Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta-burst stimulation (iTBS) can be used to manage post-stroke spasticity, but a meta-analysis of the recent randomized-controlled trials (RCTs) is lacking. Our aim is to perform a meta-analysis of the RCTs that investigated the efficacy of rTMS in patients with post-stroke spasticity. PubMed, Embase, and Cochrane Library databases were searched for eligible papers published up to February 2020. The primary outcome was the Modified Ashworth Scale (MAS), measured as the effect of rTMS compared with controls and after rTMS (using a change score calculated separately in the active and sham treatment groups). Finally, five papers and eight data sets were included. rTMS had no significant benefit on MAS in patients with post-stroke spasticity compared to sham treatment (WMD = − 0.29, 95% CI − 0.58, 0.00; P = 0.051). When analyzing the change score in the treatment groups, a significant effect of rTMS was observed (WMD = − 0.27, 95% CI − 0.51, − 0.04; P = 0.024). When analyzing the change score in the sham treatment groups, no significant effect of sham treatment was observed, indicating no placebo effect (WMD = 0.32, 95% CI: − 0.40, 1.04; P = 0.387). We included the sample size, year of publication, percentage of male patients, and age difference in each study as covariates, and performed a meta-regression. The results showed no association between these variables and the MAS. Compared with sham stimulation, rTMS did not show a significant reduction in MAS for the patients who experienced post-stroke spasticity, but the patients reported a better outcome in MAS on a before-after scenario.

重复经颅磁刺激 (rTMS) 和间歇性 theta-burst 刺激 (iTBS) 可用于治疗中风后痉挛，但缺乏对最近随机对照试验 (RCT) 的荟萃分析。我们的目标是对 RCT 进行荟萃分析，这些 RCT 研究了 rTMS 在卒中后痉挛患者中的疗效。在 PubMed、Embase 和 Cochrane 图书馆数据库中搜索了截至 2020 年 2 月发表的符合条件的论文。主要结果是改良 Ashworth 量表 (MAS)，衡量 rTMS 与对照和 rTMS 后的效果（使用单独计算的变化评分）在主动治疗组和假治疗组中）。最后，收录了五篇论文和八个数据集。与假治疗相比，rTMS 对中风后痉挛患者的 MAS 没有显着益处（WMD = - 0.29，P  = 0.051）。在分析治疗组的变化评分时，观察到 rTMS 的显着效果（WMD = - 0.27，95% CI - 0.51，- 0.04；P  = 0.024）。在分析假治疗组的变化评分时，没有观察到假治疗的显着影响，表明没有安慰剂效应（WMD = 0.32, 95% CI: − 0.40, 1.04; P = 0.387）。我们将每项研究中的样本量、发表年份、男性患者的百分比和年龄差异作为协变量，并进行了荟萃回归。结果显示这些变量与 MAS 之间没有关联。与假刺激相比，rTMS 并未显示中风后痉挛患者的 MAS 显着降低，但患者在前后情况下的 MAS 结果更好。