Kang 2009

Methods	Cross‐over RCT
Participants	Country of study: South Korea Setting: university hospital outpatient setting Condition: post‐SCI central neuropathic pain Prior management details: resistant to drug, physical or complementary therapies n = 11 Age: 33‐75 years, mean 54.8 Duration of symptoms: chronic Gender distribution: 6 M, 5 F
Interventions	Stimulation type: rTMS Stimulation parameters: frequency 10 Hz; coil orientation angled 45º posterolaterally; 80% RMT; number of trains 20; duration of trains 5 s; ITI 55 s; total number pulses 1000 Stimulation location: R M1, hand area Number of treatments: 5, x 1 daily Control type: coil elevated and angled away from the scalp
Outcomes	Primary: NRS average pain over last 24 h, anchors "no pain sensation" to "most intense pain sensation imaginable" When taken: immediately after the 3rd and 5th treatments and 1, 3, 5 and 7 weeks after the end of the stimulation period Secondary: BPI ‐ pain interference (surrogate measure of disability) When taken: as for the NRS
Notes	AEs: not reported COI: studu authors declared no COI Sources of support: supported by the Seoul National University Bundang Hospital
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "The real and sham rTMS stimulations were separated by 12 weeks and performed in a random order according to the prepared allocation code." Comment: method of randomisation not specified but less critical in cross‐over design
Adequate blinding of participants?	Unclear risk	Comments: sham credibility assessment ‐ suboptimal. Coil angled away from scalp and not in contact in sham condition. Didnot control for sensory characteristics of active stimulation and was visually distinguishable
Adequate blinding of assessors?	Low risk	Quote: "... a different researcher collected the clinical data; the latter researcher was not aware of the type of rTMS (real or sham)"
Incomplete outcome data (attrition bias) All outcomes	Low risk	Comment: no participants withdrew after receiving the first treatment condition
Selective reporting (reporting bias)	Low risk	Comment: results for primary outcomes reported clearly and in full
Free from carry‐over effects?	Low risk	Comment: a 12‐week washout period was observed. The pre‐stimulation baseline scores closely match
Study Size	High risk	Comment: < 50 participants per treatment arm
Study duration	Unclear risk	Comment: ≥ 2 weeks but < 8 weeks' follow‐up
Other bias	Low risk	Comment: no significant other bias detected