[Effect of low frequency rTMS on stiffness of joints of the upper limbs in hemiplegic patients]

Disabilities of the upper limbs due to stroke can lead to more prolonged functional problems in comparison to lower limb disabilities, and fewer numbers of investigations have been performed on this problem. Use of magnetic stimulation to produce induction currents in the brain for therapeutic purposes is a new method. The aim of this study was to determine the effects of rTMS plus routine rehabilitation on hand stiffness, and compare them with pure routine rehabilitation program in hemiplegic patients. 12 hemiplegic patients were assigned randomly to two groups. Control group, received rehabilitation program with placebo magnetic stimulation, and experimental group, received magnetic stimulation with routine rehabilitation program, 3 times/week for 10 sessions. Using Wrist Robo Hab, we assessed joint stiffness during flexion-extension of the wrist, and supination-pronation of forearm before and after treatment. In the control group we did not find any significant decrease in the resistance of flexor [p=0.207] and pronator [p=0.291] muscles. But in the experimental group the resistance of flexor [p=0.009] and pronator [p=0.035] muscles decreased significantly. rTMS can decrease stiffness of the upper limb joints and can be used in chronic hemiplegic patients, when conventional treatments are not effective

[Comparision of rehabilitation plus joystick versus routine rehabilitation treatment on hand muscles stiffness in hemiplegic patients]

Disabilities in upper limb due to stroke are the major problems in hemiplegic patients. Recently, joystick method as new method is applied for the improvment of upper limb disabilities. This study was carried out to compare the effect of joystick in combination verses routine rehabilitation and routine rehabilitation program on hand muscles stiffness in hemiplegic patients. In this clinical trial study, 12 hemiplegic patients were randomly divided into two control and interventional groups. Subjects in the control group were received rehabilitation program with placebo joystick. Patients in interventional group were received joystick treatment with routine rehabilitation program for 10 sessions, 3 times a week. Pre and post-treatment evaluation was performed based on Wrist Robo Hab method. Flexion and pronation muscle stiffness in control patients showed non significant improvement, but in the interventional group, significant improvement were observed [P<0.05]. At the end of study, there was not any significant difference between control and interventional group. According to this finding, there was not any significant difference between the combination of joystick and rehabilitation treatment and routine rehabilitation program on the hand muscle function in hemiplegic patients