girach A, Sarrigiannis P G, et al. Repetitive magnetic stimulation for the management of peripheral neuropathic pain: A systematic review. Adv Ther, 2020, 37(3): 998-1012.
20.	Fernandez-Lobera M, Morales M, Valls-Sole J. Repetitive peripheral magnetic stimulation for the assessment of wrist spasticity: reliability, validation and correlation with clinical measures. Disabil Rehabil, 2022, 44(18): 5257-5267.
21.	Jiang Y F, Zhang D, Zhang J, et al. A randomized controlled trial of repetitive peripheral magnetic stimulation applied in early subacute stroke: Effects on severe upper-limb impairment. Clin Rehabil, 2022, 36(5): 693-702.
22.	李陽, 陳樹耿, 王傳凱, 等. 重復外周磁刺激對腦卒中患者上肢痙攣和運動功能的即刻影響. 中國康復理論與實踐, 2018, 24(12): 1376-1379.
23.	Struppler A, Angerer B, Gündisch C, et al. Modulatory effect of repetitive peripheral magnetic stimulation on skeletal muscle tone in healthy subjects: stabilization of the elbow joint. Exp Brain Res, 2004, 157(1): 59-66.
24.	Werner C, Schrader M, Wernicke S, et al. Repetitive peripheral magnetic stimulation (rpMS) in combination with muscle stretch decreased the wrist and finger flexor muscle spasticity in chronic patients after CNS lesion. Int J Phys Med Rehabil, 2016, 4(4): 352.
25.	Qin Y, Liu X, Zhang Y, et al. Effects of transcranial combined with peripheral repetitive magnetic stimulation on limb spasticity and resting-state brain activity in stroke patients. Front Hum Neurosci, 2023, 17: 992424.
26.	Kamo T, Wada Y, Okamura M, et al. Repetitive peripheral magnetic stimulation for impairment and disability in people after stroke. Cochrane Database Syst Rev, 2022, 9(9): CD11968.
27.	Krewer C, Hartl S, Müller F, et al. Effects of repetitive peripheral magnetic stimulation on upper-limb spasticity and impairment in patients with spastic hemiparesis: a randomized, double-blind, sham-controlled study. Arch Phys Med Rehabil, 2014, 95(6): 1039-1047.
28.	孫藤方, 任夢婷, 楊琳, 等. 高壓氧治療聯合重復外周磁刺激干預腦卒中患者踝運動功能和平衡能力的效果. 中國康復理論與實踐, 2023, 29(8): 875-881.
29.	Ke J, Wei J, Zheng B, et al. Effect of high-frequency repetitive peripheral magnetic stimulation on motor performance in intracerebral haemorrhage: A clinical trial. J Stroke Cerebrovasc Dis, 2022, 31(7): 106446.
30.	Beaulieu L D, Massé-Alarie H, Brouwer B, et al. Noninvasive neurostimulation in chronic stroke: a double-blind randomized sham-controlled testing of clinical and corticomotor effects. Top Stroke Rehabil, 2015, 22(1): 8-17.
31.	Nevine El Nahas, Fatma Fathalla Kenawy, Eman Hamid Abd Eldayem, et al. Peripheral magnetic theta burst stimulation to muscles can effectively reduce spasticity: a randomized controlled trial. J Neuroeng Rehabil, 2022, 19(1): 5.
32.	Pan J X, Diao Y X, Peng H Y, et al. Effects of repetitive peripheral magnetic stimulation on spasticity evaluated with modified Ashworth scale/Ashworth scale in patients with spastic paralysis: A systematic review and meta-analysis. Front Neurol, 2022, 13: 997913.
33.	Sakai K, Yasufuku Y, Kamo T, et al. Repetitive peripheral magnetic stimulation for impairment and disability in people after stroke. Cochrane Database Syst Rev, 2019, 11(11): CD11968.
34.	Momosaki R, Yamada N, Ota E, et al. Repetitive peripheral magnetic stimulation for activities of daily living and functional ability in people after stroke. Cochrane Database Syst Rev, 2017, 6(6): CD11968.
35.	Ghandehari K, Ghandehari K, Saffarian-Toosi G, et al. Comparative interrater reliability of Asian Stroke Disability Scale, modified Rankin Scale and Barthel Index in patients with brain infarction. ARYA Atheroscler, 2012, 8(3): 153-157.
36.	Wissel J, Schelosky L D, Scott J, et al. Early development of spasticity following stroke: a prospective, observational trial. J Neurol, 2010, 257(7): 1067-1072.
