ABSTRACT
Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) combined with the mirror therapy (MT) on the recovery of upper limb function recovery 3 to 6 months after a stroke.Methods Forty-five male patients were randomly assigned to an MT (A) group,an rTMS+MT (B) group or an MT +rTMS group (C),each of 15.All received conventional medical treatment and stroke rehabilitation.In addition,group A received 60 min of MT daily,5 days a week for 4 weeks.Group B received 10 min of rTMS over the M1 area of the affected hemisphere followed by 50 min of MT treatment,and group C received 50 min of MT treatment followed by 10 min of rTMS.rTMS was delivered at a frequency of 10 Hz and an intensity of 90％ resting motor threshold.The latency of motor evoked potential (MEP) for the affected abductor pollicis brevis muscle and its central motor conduction time (CMCT) were observed before and after the treatment.The upper extremity portion of the Fugl-Meyer assessment (FMA) was performed along with a functional test for the hemiplegic upper extremity (FTHUE).The motricity index (MI) was also quantified.Results Average MEP latency and CMCT had decreased significantly in all three groups after the treatments.The average MEP latency of group B was significantly shorter than that of group A,and CMCT was also significantly shorter than for groups A and C.Moreover,after the intervention,all of the groups had significantly improved their average FMA,MI and FTHUE scores,with the average FMA score of group B significantly better than those of groups A and C.The average FTHUE score of group B was also significantly better than that of group A.Conclusions MT either alone or in combination with rTMS can improve cerebral motor cortex excitability and motor recovery after a stroke.Ten minute rTMS sessions followed by 50 min of MT have the best effect.