Effects of High-frequency Repetitive Transcranial Magnetic Stimulation in Different Frequencies on Upper Limb Function after Ischemic Stroke / 中国康复理论与实践

ABSTRACT

Objective:To observe the effect of 3 Hz and 10 Hz repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function and activities of daily living in patients with ischemic stroke. Methods:From June, 2016 to September, 2017, 60 inpatients with ischemic stroke were randomly divided into sham rTMS group (n = 19), 3 Hz-rTMS group (n = 21) and 10 Hz-rTMS group (n = 20). All the patients received routine training and their own rTMS for two weeks. Their rest motor threshold (RMT) was measured, and they were assessed with modified Ashworth Scale (MAS), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after treatment, and at six weeks follow-up. Results:There were 48 patients completing the trial, while five in 3 Hz-rTMS group, five in 10 Hz-rTMS group and two in the sham rTMS group dropped. The RMT increased in 3 Hz and 10 Hz rTMS groups (t > 2.390, P < 0.05) after treatment, but there was no significantly difference among the three groups (F = 0.164, P > 0.05). The MAS scores of elbow and wrist decreased gradually over time in 3 Hz and 10 Hz rTMS groups (P < 0.05), and the MAS scores of elbow was less in 3 Hz and 10 Hz rTMS groups than in the sham rTMS group at follow-up (P < 0.05). The interaction of time and group was significant on the FMA-UE scores (F = 14.243, P < 0.001), and the FMA-UE scores improved more in 3 Hz and 10 Hz rTMS groups than in the sham rTMS group at different stages (P < 0.01). The interaction of time and group was not significant in MBI score (F = 1.481, P > 0.05), and there was no significant difference among the three groups at any time (F < 2.925, P > 0.05). Conclusion:Both 3 Hz and 10 Hz rTMS can promote the recovery of upper limb motor function in ischemic stroke patients safely and effectively, and 10 Hz rTMS is recommended as less time is needed.