37.	Pandyan A D, Gregoric M, Barnes M P, et al. Spasticity: clinical perceptions, neurological realities and meaningful measurement. Disabil Rehabil, 2005, 27(1-2): 2-6.
38.	Li S, Francisco G E, Rymer W Z. A new definition of poststroke spasticity and the interference of spasticity with motor recovery from acute to chronic stages. Neurorehabil Neural Repair, 2021, 35(7): 601-610.
39.	Guo X, Tang J, Crocher V, et al. Using sEMG signal frequency to evaluate post-stroke elbow spasticity. Annu Int Conf IEEE Eng Med Biol Soc, 2023, 2023: 1-4.
40.	Boulard C, Mathevon L, Arnaudeau L F, et al. Reliability of shear wave elastography and ultrasound measurement in children with unilateral spastic cerebral palsy. Ultrasound Med Biol, 2021, 47(5): 1204-1211.
41.	朱光躍, 陳思韻, 霍聰聰, 等. 外周聯合中樞雙靶磁刺激促進腦卒中運動功能障礙康復專家共識. 中國康復醫學雜志, 2023, 38(7): 880-884.
42.	Fujimura K, Kagaya H, Itoh R, et al. Repetitive peripheral magnetic stimulation for preventing shoulder subluxation after stroke: a randomized controlled trial. Eur J Phys Rehabil Med, 2024, 60(2): 216-224.
43.	Asao A, Wada K, Nomura T, et al. Time course changes in corticospinal excitability during repetitive peripheral magnetic stimulation combined with motor imagery. Neurosci Lett, 2022, 771: 136427.
44.	Schabrun S M, Ridding M C, Galea M P, et al. Primary sensory and motor cortex excitability are co-modulated in response to peripheral electrical nerve stimulation. PLoS One, 2012, 7(12): e51298.
45.	Suputtitada A. Emerging theory of sensitization in post-stroke muscle spasticity. Front Rehabil Sci, 2023, 4: 1169087.
46.	Chen S, Li Y, Shu X, et al. Electroencephalography mu rhythm changes and decreased spasticity after repetitive peripheral magnetic stimulation in patients following stroke. Front Neurol, 2020, 11: 546599.
47.	Okudera Y, Matsunaga T, Sato M, et al. The impact of high-frequency magnetic stimulation of peripheral nerves: muscle hardness, venous blood flow, and motor function of upper extremity in healthy subjects. Biomed Res, 2015, 36(2): 81-87.
48.	劉浩, 賈延兵, 魏靜, 等. 重復外周磁刺激在康復治療中的應用及研究進展. 中國康復醫學雜志, 2021, 36(5): 631-637.

1. Kuriakose D, Xiao Z. Pathophysiology and treatment of stroke: Present status and future perspectives. Int J Mol Sci, 2020, 21(20): 7609.
2. 王隴德, 彭斌, 張鴻祺, 等. 《中國腦卒中防治報告2020》概要. 中國腦血管病雜志, 2022, 19(2): 136-144.
3. Vaduganathan M, Mensah G A, Turco J V, et al. The global burden of cardiovascular diseases and risk: A compass for future health. J Am Coll Cardiol, 2022, 80(25): 2361-2371.
4. Lundstr?m E, Terént A, Borg J. Prevalence of disabling spasticity 1 year after first-ever stroke. Eur J Neurol, 2008, 15(6): 533-539.
5. 侯牧韶, 崔曉格, 劉子渤, 等. 肌骨超聲技術在腦卒中后痙攣評估中的應用研究進展. 中華物理醫學與康復雜志, 2024, 46(5): 460-463.
6. Armstrong A W, Read C. Pathophysiology, clinical presentation, and treatment of psoriasis: A review. JAMA, 2020, 323(19): 1945-1960.
7. Bates B, Choi J Y, Duncan P W, et al. Veterans affairs/department of defense clinical practice guideline for the management of adult stroke rehabilitation care: executive summary. Stroke, 2005, 36(9): 2049-2056.
8. Gomez-Cuaresma L, Lucena-Anton D, Gonzalez-Medina G, et al. Effectiveness of stretching in post-stroke spasticity and range of motion: Systematic review and meta-analysis. J Pers Med, 2021, 11(11): 1074.
9. 程期琳, 胡昔權. 外周磁刺激治療腦卒中患者上肢運動功能障礙的研究進展. 中國康復醫學雜志, 2023, 38(6): 840-844.
10. Wissel J, Verrier M, Simpson D M, et al. Post-stroke spasticity: predictors of early development and considerations for therapeutic intervention. PM R, 2015, 7(1): 60-67.
