Background: In recent years, repetitive transcranial magnetic stimulation (rTMS) has emerged as a noninvasive and painless treatment for post-stroke cognitive impairment (PSCI). However, few studies have analyzed the intervention parameters of cognitive function and the effectiveness and safety of rTMS for treating patients with PSCI. Thus, this meta-analysis aimed to analyze the interventional parameters of rTMS and evaluate the safety and effectiveness of rTMS for treating patients with PSCI.Methods: According to the PRISMA guidelines, we searched the Web of Science, PubMed, EBSCO, Cochrane Library, PEDro, and Embase to retrieve randomized controlled trials (RCTs) of rTMS for the treatment of patients with PSCI. Studies were screened according to the inclusion and exclusion criteria, and two reviewers independently performed literature screening, data extraction, and quality assessment. RevMan 5.40 software was used for data analysis.Results: 12 RCTs involving 497 patients with PSCI met the inclusion criteria. In our analysis, rTMS had a positive therapeutic effect on cognitive rehabilitation in patients with PSCI (P < 0.05). Both high-frequency rTMS and low-frequency rTMS were effective in improving the cognitive function of patients with PSCI by stimulating the dorsolateral prefrontal cortex (DLPFC), but their efficacy was not statistically different (P > 0.05).Conclusions: rTMS treatment on the DLPFC can improve cognitive function in patients with PSCI. There is no significant difference in the treatment effect of high-frequency rTMS and low-frequency rTMS in patients with PSCI between high-frequency and low-frequency rTMS.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=323720, identifier CRD 42022323720.

Knee osteoarthritis (KOA) usually leads to quadriceps femoris atrophy, which in turn can further aggravate the progression of KOA. Curcumin (CUR) has anti-inflammatory and antioxidant effects and has been shown to be a protective agent for skeletal muscle. CUR has been shown to have a protective effect on skeletal muscle. However, there are no studies related to whether CUR improves KOA-induced quadriceps femoris muscle atrophy. We established a model of KOA in rats. Rats in the experimental group were fed CUR for 5 weeks. Changes in autophagy levels, reactive oxygen species (ROS) levels, and changes in the expression of the Sirutin3 (SIRT3)-superoxide dismutase 2 (SOD2) pathway were detected in the quadriceps femoris muscle of rats. KOA led to quadriceps femoris muscle atrophy, in which autophagy was induced and ROS levels were increased. CUR increased SIRT3 expression, decreased SOD2 acetylation and ROS levels, inhibited the over-activation of autophagy, thereby alleviating quadriceps femoris muscle atrophy and improving KOA. CUR has a protective effect against quadriceps femoris muscle atrophy, and KOA is alleviated after improvement of quadriceps femoris muscle atrophy, with the possible mechanism being the reduction of ROS-induced autophagy via the SIRT3-SOD2 pathway.

Objective: This study aimed to investigate the use intention and influencing factors of telerehabilitation in people with rehabilitation needs.Methods: This cross-sectional survey recruited a total of 183 participants with rehabilitation needs from May 2022 to December 2022. Sociodemographic and medical data were collected by a structured questionnaire. The factors influencing the use intention of telerehabilitation were measured by the extended Unified Theory of Acceptance and Use of Technology (UTAUT) model. Multiple hierarchical regression analyses were performed.Results: A total of 150 valid questionnaires were included for analysis. The results indicated that the use intention of telerehabilitation was overall high in people with rehabilitation needs. Health condition (β = −0.21, p = 0.03), performance expectancy (β = 0.21, p = 0.01), facilitating conditions (β = 0.25, p = 0.03), perceived trust (β = 0.25, p < 0.01), and self-efficacy (β = 0.19, p = 0.04) were significant factors influencing the use intention of telerehabilitation.Conclusion: Overall, the use intention of telerehabilitation is high in individuals with rehabilitation needs. Health conditions, performance expectancy, facilitating conditions, perceived trust, and self-efficacy are important factors influencing the use intention of telerehabilitation in individuals with rehabilitation needs.

