A pilot study on the effects of low frequency repetitive transcranial magnetic stimulation on lower extremity spasticity and motor neuron excitability in patients after stroke

Abstract

To evaluate the effect of low frequency, repetitive transcranial magnetic stimulation (rTMS) on the lower extremity spasticity and motor neuron excitability in patients after stroke. Seven patients after stroke aged 42-78 years were included in this pretest-posttest clinical trial. The rTMS at 1 Hz and duration of 20 min was applied to the intact leg motor cortex for five consecutive sessions. Primary outcome measures were the Modified Modified Ashwoth Scale (MMAS) and the H(max)/M(max) ratio. Measurements were taken at baseline (T0), after the last treatment (5th) session (T1), and at 1 week follow up (T2). Clinically assessed ankle plantar flexor spasticity (p = 0.05) improved significantly after treatment at T1. Knee extensor spasticity scored 0 after treatment at T1 and T2. The H(max)/M(max) ratio showed no statistically significant improvement after treatment. The pilot data indicate that the inhibitory rTMS of the intact leg motor cortex in patients after stroke may improve the lower extremity spasticity.