11. Thibaut A, Chatelle C, Ziegler E, et al. Spasticity after stroke: physiology, assessment and treatment. Brain Inj, 2013, 27(10): 1093-1105.
12. 何偉, 韓伯軍, 王慶廣, 等. 體外沖擊波作用于肌腹或肌肉-肌腱接合處對腦卒中患者下肢痙攣及步行能力的影響. 中華物理醫學與康復雜志, 2023, 45(10): 904-908.
13. Cabanas-Valdés R, Calvo-Sanz J, Urrùtia G, et al. The effectiveness of extracorporeal shock wave therapy to reduce lower limb spasticity in stroke patients: a systematic review and meta-analysis. Top Stroke Rehabil, 2020, 27(2): 137-157.
14. Lin S, Sun Q, Wang H, et al. Influence of transcutaneous electrical nerve stimulation on spasticity, balance, and walking speed in stroke patients: A systematic review and meta-analysis. J Rehabil Med, 2018, 50(1): 3-7.
15. Xu P, Huang Y, Wang J, et al. Repetitive transcranial magnetic stimulation as an alternative therapy for stroke with spasticity: a systematic review and meta-analysis. J Neurol, 2021, 268(11): 4013-4022.
16. Salazar A P, Pinto C, Ruschel M J, et al. Effectiveness of static stretching positioning on post-stroke upper-limb spasticity and mobility: Systematic review with meta-analysis. Ann Phys Rehabil Med, 2019, 62(4): 274-282.
17. Kinoshita S, Ikeda K, Hama M, et al. Repetitive peripheral magnetic stimulation combined with intensive physical therapy for gait disturbance after hemorrhagic stroke: an open-label case series. Int J Rehabil Res, 2020, 43(3): 235-239.
18. Zschorlich V, Yamaguchi T, Schneider C. Editorial: The use of repetitive peripheral magnetic stimulation (rPMS) in neurological disorders and neurorehabilitation. Front Neurol, 2023, 14: 1324882.
19. Aamir A, Girach A, Sarrigiannis P G, et al. Repetitive magnetic stimulation for the management of peripheral neuropathic pain: A systematic review. Adv Ther, 2020, 37(3): 998-1012.
20. Fernandez-Lobera M, Morales M, Valls-Sole J. Repetitive peripheral magnetic stimulation for the assessment of wrist spasticity: reliability, validation and correlation with clinical measures. Disabil Rehabil, 2022, 44(18): 5257-5267.
21. Jiang Y F, Zhang D, Zhang J, et al. A randomized controlled trial of repetitive peripheral magnetic stimulation applied in early subacute stroke: Effects on severe upper-limb impairment. Clin Rehabil, 2022, 36(5): 693-702.
22. 李陽, 陳樹耿, 王傳凱, 等. 重復外周磁刺激對腦卒中患者上肢痙攣和運動功能的即刻影響. 中國康復理論與實踐, 2018, 24(12): 1376-1379.
23. Struppler A, Angerer B, Gündisch C, et al. Modulatory effect of repetitive peripheral magnetic stimulation on skeletal muscle tone in healthy subjects: stabilization of the elbow joint. Exp Brain Res, 2004, 157(1): 59-66.
24. Werner C, Schrader M, Wernicke S, et al. Repetitive peripheral magnetic stimulation (rpMS) in combination with muscle stretch decreased the wrist and finger flexor muscle spasticity in chronic patients after CNS lesion. Int J Phys Med Rehabil, 2016, 4(4): 352.
25. Qin Y, Liu X, Zhang Y, et al. Effects of transcranial combined with peripheral repetitive magnetic stimulation on limb spasticity and resting-state brain activity in stroke patients. Front Hum Neurosci, 2023, 17: 992424.
26. Kamo T, Wada Y, Okamura M, et al. Repetitive peripheral magnetic stimulation for impairment and disability in people after stroke. Cochrane Database Syst Rev, 2022, 9(9): CD11968.
27. Krewer C, Hartl S, Müller F, et al. Effects of repetitive peripheral magnetic stimulation on upper-limb spasticity and impairment in patients with spastic hemiparesis: a randomized, double-blind, sham-controlled study. Arch Phys Med Rehabil, 2014, 95(6): 1039-1047.
28. 孫藤方, 任夢婷, 楊琳, 等. 高壓氧治療聯合重復外周磁刺激干預腦卒中患者踝運動功能和平衡能力的效果. 中國康復理論與實踐, 2023, 29(8): 875-881.
29. Ke J, Wei J, Zheng B, et al. Effect of high-frequency repetitive peripheral magnetic stimulation on motor performance in intracerebral haemorrhage: A clinical trial. J Stroke Cerebrovasc Dis, 2022, 31(7): 106446.
