The potential benefits of repetitive transcranial magnetic stimulation (rTMS), applied either alone or as a combination treatment, on recovery of lower extremities after stroke have been insufficiently studied.
To evaluate the effect of priming with 1-Hz rTMS over contralesional leg motor area with a double cone coil prior physical therapy (PT) on regaining ambulation.
Thirty-eight subacute stroke patients with significant leg disabilities were randomly assigned into the experimental (E) group or control (C) group to receive a 15-min real or sham 1-Hz rTMS, respectively, over the contralesional motor cortex representing the quadriceps muscle followed by 45-min PT for 15 sessions over 3 weeks. Functional measures, motor evoked potentials and quality of life were assessed.
There was no significant difference between Group E and C regarding the recovery in ambulation, balance, motor functions, and activity of daily living. No significant difference was found in other functional measures and the quality of life. Only group C displayed significantly increased cortical excitability of the contralesional hemisphere after the intervention.
The present study found insufficient evidence that contralesional priming with 1-Hz rTMS improves ambulatory and other motor functions among patients with a severe leg dysfunction in subacute stroke.
1Neuroscience Research Center and Department of Neurology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
2Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan, Taiwan
3Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
4Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
5Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
6Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
*Corresponding author: Yen-Nung Lin, MD, MS, Department of Physical Medicine and Rehabilitation, Wan-Fang Hospital, Taipei Medical University, Address: No. 111, Section 3, Hsing-Long Rd, Taipei 116, Taiwan. Telephone: 886-2-29307930 Ext 1600. E-mail: email@example.com
Acknowledgements: This study was supported by grants from Wan Fang Hospital, Taipei Medical University (104-wf-eva-11), the Ministry of Science and Technology (MOST-102-2314-B-182-030-MY3), and the Chang Gung Medical Foundation (CMRPD3E0112 and BMRP844).
Conflict of interest: none.