ABSTRACT
Objective To study the effect of low frequency repetitive transcranial magnetic stimulation (rTMS) on the recovery of neural function in patients with cerebral infarction.Methods Thirty cerebral infarction patients with hemiparalysis were divided randomly into three groups: unaffected side stimulation group ( 1Hz rTMS on M1 area of unaffected hemisphere, n = 10), affected side stimulation group ( 1Hz rTMS on M1 area of affected hemisphere, n = 10), and control group without rTMS, n = 10).All the groups were assessed with their motor function and ADL scores ( NIHSS, MBI) and corticospinal excitability (MEP, CMCT ) before and after 10 and 40 days of treatment.Three patients were chosen randomly in each group who accepted magnetic resonance spectroscopy (MRS) examination before and after 40 days of treatment and assessed with regard to the ratio of N-acetyl aspartate/creating(NAA/Cr).Results Before treatment the scores of National Institute of Health Stroke Scale (NIHSS), modified Barthel Index( MBI), Motor evoked potential (MEP) and central motor conduction time (CMCT) were not statistically different among the three groups ( P > 0.05 ).After treatment, scores of NIHSS and MBI were obviously higher than those before treatment (P < 0.01 ) in rTMS groups no matter the rTMS was applied on the affected or unaffected hemisphere.However, the score in unaffected side stimulation group was higher than that in the affected side stimulation group ( P < 0.05 ).The MEP latency and CMCT was significantly shorter after treatment in all the stimulation groups, with the unaffected side stimulation group improved to a significantly greater extent, in terms of MEP latency and CMCT than the affected side stimulation and control groups at the 10th d and 40th d of treatment(P <0.05 or P <0.01 ).There was a significantly higher ratio of NAA/Cr in two rTMS treatment groups compared with control group.Conclusion Low frequency rTMS on M1 of the unaffected or affected hemisphere can both improve neural function in patients with acute cerebral infarction, rTMS on unaffected hemisphere seems more effective than that on affected hemisphere.
ABSTRACT
Objective To investigate the impact of motor imaginary therapy on the recovery of upper limb function in acute cerebral infarction patients with bemiplegia. Methods Fifty cerebral infarction patients with hemiplegia were randomly divided into a control group (drug therapy + early exercise therapy) and a motor imaginary therapy group (drug therapy + early exercise therapy + motor imaginary therapy) using single-blind method (n = 25 in each group). Ipsilateral upper extremity function was assessed by the Fugl-Meyer assessment (FMA) before the treatment and at day 40. The active range of motion (AROM) of the ipsilateral wrist was measured by a conimeter. Eating, washing, dressing, and putting on and off clothes were assessed by the Functional Independence Measure (FIM) scale. Results The scores of FMA, AROM and FIM were increased more significantly than those before the treatment in both groups (P <0.05). All the scores in the motor imaginary therapy group after the treatment were superior to those in the control group (P <0. 05) (FMA 28.33 ± 8.63 versus 15.93 ± 5.39;AROM 19.55 ± 8.30 versus11.97 ± 6.59; FIM 16.83 ± 5.43 versus 12.51 ± 3.36).Conclusions Conventional motor rehabilitation training + motor imaginary therapy during the acute phase may promote the motor function reco,,ery in cerebral infarction patients with hemiplegia.