30. Beaulieu L D, Massé-Alarie H, Brouwer B, et al. Noninvasive neurostimulation in chronic stroke: a double-blind randomized sham-controlled testing of clinical and corticomotor effects. Top Stroke Rehabil, 2015, 22(1): 8-17.
31. Nevine El Nahas, Fatma Fathalla Kenawy, Eman Hamid Abd Eldayem, et al. Peripheral magnetic theta burst stimulation to muscles can effectively reduce spasticity: a randomized controlled trial. J Neuroeng Rehabil, 2022, 19(1): 5.
32. Pan J X, Diao Y X, Peng H Y, et al. Effects of repetitive peripheral magnetic stimulation on spasticity evaluated with modified Ashworth scale/Ashworth scale in patients with spastic paralysis: A systematic review and meta-analysis. Front Neurol, 2022, 13: 997913.
33. Sakai K, Yasufuku Y, Kamo T, et al. Repetitive peripheral magnetic stimulation for impairment and disability in people after stroke. Cochrane Database Syst Rev, 2019, 11(11): CD11968.
34. Momosaki R, Yamada N, Ota E, et al. Repetitive peripheral magnetic stimulation for activities of daily living and functional ability in people after stroke. Cochrane Database Syst Rev, 2017, 6(6): CD11968.
35. Ghandehari K, Ghandehari K, Saffarian-Toosi G, et al. Comparative interrater reliability of Asian Stroke Disability Scale, modified Rankin Scale and Barthel Index in patients with brain infarction. ARYA Atheroscler, 2012, 8(3): 153-157.
36. Wissel J, Schelosky L D, Scott J, et al. Early development of spasticity following stroke: a prospective, observational trial. J Neurol, 2010, 257(7): 1067-1072.
37. Pandyan A D, Gregoric M, Barnes M P, et al. Spasticity: clinical perceptions, neurological realities and meaningful measurement. Disabil Rehabil, 2005, 27(1-2): 2-6.
38. Li S, Francisco G E, Rymer W Z. A new definition of poststroke spasticity and the interference of spasticity with motor recovery from acute to chronic stages. Neurorehabil Neural Repair, 2021, 35(7): 601-610.
39. Guo X, Tang J, Crocher V, et al. Using sEMG signal frequency to evaluate post-stroke elbow spasticity. Annu Int Conf IEEE Eng Med Biol Soc, 2023, 2023: 1-4.
40. Boulard C, Mathevon L, Arnaudeau L F, et al. Reliability of shear wave elastography and ultrasound measurement in children with unilateral spastic cerebral palsy. Ultrasound Med Biol, 2021, 47(5): 1204-1211.
41. 朱光躍, 陳思韻, 霍聰聰, 等. 外周聯合中樞雙靶磁刺激促進腦卒中運動功能障礙康復專家共識. 中國康復醫學雜志, 2023, 38(7): 880-884.
42. Fujimura K, Kagaya H, Itoh R, et al. Repetitive peripheral magnetic stimulation for preventing shoulder subluxation after stroke: a randomized controlled trial. Eur J Phys Rehabil Med, 2024, 60(2): 216-224.
43. Asao A, Wada K, Nomura T, et al. Time course changes in corticospinal excitability during repetitive peripheral magnetic stimulation combined with motor imagery. Neurosci Lett, 2022, 771: 136427.
44. Schabrun S M, Ridding M C, Galea M P, et al. Primary sensory and motor cortex excitability are co-modulated in response to peripheral electrical nerve stimulation. PLoS One, 2012, 7(12): e51298.
45. Suputtitada A. Emerging theory of sensitization in post-stroke muscle spasticity. Front Rehabil Sci, 2023, 4: 1169087.
46. Chen S, Li Y, Shu X, et al. Electroencephalography mu rhythm changes and decreased spasticity after repetitive peripheral magnetic stimulation in patients following stroke. Front Neurol, 2020, 11: 546599.
47. Okudera Y, Matsunaga T, Sato M, et al. The impact of high-frequency magnetic stimulation of peripheral nerves: muscle hardness, venous blood flow, and motor function of upper extremity in healthy subjects. Biomed Res, 2015, 36(2): 81-87.
48. 劉浩, 賈延兵, 魏靜, 等. 重復外周磁刺激在康復治療中的應用及研究進展. 中國康復醫學雜志, 2021, 36(5): 631-637.

Journal of Biomedical Engineering

The research progress on the improvement effect of repeated peripheral magnetic stimulation on upper limb and lower limb spasm after stroke

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