Objective:

To critically appraise the methodological and reporting quality of existing systematic reviews and meta-analyses addressing the effects of repetitive transcranial magnetic stimulation (rTMS) on upper limb motor recovery after stroke, highlighting its significance for clinical practice.

Key Findings:

• 17 MAs/SRs were included with an average multivariate rank score of 11.82, indicating a need for improved methodological standards.
• GRADE assessment showed high certainty for 13 outcome indicators, moderate for 47, low for 91, and very low for 71, suggesting variability in evidence quality.
• Overall methodological and reporting quality was suboptimal, primarily due to insufficient rigor and incomplete reporting, which limits clinical applicability.

Interpretation:

Current systematic reviews suggest that rTMS may enhance upper limb motor function post-stroke, but the overall quality of evidence remains limited, necessitating further research to validate these findings.

Limitations:

• Insufficient methodological rigor and incomplete reporting were identified as primary issues, which future studies should address.
• Publication year and potential bias played secondary roles, indicating the need for ongoing scrutiny of published literature.

Conclusion:

Future research must adopt rigorous methodological standards and transparent reporting practices, integrating MRI-derived biomarkers to address evidence heterogeneity and enhance the clinical relevance of findings.

Sources:

• Systematic review registration