Repetitive peripheral magnetic stimulation for pain, disability, and kinesiophobia in patients with chronic musculoskeletal pain: a systematic review and meta-analysis.

Abstract

Introduction: Repetitive peripheral magnetic stimulation (rPMS) is a non-invasive and painless approach developed for therapeutic intervention in clinical rehabilitation. Chronic musculoskeletal pain (CMP) originates from the musculoskeletal system and leads to disability and fear of pain. It may be an option for CMP treatment, but its effectiveness is still unclear.

Evidence acquisition: PubMed, PEDro, the Cochrane Library, Web of Science, and Embase were searched for relevant literatures according to strict inclusion and exclusion criteria on May 26^th, 2023.

Evidence synthesis: The methodology quality of the included studies was assessed using the Cochrane Collaboration's Risk of Bias tool (ROB 2.0) and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system. The cumulative effects of available data were processed for a meta-analysis using RevMan software. Eight RCTs with 177 participants were included. All studies were assessed as having some concerns regarding the risk of bias. rPMS significantly reduced pain intensity compared with the control, with a standardized mean difference (SMD) across visual analogue scales (VAS) and numerical rating scales (NRS) was -1.16 (95% CI: -1.56 to -0.76, I²=21%, very low-quality evidence), indicating effective pain relief. For subgroup analysis of patients with chronic low back pain (CLBP), the meta-analysis revealed a remarkable pain relief (SMD=-0.92, 95% CI: -1.67 to -0.17, I²=45%, very low-quality evidence). In addition, rPMS exhibited significant cumulative effects on disability improvement (Oswestry disability index: MD=-6.55, 95% CI: -10.27 to -2.82, I²=0%, very low-quality evidence) but not on kinesiophobia (Tampa scale for kinesiophobia: MD=-1.81, 95% CI: -7.60 to 3.98, I²=0%, low quality-evidence).

Conclusions: This meta-analysis demonstrated that rPMS is an effective method for relieving pain and improving disability in the treatment of CMP, especially for patients with CLBP.