Effect of rTMS with Rehabilitation on Hand Function and Corticomotor Excitability in Sub-Acute Stroke

Objectives: Stroke is the leading cause of long-term disability. Hand motor impairment resulting from chronic stroke may have extensive physical, psychological, economical, and social implications despite available rehabilitative treatments. The best time to start treatment for stroke is in sub-acute period. Repetitive Transcranial Magnetic Stimulation [rTMS] is a method of stimulating and augmenting the neurophysiology of the motor cortex in order to promote the neuroplastic changes that are associated with motor recovery. The purpose of this study was to compare the effects of repetitive transcranial magnetic stimulation protocols plus routine rehabilitation on hand motor functions and hand corticomotor excitability in stroke patients with hemiplegia with pure routine rehabilitation programs.

Methods: This study was a randomized clinical trial which was performed on 24 patients with hemiplegia who were randomly divided in to three groups: received high frequency rTMS, received rehabilitation program with low frequency rTMSl, who were given only routine rehabilitation programs. The treatment was performed for 10 sessions, three times pre-post test and follow-up about neurophysiological contralesional hemisphere evaluations using record of MEP wave indices by single pulse TMS, and assessing functional wolf test and hand grip power of disabled hand by dynamometer.

Results: The results demonstrated that the rest MEP threshold reduction in experimental group which received high frequency magnetic stimulation was not statistically significant [P=0.387]. There was significant reduction for active MEP threshold in the within group [P=0.031]. Also there were statistically significant between obtained results from WOLF test and grip test.

Discussion: According to the results, it seems that Hf rTMS combined with routine physiotherapy can significantly improve hand functions and brain neurophysiology via specifically increase of contralesional corticomotor excitability in sever stroke patients. It indicated the role of neuroplasticity in nonlesioned hemisphere; but the hypothesis of movement improvement related cognitive balance can't be eliminated by exploring powerful approved effect of Hf rTMS on mood regulation.

Review of abuse and violence against women and children in psycho-social rehabilitation centers

The growth and development process of the child is influenced by reciprocal environmental, psychological and social factors, and the family's role is very crucial in all of this. It is obvious that although it's important to start a family, but what's further important is its survival in a healthy and intimate atmosphere. It has been estimated that between 2 and 12 million American families are subjected to wife abuse. Child abuse takes place in different forms. According to a World Bank report one third of children in the first few years of the new millennium are deprived of their fundamental rights. The present research indicates that those that reported abuse through public information were low in number only at 4.5 percent, which is indicative of poor education and people participation. In the services that were provided to the victims, counselling and psychotherapy were the highest number, and it is necessary to raise the number of legal services provided for the victims [3%], in order to realise the rights of the individual

study in depression levels among mothers of disabled children

The global prevalence of lifetime depression is very high among women in the world approximately 12-25 percent. The global prevalence of disability is also very high and the estimated figure for the end of 2000 was put at around 300million. The child's disability stresses the mother the most, and this stress shows itself in the form of depression, and causes the mother's performance or function to drop, and thus has a negative effect on the child's treatment. The research is of the analytical kind [cross sectional], and as well as depression other demographic items are reviewed. The sample study volume is one hundred mothers of disabled children who went to one of the rehabilitation centers of the provincial town of Karaj between 2002 and 2006. The tools for this study is the standardised beck depression scale, and the test data was broken down and analysed by [chi square] and the SPSS software. The results of this study indicated that 73% of mothers, had degrees of depression, and approximately 21% of them suffered from severe depression, and out of all the variables, there was a significant relationship only between the mothers' depression and the children's type of disability. The results of this study indicated that the depression levels among mothers of disabled children were equal to 3-5 of the global range, and in view of the negative effects that the mothers' depression have on the recuperation process of the children, the necessity to support parents with disabled children which would to a large extent reduce the stress levels is felt more than before