Background: Previous studies have demonstrated the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in treating post-stroke dysphagia (PSD). However, consensus on optimal clinical protocols for rTMS remains unclear. This study systematically evaluated the efficacy and safety of rTMS with different stimulation parameters in the treatment of PSD to provide evidence-based recommendations for clinical practice.Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, related randomized controlled trials (RCTs) were searched across five databases (PubMed, Web of Science, Embase, Cochrane Library, MEDLINE) up to November 2024. Two reviewers independently screened studies, extracted data, and assessed quality using RevMan 5.40. Heterogeneity was evaluated via I² values, with fixed/random effects models applied accordingly.Results: A total of 18 RCTs with 835 PSD patients were included in this study. The overall risk of bias in the included trials was evaluated as low, and the level of evidence recommendation was rated as “strong.” Meta-analyses demonstrated that both cerebral and cerebellar rTMS treatments significantly improved the swallowing function of PSD patients (p < 0.05). Subgroup analysis of cerebral rTMS showed that high-frequency rTMS (HF-rTMS) could effectively improve the swallowing function of PSD patients (p < 0.05), while low-frequency rTMS (LF-rTMS) failed to improve the swallowing function of PSD patients compared with the control group (p > 0.05). Furthermore, bilateral cerebral rTMS demonstrated superior efficacy in enhancing swallowing function compared to unilateral cerebral rTMS (p < 0.05). Subgroup analyses based on the Penetration Aspiration Scale (PAS) and Dysphagia Outcome Severity Scale (DOSS) revealed that cerebellar rTMS was more effective than cerebral rTMS in improving swallowing function in patients with PSD (p < 0.05). Regarding safety profiles, only 5 of the 18 RCTs documented mild and transient adverse events, including isolated cases of dizziness, headache, and temporary hearing impairment during treatment sessions.Conclusion: Both cerebral and cerebellar rTMS therapy can effectively and safely improve swallowing function in patients with PSD. Furthermore, cerebellar rTMS appears to be superior to cerebral rTMS in the treatment of PSD.Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024498567.

Background: Sarcopenia is an age-related decline in muscle strength and mass, which significantly impacts the quality of life for older adults. Resistance training (RT) is well established as an effective intervention for sarcopenia. Some studies suggest that additional benefits may be obtained when RT is combined with creatine supplement (Cr). However, critical confounding factors, such as age and intervention duration, have not been systematically controlled in previous investigations. This systematic review and meta-analysis aims to quantify the efficacy of Cr + RT on appendicular muscle strength and lean tissue mass in older adults, with a particular emphasis on temporal effect modification through duration-stratified subgroup analyses. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) through searches across eight databases. Eligible studies involved aged individuals undergoing resistance training (2–3 sessions/week) with Cr or placebo (PL) for 8-104 weeks. After screening, 8 RCTs ( n = 482 participants) were included, assessing outcomes of lean tissue mass, chest press, and leg press strength. Results: Compared to PL + RT, Cr + RT significantly improved lower limb strength (SMD = 0.29 [95% CI 0.00-0.57]; p = 0.05) and lean tissue mass (SMD = 0.27 [95% CI 0.02–0.53]; p = 0.03), but did not show significant improvements in upper extremity muscle strength. Subgroup analysis revealed intervention duration effects: interventions lasting ≤ 32 weeks (5 studies) showed better upper limb strength gains (SMD = 0.45 [95% CI 0.14–0.77]; p = 0.005) and increases in lean tissue mass (SMD = 0.57 [95% CI 0.19–0.96]; p = 0.004). Conclusions: Cr + RT can significantly increase muscle strength and lean tissue mass in older adults, particularly in interventions lasting up to 32 weeks. These time-dependent effects highlight the importance of intervention duration in nutritional ergogenic strategies for sarcopenia management. Trial registration: This systematic review has the registration number CRD420251018405 on PROSPERO.